title: Clinical and Epidemiological Characteristics of Scrub Typhus and Murine Typhus among Hospitalized Patients with Acute Undifferentiated Fever in Northern Vietnam.
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.
authors.forename: Sugihiro
authors.initials: S
authors.lastname: Hamaguchi
authors.forename: Ngo Chi
authors.initials: NC
authors.lastname: Cuong
authors.forename: Doan Thu
authors.initials: DT
authors.lastname: Tra
authors.forename: Yen Hai
authors.initials: YH
authors.lastname: Doan
authors.forename: Kenta
authors.initials: K
authors.lastname: Shimizu
authors.forename: Nguyen Quang
authors.initials: NQ
authors.lastname: Tuan
authors.forename: Lay-Myint
authors.initials: LM
authors.lastname: Yoshida
authors.forename: Le Quynh
authors.initials: LQ
authors.lastname: Mai
authors.forename: Dang
authors.initials: D
authors.lastname: Duc-Anh
authors.forename: Shuji
authors.initials: S
authors.lastname: Ando
authors.forename: Jiro
authors.initials: J
authors.lastname: Arikawa
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Parry
authors.forename: Koya
authors.initials: K
authors.lastname: Ariyoshi
authors.forename: Pham Thanh
authors.initials: PT
authors.lastname: Thuy
mesh_terms: D000328:Adult; D000907:Antibodies, Bacterial / Q000097:blood*; D000942:Antigens, Bacterial / Q000276:immunology*; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods; D005260:Female; D005334:Fever; D019084:Fluorescent Antibody Technique, Indirect; D006760:Hospitalization; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D008297:Male; D008875:Middle Aged; D012285:Orientia tsutsugamushi / Q000276:immunology / Q000302:isolation & purification*; D011994:Recombinant Proteins; D012286:Rickettsia typhi / Q000276:immunology / Q000302:isolation & purification*; D012612:Scrub Typhus / Q000453:epidemiology* / Q000382:microbiology; D012621:Seasons; D012680:Sensitivity and Specificity; D014437:Typhus, Endemic Flea-Borne / Q000453:epidemiology* / Q000382:microbiology; D014744:Vietnam / Q000453:epidemiology
chemical_list: D000907:Antibodies, Bacterial; D000942:Antigens, Bacterial; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D011994:Recombinant Proteins