Do you have a recurring high fever? Be careful! It may be caused by this little bug!

Recently, a small insect has been quite active, so be careful when you go out to play! Some people have been "infected" and have had repeated high fevers and have had to be hospitalized for treatment.

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After picking oranges in the orchard

Repeated high fever

Recently, Ms. Wang (pseudonym of the patient) went to the emergency room of the Third Affiliated Hospital of Guangzhou University of Chinese Medicine due to recurring high fever for a week. She had previously received "anti-inflammatory" treatment in a local hospital but the effect was not good.

The doctor asked about the patient's medical history and found that Ms. Wang had gone to the orchard to pick oranges the day before she developed a fever. There was a large lawn in the orchard. During a detailed physical examination, a round dark red eschar was found near the perineum of the right groin, about 0.5 x 0.5 cm in size, and enlarged inguinal lymph nodes could be felt. The doctor combined the elevated transaminase and bilirubin levels and initially diagnosed it as scrub typhus. He gave her doxycycline capsules and liver protection treatment. Ms. Wang's fever subsided and her liver function improved before she was discharged from the hospital.

Dr. Li Yan from the hospital's emergency department said that this case of unexplained fever was caused by scrub typhus!

Image source: Internet

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Incubation period: 4 to 20 days

Be alert if you have these symptoms

After this little bug bites us, it reproduces at the bite site, causing skin lesions, migrating to the lymph nodes around the tissue, entering the blood circulation, causing oriental blood disease, inducing systemic toxemia and organ inflammatory lesions, and then producing a series of systemic clinical symptoms.

Scrub typhus has significant seasonal and regional characteristics, and occurs more often in spring and autumn . Guangdong is one of the high-incidence areas with high temperatures, rain and humidity.

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After contracting scrub typhus, the severity of the disease varies, the clinical manifestations are diverse, and the incubation period is 4 to 20 days. The patient's onset is relatively acute, with repeated fever of unknown cause, and high fever exceeding 38.5℃ is common.

Many diseases can cause recurrent fevers. How do you know if it is scrub typhus?

There are four characteristics of scrub typhus:

1. There will be specific eschar or ulcer

If the doctor suspects that you have scrub typhus, he may ask you to take off your clothes and carefully check every corner of your body. Don't be surprised, and try to cooperate actively and don't miss any wrinkles.

After being bitten by a scrub typhus , there is no pain or itching, but a round black eschar is formed with a red halo around it. When the scab falls off, a painless ulcer is formed. Most patients have one eschar, and a few have multiple eschars. They can be distributed on the trunk, limbs, or in the groin, popliteal fossa, axilla, perineum and other hidden areas with wrinkles, which are easy to miss and misdiagnose.

2. Swollen lymph nodes

Before the fever occurs, swollen lymph nodes can usually be felt near the bite site. Some are as big as soybeans, while others are as big as pigeon eggs. They have a smooth and slidable surface and are tender when pressed. They are usually found in the neck, groin, armpits , etc.

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3. Skin rash

It is usually a dark red, congested maculopapular rash, which usually occurs 4 to 6 days into the course of the disease, and in a few patients, occurs at onset or 14 days after onset. The diameter is about 0.2 to 0.5 cm, and there is no itching. It first appears on the trunk and then spreads to the limbs.

4. Hepatosplenomegaly

About 10% to 30% of patients experience hepatomegaly, and about 30% to 50% experience splenomegaly. The liver is soft in texture, has a smooth surface, and is not painful to touch.

03

How to protect yourself when going out for an outing?

Now we have entered the high season of scrub typhus. To avoid getting "scrub typhus", pay attention to the following points:

1. Try to avoid long periods of outdoor activities. If you need to go out, fasten your collar, cuffs and trouser legs, do not wear sandals, avoid exposing your body directly to the ground or sitting or lying on the grass, and it is best to apply insect repellent on your body.

2. After outdoor activities or work, you should take a shower and change clothes immediately when you get home, and pay special attention to scrubbing the skin of the armpits, popliteal fossa, perineum, etc.

3. If you have a fever, check whether there is ulcerative eschar on your body, and don't miss any part of your skin. Scrub typhus is not a self-limiting disease, that is, it will not heal on its own, so you need to seek medical attention in time and get treatment as soon as possible.

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04

Emphasis on early diagnosis and early treatment

According to Li Hui, deputy director of the hospital's emergency department, early treatment of scrub typhus is not complicated, and the earlier the treatment, the better the prognosis. The key to treatment is the proper selection of antibacterial drugs.

It should be noted that the commonly used antibiotics in clinical practice, such as aminoglycosides (gentamicin) and β-lactams (amoxicillin, ceftriaxone), have limited therapeutic effects on scrub typhus.

The recommended therapeutic drugs are tetracyclines, macrolides, chloramphenicol, quinolones, etc., specifically tetracycline, doxycycline, minocycline, erythromycin, azithromycin, chloramphenicol, etc.

Source: People's Daily Online

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