Rickettsial infections and fever, Vientiane, Laos.
Rickettsial diseases have not been described previously from Laos, but in a prospective study, acute rickettsial infection was identified as the cause of fever in 115 (27%) of 427 adults with negative blood cultures admitted to Mahosot Hospital in Vientiane, Laos. The organisms identified by serologic analysis were Orientia tsutsugamushi (14.8%), Rickettsia typhi (9.6%), and spotted fever group rickettsia (2.6% [8 R. helvetica, 1 R. felis, 1 R. conorii subsp. indica, and 1 Rickettsia "AT1"]). Patients with murine typhus had a lower frequency of peripheral lymphadenopathy than those with scrub typhus (3% vs. 46%, p<0.001). Rickettsioses are an underrecognized cause of undifferentiated febrile illnesses among adults in Laos. This finding has implications for the local empiric treatment of fever.
Mahosot Hospital, Vientiane, Laos.
Simaly
S
Phongmany
Jean-Marc
JM
Rolain
Rattanaphone
R
Phetsouvanh
Stuart D
SD
Blacksell
Vimone
V
Soukkhaseum
Bouachanh
B
Rasachack
Khamphong
K
Phiasakha
Surn
S
Soukkhaseum
Khamthavi
K
Frichithavong
Vang
V
Chu
Valy
V
Keolouangkhot
Bertrand
B
Martinez-Aussel
Ko
K
Chang
Chirapha
C
Darasavath
Oudayvone
O
Rattanavong
Siho
S
Sisouphone
Mayfong
M
Mayxay
Sisouphane
S
Vidamaly
Philippe
P
Parola
Changpeng
C
Thammavong
Mayboun
M
Heuangvongsy
Bounkong
B
Syhavong
Didier
D
Raoult
Nicholas J
NJ
White
Paul N
PN
Newton
D000293:Adolescent; D000328:Adult; D000368:Aged; D000907:Antibodies, Bacterial / Q000097:blood; D005260:Female; D005334:Fever / Q000209:etiology*; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D007812:Laos / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012285:Orientia tsutsugamushi / Q000276:immunology; D011446:Prospective Studies; D012286:Rickettsia typhi / Q000276:immunology; D012612:Scrub Typhus / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D014437:Typhus, Endemic Flea-Borne / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology
D000907:Antibodies, Bacterial; D007074:Immunoglobulin G; D007075:Immunoglobulin M