Misdiagnosis of Scrub Typhus in Guangxi Zhuang Autonomous Region:A Study of 191 Cases of Scrub Typhus

ZENG Cheng; ZHANG Jian-feng; HUANG Ying-hua

doi:10.3969/j.issn.1002-3429.2015.04.002

Abstract：Objective To investigate the misdiagnosis of scrub typhus in Guangxi Zhuang Autonomous Region in order to provide evidence of improving the diagnosis and reducing multiple organ damages. Methods We analyzed the patients with scrub typhus admitted to the First Affiliated Hospital of Guangxi Medical University and Liuzhou People's Hospital during January 2009 and December 2013. Results There were 216 patients diagnosed with scrub typhus in the region in five years, and 191 ca-ses (88. 43%) were misdiagnosed in other hospitals. The clinical manifestations were complex, including fever, respiratory symptoms, gastrointestinal symptoms, headache, skin rash and scar, etc. They were mainly misdiagnosed as fever of unknown origin (FUO) (74. 87%), pneumonia (9. 42%), upper respiratory tract infection (6. 81%). Sixty-seven (35. 08%) misdiag-nosed cases were in the district hospitals 64 (33. 51%) in the county hospitals, 30 cases (15. 71%) in private clinics, dispen-sary or health stations, 26 cases (13. 61%) in municipal hospitals, 4 cases (2. 09%) in the provincial hospitals. The first ma-jor diagnostic departments were internal medicine and emergency departments. There were 125 patients (65. 45%) with multiple organ and system damage because of misdiagnosis of scrub typhus, and 16 patients (8. 38%) died. Conclusion The rate of misdiagnosis of scrub typhus has been rising in recent years, mainly in the county hospitals or the lower level medical centers. It is necessary to improve level of diagnosis and treatment of scrub typhus in county hospitals or the lower level medical stations in order to reduce the misdiagnosis rate of scrub typhus.