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.
Phongmany
Simaly
S
Mahosot Hospital, Vientiane, Laos.
Rolain
Jean-Marc
JM
Phetsouvanh
Rattanaphone
R
Blacksell
Stuart D
SD
Soukkhaseum
Vimone
V
Rasachack
Bouachanh
B
Phiasakha
Khamphong
K
Soukkhaseum
Surn
S
Frichithavong
Khamthavi
K
Chu
Vang
V
Keolouangkhot
Valy
V
Martinez-Aussel
Bertrand
B
Chang
Ko
K
Darasavath
Chirapha
C
Rattanavong
Oudayvone
O
Sisouphone
Siho
S
Mayxay
Mayfong
M
Vidamaly
Sisouphane
S
Parola
Philippe
P
Thammavong
Changpeng
C
Heuangvongsy
Mayboun
M
Syhavong
Bounkong
B
Raoult
Didier
D
White
Nicholas J
NJ
Newton
Paul N
PN
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