目的了解海南地区近年恙虫病的发病情况及临床特点,为减少恙虫病的临床误诊提供参考依据。方法收集海南省海口市三家三甲医院2011~2013年恙虫病病例,对所得资料进行统计分析。结果共收集恙虫病确诊病例169份,其中男性79例,女性90例,男女性别比例0.88;年龄最大的82岁,最小的仅122d,平均年龄(36.70±26.98)岁;10岁以下儿童组占35.50%(60/169),显著高于其他年龄组(P<0.01)。除了幼儿及学生外,患者的职业分布以农民为主,占38.46%(65/169),其他由离退休人员、工人、居民及无业人员等组成,占24.26%(41/169);全年均有病例,患者来自海南15个市县;均以发热为主要症状收治,其中140例有特征性焦痂或溃疡,占82.84%;发病前有野外接触史或虫媒叮咬史记录的38例,占总病例数的22.49%;外斐氏实验检测145例中阳性仅6例。结论 169例恙虫病以儿童、农民为主;海南岛分布广泛;全年发病,误诊率高;外斐氏反应实验室诊断此病敏感性及特异性低。 Objective To understand the incidence and clinical features of tsutsugamushi disease in Hainan area in recent years and provide reference for reducing the clinical misdiagnosis of tsutsugamushi disease. Methods The cases of tsutsugamushi disease from 2011 to 2013 in three top three hospitals in Haikou City, Hainan Province were collected, and the data were statistically analyzed. Results A total of 169 confirmed cases of tsutsugamushi disease were collected, including 79 males and 90 females, with a sex ratio of 0.88. The oldest was 82 years old, the youngest only 122 days old, with an average age of (36.70 ± 26.98) years; children under 10 accounted for 35.50% (60/169), significantly higher than other age groups (P <0.01). Apart from young children and students, the occupations of the patients were mainly peasants, accounting for 38.46% (65/169) of the total occupations and 24.26% (41/169) of them were retired staff, workers, residents and unemployed persons. The annual All cases were from 15 cities and counties in Hainan. All of them had fever as the main symptom, of which 140 cases had characteristic eschar or ulcer, accounting for 82.84%. There were 38 cases of history of exposure or insect bites before onset , Accounting for 22.49% of the total number of cases; only 6 cases were positive in the detection of 145 cases by external Peijie test. Conclusion 169 cases of tsutsugamushi disease mainly children and peasants; Hainan Island is widely distributed; year-round incidence, high misdiagnosis rate; external Peijas response laboratory diagnosis of the disease sensitivity and specificity is low.