Abstract: Objective　To investigate the injury，treatment and prevention secondary to infection from tick bites.Methods　Based on literature review，the clinical data（sex，age，symptoms，signs，laboratory examination，treatment） of 3 children with tick bite infection admitted to the Children's Hospital of Nanjing Medical University were analyzed from July 6 2018 to July 19 2018.Results　Among the 3 cases，1 was male and 2 was female；three children were aged 1 year and 7 months，5 years and 3 months and 15 years and 6 months，respectively.Three patients all had fever with body temperature exceeding 38.5 ℃.
In one of the cases，the biting tick was removed by surgery followed by debridement of the wounded area.This case had a good outcome with short course and low medical expenses.The other two cases were siblings without findings of specific site of the biting ticks.These two patients presented with fever，and were diagnosed with severe fever with thrombocytopenia syndrome virus（SFTSV） infection by the center for disease control and prevention subsequently.The little brother bacame better after conventional therapy.The big sister with worse condition became better as well after treating with ribavirin and r-globulin of 2 g/kg.Conclusion　Removing the ticks in time is of good efficacy.For patients who can not find the bite site，if fever occurs，white blood cell count and platelet count decrease，their blood should be sent to the center for disease control and prevention in time to identify the cause，receive early treatment as soon as possible to reduce complications.

Key words: Bites and stings, Ticks, Infection, Case reports, Historical article

摘要： 目的　探讨儿童蜱虫叮咬后的继发危害、处理及预防。方法　结合文献复习，对2018-07-06、2018-07-19南京医科大学附属儿童医院收治的3例蜱虫叮咬致感染患儿的临床资料（性别、年龄、症状、体征、实验室检查、处理等）进行分析。结果　3例患儿中，男1例，女2例；年龄分别为1岁7个月、5岁3个月、15岁6个月；病程中均有发热，体温最高均超过38.5 ℃。患儿1经外科清除蜱虫，同时局部行清创缝合，治疗效果最好，病程最短，费用最少。患儿2和患儿3为姐弟俩，均未找到明确蜱虫叮咬部位，均因“发热”就诊，经疾病预防控制中心血液检验确诊为“新型布尼亚病毒”感染，其中弟弟常规对症治疗后好转，姐姐病情较重，在常规治疗基础上加用利巴韦林和丙种球蛋白2 g/kg后好转。结论　蜱虫叮咬后及时有效清除虫体效果好，对找不到叮咬部位者，如出现发热，白细胞计数和血小板计数降低，应及时向疾病预防控制中心送检血液，尽早明确病因，早期治疗，减少并发症。

关键词: 咬伤和蛰伤, 蜱, 感染, 病例报告, 历史文献