1. Clinical and Epidemiological Characteristics of Scrub Typhus and Murine Typhus among Hospitalized Patients with Acute Undifferentiated Fever in Northern Vietnam
- Author
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Sugihiro Hamaguchi, Yen Hai Doan, Dang Duc-Anh, Ngo Chi Cuong, Jiro Arikawa, Doan Thu Tra, Kenta Shimizu, Nguyen Quang Tuan, Koya Ariyoshi, Shuji Ando, Pham Thanh Thuy, Lay-Myint Yoshida, Christopher M. Parry, and Le Quynh Mai
- Subjects
Adult ,Male ,medicine.medical_specialty ,Orientia tsutsugamushi ,animal structures ,Fever ,Enzyme-Linked Immunosorbent Assay ,Scrub typhus ,Eschar ,Murine typhus ,Sensitivity and Specificity ,Typhoid fever ,Virology ,Rickettsia typhi ,Internal medicine ,medicine ,Humans ,Fluorescent Antibody Technique, Indirect ,Antigens, Bacterial ,biology ,business.industry ,Typhus, Endemic Flea-Borne ,Articles ,Middle Aged ,biology.organism_classification ,medicine.disease ,bacterial infections and mycoses ,Antibodies, Bacterial ,Recombinant Proteins ,Spotted fever ,Hospitalization ,Infectious Diseases ,Rickettsiosis ,Immunoglobulin M ,Scrub Typhus ,Vietnam ,Immunoglobulin G ,Immunology ,bacteria ,Parasitology ,Female ,Seasons ,medicine.symptom ,business - Abstract
A descriptive study on rickettsiosis was conducted at the largest referral hospital in Hanoi, Vietnam, to identify epidemiological and clinical characteristics of specific rickettsiosis. Between March 2001 and February 2003, we enrolled 579 patients with acute undifferentiated fever (AUF), excluding patients with malaria, dengue fever, and typhoid fever, and serologically tested for Orientia tsutsugamushi and Rickettsia typhi. Of the patients, 237 (40.9%) and 193 (33.3%) had scrub and murine typhus, respectively, and 149 (25.7%) had neither of them (non-scrub and murine typhus [non-ST/MT]). The proportion of murine typhus was highest among patients living in Hanoi whereas that of scrub typhus was highest in national or regional border areas. The presence of an eschar, dyspnea, hypotension, and lymphadenopathy was significantly associated with a diagnosis of scrub typhus (OR = 46.56, 10.90, 9.01, and 7.92, respectively). Patients with murine typhus were less likely to have these findings but more likely to have myalgia, rash, and relative bradycardia (OR = 1.60, 1.56, and 1.45, respectively). Scrub typhus and murine typhus were shown to be common causes of AUF in northern Vietnam although the occurrence of spotted fever group rickettsiae was not determined. Clinical and epidemiological information may help local clinicians make clinical diagnosis of specific rickettsioses in a resource-limited setting.
- Published
- 2014