4 cases of scrub typhus on pregnancy.docVIP

 PAGE \* MERGEFORMAT 8 4 cases of scrub typhus on pregnancy Study: Dai Yuping Xu Xiaoju Bai Yanqiong [Keywords:] pregnancy scrub typhus China Scrub typhus (tsutsugamushi disease) foci in virtually every country, increase in cases, was sporadic and spread posture, but pregnant women with scrub typhus is rare [1]. Pregnant women with scrub typhus caused by multiple organ dysfunction in pregnant women may cause miscarriage, premature delivery , fetal death [2,3]. now to our hospital 4 patients analyzed as follows. Clinical data Cases of 122-year-old farmer. Due to menopause, 29 +5 weeks, fever, 7 d, lower abdominal pain 12 h hospitalization. 1 week before admission because of fever of unknown origin (40 ℃) to ampicillin in the hospital treatment fails, history of fever before field work. Physical examination: T 37.8 ℃, skin, sclera jaundice, coarse breath sounds in both lungs, liver and spleen slightly enlarged. Cervix large 5 cm, 1 h admission was delivered of a dead baby, 1 400 g, body surface without deformity. Postpartum body increased rapidly up to 39.8 ℃, bronchitis, chest X-ray examination of lungs like change double. B ultrasound showed left pleural effusion, mild hepatosplenomegaly, blood: white blood cell count (WBC) 11.05 × 109 / L, neutrophils percentage (GRAN%) 82%, platelet count (PLT) 40 × 109 / L; alanine aminotransferase 63 IU / L, albumin 17.5 g / L, globulins 18.7 g / L, albumin / globulin 0.9; total cholesterol Red pigment 76.7 μmol / L, direct bilirubin 49.6 μmol / L, indirect bilirubin 27.1 μmol / L, total bile acid 34.37 IU / L; serum potassium 3.12 mmol / L, serum sodium 122 mmol / L, serum chloride 90 mmol / L, urea nitrogen 7.9 mmol / L, urine protein (++), granular casts (++). Found in the left popliteal fossa respiratory consultation with the size of 0.5 cm × 1.0 cm oval eschar, transfer of infectious diseases, to chloramphenicol and symptomatic support, comprehensive treatment, his condition worsened suddenly appeared