After climbing the mountain, I had a high fever and a rash all over my body! We have treated many cases recently, so be careful of it when you go out!

Recently, the First Affiliated Hospital of Zhejiang University School of Medicine admitted several patients who were bitten by insects. In addition to experiencing fever, rash and other discomfort symptoms, some people also developed hemophagocytosis and their conditions were critical.

High fever persists after outdoor activities

It was caused by this insect

Ms. Lin, 44, from Lishui, started to have a fever after climbing a mountain with her friends some time ago. The fever once reached 39 degrees. She did not feel better after taking antipyretics, and she developed a rash all over her body after 4 or 5 days.

After visiting a local hospital, examinations revealed that she had liver damage and a decrease in platelets. After a series of liver protection treatments, her condition did not improve significantly. At the suggestion of a local doctor, Ms. Lin was transferred to the Department of Infectious Diseases at the First Hospital of Zhejiang University for treatment.

"After she was admitted to the hospital, we found a peanut-sized, black 'eschar' on her left buttock." Tao Jingjing, attending physician of the Infectious Diseases Department of Zhejiang University First Hospital, said that based on the clinical manifestations, it was highly suspected to be a rickettsial infection. Although Ms. Lin said that she had no recollection of being bitten by insects recently and had worn long sleeves and long pants when she went hiking, the department still treated her according to this idea and conducted further examinations.

The final pathogen metagenomic sequencing indicated that Ms. Lin was infected with Rickettsia japonicum, which causes Japanese spotted fever, a disease characterized by high fever, rash, and eschar formation. After symptomatic treatment, Ms. Lin has been cured and discharged from the hospital.

Ms. Xu, 33, from Xuancheng, Anhui, developed fever, rash all over the body and other symptoms after an outdoor activity. There was also crater-like eschar on her lower back. After seeing a doctor, she was diagnosed with rickettsial infection. As indicators such as white blood cells, platelets, and hemoglobin continued to decline, she developed hemophagocytosis. She was in critical condition and was transferred to Zhejiang University First Hospital for further treatment, where she eventually recovered.

Be cautious when doing outdoor activities

Pay attention to these situations

"Recently, our department has admitted many patients of this type." Sheng Jifang, chief physician and director of the Department of Infectious Diseases at the First Hospital of Zhejiang University, said that Rickettsia is a microorganism between bacteria and viruses. In nature, it mainly reproduces in storage hosts such as rodents (rats) and livestock (cattle, sheep, and dogs), and uses blood-sucking arthropods such as lice, fleas, ticks, and mites as the main transmission medium. Rickettsia infections in my country mainly include epidemic typhus, murine typhus, and scrub typhus.

The most typical symptoms are eschar or ulceration at the bite site. In addition, patients may also experience high fever, rash, swollen lymph nodes, headache, etc. As the disease worsens, some patients may experience hepatosplenomegaly, organ failure or bleeding. Since the bite site of the chigger larvae is relatively hidden and difficult to find, it is easy for patients to ignore the symptoms of discomfort, delaying treatment. Director Sheng Jifang reminded that the main way of transmission of the disease is through the bite of the chigger larvae, and it will not be transmitted from person to person. People who work or play outdoors need to pay special attention.

When doing outdoor activities, try to wear long sleeves and long pants, preferably clothes with closed sleeves and collars, and avoid sitting or lying in the grass or on the grass.

After outdoor activities, you should change clothes in time, and place and wash them separately; at the same time, take a bath in time, especially in soft skin areas such as the armpits, waist, and perineum.

If you plant flowers and plants at home, you should keep them clean and frequently weed, kill insects and rodents.

If you have a history of outdoor activities, especially outdoor activities, and have symptoms such as high fever, rash, and eschar on your body, you should seek medical attention and receive symptomatic treatment as soon as possible.

In addition to scrub typhus, doctors also remind people to be highly vigilant against tick bites during outdoor activities. Once bitten by a tick, do not pull it hard. Instead, apply alcohol, iodine, etc. on the tick's head to allow it to loosen its bite and fall off on its own, or go to the nearest hospital immediately for treatment.

Metropolis Express·Chengshi Interactive reporter Jin Jing, correspondent Wang Rui, Hu Xiaofeng