title: Contribution of rickettsioses in Sri Lankan patients with fever who responded to empirical doxycycline treatment.
abstract: Twenty-eight febrile Sri Lankan patients with undiagnosed fever for 7 days after hospital admission, who responded to empirical treatment with doxycycline, were retrospectively investigated using microimmunofluorescence assay to verify whether they had rickettsial infection. Eleven (39%) patients were confirmed as having spotted fever group rickettsioses and 10 (36%) as having Orientia tsutsugamushi. Seven were negative for all tests. This suggests that greater use of doxycycline appears justified for patients with undiagnosed fever in settings where rickettsial diseases are endemic or re-emerging with inadequate diagnostic facilities.
authors.affiliation: Department of Medicine, Faculty of Medicine, University of Kelaniya PO Box 6, Thalagolla Road, Ragama, Sri Lanka. ranjan premaratna@lycos.com
authors.forename: R
authors.initials: R
authors.lastname: Premaratna
authors.forename: R P V J
authors.initials: RP
authors.lastname: Rajapakse
authors.forename: T G A N
authors.initials: TG
authors.lastname: Chandrasena
authors.forename: D M
authors.initials: DM
authors.lastname: Nanayakkara
authors.forename: N K B K R G W
authors.initials: NK
authors.lastname: Bandara
authors.forename: S A M
authors.initials: SA
authors.lastname: Kularatna
authors.forename: M E
authors.initials: ME
authors.lastname: Eremeeva
authors.forename: G A
authors.initials: GA
authors.lastname: Dasch
authors.forename: H J
authors.initials: HJ
authors.lastname: de Silva
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D004318:Doxycycline / Q000627:therapeutic use*; D005260:Female; D005335:Fever of Unknown Origin / Q000188:drug therapy / Q000382:microbiology*; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D008297:Male; D012285:Orientia tsutsugamushi / Q000302:isolation & purification; D012281:Rickettsia / Q000302:isolation & purification*; D012282:Rickettsia Infections / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D012612:Scrub Typhus / Q000175:diagnosis; D013188:Sri Lanka; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D004318:Doxycycline