摘要
恙蟲病(Scrub tyhpus)是由恙蟲媒介的立克次體感染疾病，在以往多流行於東南亞、印度、及太平洋島嶼地區，臺灣本島病例較少，大多病例，多發生在離島地區如蘭嶼、澎佳嶼、澎湖等地方。診斷上須注意病人有無去過流行地區，皮膚一般可見到典型的焦痂(Eschar)，此外病患常有發燒、畏寒、結膜充血、淋巴腺及肝脾腫大的症狀，實驗室診斷可以Weil-Felix test及間接免疫螢光抗體試驗(Indirect Immunofluorescent antibody test)來證實。本院小兒科於民國73年分別經歷2個病例。病例1爲3歲男童來自蘭嶼，病例2爲4歲男童曾至澎湖觀光，兩例均可見到焦痂，並有發燒不退、肝脾腫大及皮膚出疹的症狀。Weil-Felilx test OX K有強烈陽性反應，另外做了間接免疫螢光抗體實驗，證明是Karp strain。鄰國日本最近病例有增多的現象，媒介的恙蟲種類亦有改變，在臺灣，此病也可能並非罕見，所以對於長期不明熱的病人，且最近曾到過流行地區，此病必須考慮。
關鍵字
無資料並列摘要
Scrub typhus is an infectious disease caused by Rickettsia tsutsugamushi and mediated by mite. It was prevailing in South East Asian countries, Indonesia, and Pacific islands. Since 1970, it has been rarely found in Taiwan area with exceptions of the east coast & neighboring islands. In 1984, we have experienced two cases in the Pediatric Department of Chang Gung Memorial Hospital. One patient was from the Orchid Island and the other had stayed in the Pescadores Island for a period of time. The two cases all sufferred from intractable prolonged fever, hepatomegaly, skin rashes and an eschar formation. Weil-Felix test showed strong positive reaction to OX K in both cases. Indirect immunofluorescent antibody test showed strong positive against the Karp strain. Both of them received chloramphenicol treatment and recovered completely.
延伸閱讀
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- 劉正義、顏慕庸、宜蘭縣衛生局、宜蘭市衛生所、台灣省傳染病研究所細菌組（1987）。恙蟲病死亡病例報告。疫情報導，3(11)，85-90。https://doi.org/10.6524/EB.198711_3(11).0001
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- Taooka, Y., & Takezawa, G. (2016). Scrub typhus cases in a family. International Journal of Case Reports and Images (IJCRI), 7(9), xiv+618-621. https://doi.org/10.5348/ijcri-201612-CL-10105