So sánh đặc điểm lâm sàng, cận lâm sàng ở bệnh nhân sốt mò và sốt do Rickettsia điều trị tại Bệnh viện Quân y 103 và Bệnh viện Trung ương Quân đội 108

Abstract

Objective: To investigate clinical and laboratory differences between scrub typhus and other Rickettsiosis in hospitalized patients in 103 Military Hospital and 108 Military Central Hospital. Subject and method: This was a descriptive, comparative study on 50 cases of scrub typhus confirmed by dot-ELISA or PCR and Rickettsiosis confirmed by PCR, hospitalized in 103 Military Hospital and 108 Military Central Hospital. Result: Scrub typhus cases were mainly distributed in rural area (64%) while rickettsiosis cases were more prevalence in urban area (68.4%). Skin and mucosal manifestations were more common in scrub typhus with eschar rates (70%), skin congestion (60%), and lymphadenopathy (44%), on the contrary Rickettsia patients had a higher incidence of maculopapular rash (39.5%). Respiratory symptoms were statistically more common in scrub typhus with a crackles rate of 36% and higher frequency of breathing (20.27 ± 2.63) with p<0.05. The complication rate was higher in scrub typhus patients with respiratory distress symptoms, septic shock, encephalitis, acute kidney injuries (AKI) rates were 12%, 8%, 8%, 8%, respectively. Inflammatory maker: PCT increase > 0.05ng/ml was recorded in 100% of 2-group patients, in which the increase in PCT of the Rickettsia group ( ± SD: 0.926 ± 0.45) was significantly lower compared with Scrub ( ± SD: 2.396 ± 2.819) with p=0.026. Scrub typhus group had a 48% increase in leukocytosis, significantly higher than other Rickettsia groups (13.5%) with p<0.01. Lung lesions on X-rays were more common in Scrub typhus, but there were only statistical difference (p<0.05) in pleural effusion and serous fluid with corresponding proportions in scrub typhus were 30.8% and 33.3% respectively. Conclusion: Rickettsioses was mainly distributed in urban areas (68.4%), while scrub tuphus was more common in urban areas (64%). Eschar was the indicator of scrub typhus and only presented in 2.6% Rickettsioses patients. Respiratory symptoms were more common in the scrub typhus group with a 42% cough, 36% rale, those were associated with a higher rate of lung lesions on X-rays (infiltrates, pleural effusion) and related to higher complication rates. The PCT level of the Rickettsia group was significantly lower than the scrub typhus group.