Febrile illness in Malaysia--an analysis of 1,629 hospitalized patients.
We studied 1,629 febrile patients from a rural area of Malaysia, and made a laboratory diagnosis in 1,025 (62.9%) cases. Scrub typhus was the most frequent diagnosis (19.3% of all illnesses) followed by typhoid and paratyphoid (7.4%); flavivirus infection (7.0%); leptospirosis (6.8%); and malaria (6.2%). The hospital mortality was very low (0.5% of all febrile patients). The high prevalence of scrub typhus in oil palm laborers (46.8% of all febrile illnesses in that group) was confirmed. In rural Malaysia, therapy with chloramphenicol or a tetracycline would be appropriate for undiagnosed patients in whom malaria has been excluded. Failure to respond to tetracycline within 48 hours would usually suggest a diagnosis of typhoid, and indicate the need for a change in therapy.
D000293:Adolescent; D000328:Adult; D001424:Bacterial Infections / Q000175:diagnosis*; D002648:Child; D005260:Female; D005334:Fever / Q000209:etiology*; D005335:Fever of Unknown Origin / Q000209:etiology; D006801:Humans; D007922:Leptospirosis / Q000175:diagnosis; D008288:Malaria / Q000175:diagnosis*; D008296:Malaysia; D008297:Male; D008875:Middle Aged; D010284:Paratyphoid Fever / Q000175:diagnosis; D012612:Scrub Typhus / Q000175:diagnosis; D014036:Togaviridae Infections / Q000175:diagnosis; D014435:Typhoid Fever / Q000175:diagnosis; D014777:Virus Diseases / Q000175:diagnosis*