CAJ | 학술논문

目的：分析恩施地区恙虫病自然疫区可能性，探讨目前抗生素严格管控、药物缺乏形势下恙虫病的左氧氟沙星抗感染治疗优势。方法回顾分析恩施州咸丰县人民医院感染科2014年10月收治的2例恙虫病病例的临床资料、治疗经过。结果2例恙虫病患者为夫妻，均有发热、皮疹、典型焦痂表现，家住山区，居住地杂草较多，有菜园工作史，发病1周查变形菌OX为k1∶160，经左氧氟沙星抗感染治疗有效，恙虫病诊断明确。结论因恩施州非恙虫病疫区，但毗邻的湘西土家族自治州为恙虫病的重要疫源地，恩施州与该地区地理、气候条件极其相似，植被丰富，故本地不排除为恙虫病疫区。但确定本地区疫区属性还需疾病预防控制机构进一步行流行病学调查，了解恙虫病东方体在本地蜱虫、鼠类中的分布情况。
목적：분석은시지구양충병자연역구가능성，탐토목전항생소엄격관공、약물결핍형세하양충병적좌양불사성항감염치료우세。방법회고분석은시주함봉현인민의원감염과2014년10월수치적2례양충병병례적림상자료、치료경과。결과2례양충병환자위부처，균유발열、피진、전형초가표현，가주산구，거주지잡초교다，유채완공작사，발병1주사변형균OX위k1∶160，경좌양불사성항감염치료유효，양충병진단명학。결론인은시주비양충병역구，단비린적상서토가족자치주위양충병적중요역원지，은시주여해지구지리、기후조건겁기상사，식피봉부，고본지불배제위양충병역구。단학정본지구역구속성환수질병예방공제궤구진일보행류행병학조사，료해양충병동방체재본지비충、서류중적분포정황。
Objective To analyse the possibility of natural infected area of scrub-typhus in Enshi district , and explore the advantage of utilization of levofloxacin to scrub-typhus in the situation of strict control and deficiency of antibiotics. Methods Retrospectively reviewed the clinical data and treatment of two cases infected by scrub-typhus in the Xianfeng County People ’s Hospital in Oct. ,2014. Results The two cases were a couple ,both had fever ,rashes and typical eschar. They lived in mountainous area surrounded by many weeds and once worked in a vegetable garden. After one week of outbreak of disease ,the antibody titers of the strain were OXk1:160,the couple was diagnosed as scrub-typhus infection and it was effective with levofloxacin. Conclusion Enshi district is not a natural infected area of scrub-typhus ,but the adjacent Xiangxi Tujia Autonomous Prefecture is an important infected area of scrub-typhus ,and the area has similar geography,climate and plants with Enshi district,so Enshi district maybe another infected area. It needs further epidemiological investigation to confirm the infected area attribute ,and to know the distribution of Oriential tsutsugamushi in tick pests and rodents.