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1、ScrubTyphus（恙虫病）DepartmentofInfectiousDiseases,theThirdAffiliatedHospital LiGangDefinitionAcutefebrileinfectiousdiseaseCausedbyRickettsiatsutsugamushiTransmittedbythebiteofchiggersSourceofinfection:RatsCharacterizedbyfever,eschar,rash,andlymphadenopathyEtiologyIntracellularorgani
2、smPropagatedinmice,somecellsAntigenicallydiversemicroorganismCommonantigenwithProteusOX-KLowresistanceEpidemiology▲Sourceofinfection:Rats▲Vector:MiteThelifecycle:ovum,larva,pupa,naiadandimagoOnlyitslarva(chigger)feedingonhumansimagolarvaratpupanaiadimagoovumlarvaratpupanaiad第一代第二代
3、(遗传、传染)ThelifecycleofmitebiteovumEpidemiologyProliferateinwarm,wetenvironmentsBothavectorandareservoir▲Routeoftransmission:biteofchigger▲Susceptibility:universal▲Immunity:long-lastingimmunityagainstthehomologousstrains;PartialimmunityagainsttheotherheterologousstrainsEpidemiology▲
4、Otherepidemiologicalfeatures:Geographicdistribution:Asian-pacificregionSporadicSeasonaldistribution:rainyseasonsbetweenMayandNovemberPathogenesishumanbodyrickettsemiaescharlocalsiterickettsiamitevasculitisratsPathologyBasiclesion:inflammationofthewallsofthesmallbloodvesselsPatholo
5、gicfindings:eschar,lymphadenopathy,rash,enlargementofspleenandliverSeriouspathologicmanifestations:myocarditis,meningoencephalitis,pneumonia,interstitialnephritisClinicalmanifestationsIncubationperiod:4～21daysSuddenonset,Highfever:remittentfeveraccompaniedbychill,headache,malaise,
6、prostration,poorappetite.ClinicalmanifestationsSignsofmultiorgandamage:Meningoencephalitis:delirium,convulsion,coma,andneckstiffness.Interstitialpneumonia:cough,chestpain,breathlessness.ClinicalmanifestationsSignsofmultiorgandamage:Myocarditis:galloprhythm,poorqualityheartsounds,s
7、ystolicmurmurs.Hepatitis:jaundice,hemorrhage.Naturalcourse:2～3weeks.Characteristicmanifestations⒈Escharandulceration:Characteristicsign.Seenin36.9～98％ofpatients.Generallylocatedinwarm,wet,intensesmelledareas.escharescharulcerationCharacteristicmanifestations2.Lymphadenopathy:Enlar
8、gedmarkedlyregionallymphnodesnear
