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Title: Rickettsioses as major etiologies of unrecognized acute febrile illness, Sabah, East Malaysia
Authors: Grigg, Matthew J.
William, Timothy
Clemens, Emily G.
Patel, Kaajal
Chandna, Arjun
Wilkes, Christopher S.
Barber, Bridget E.
Anstey, Nicholas M.
Dumler, J. Stephen
Yeo, Tsin Wen
Reller, Megan E.
Keywords: Science::Medicine
Issue Date: 2020
Source: Grigg, M. J., William, T., Clemens, E. G., Patel, K., Chandna, A., Wilkes, C. S., . . . Reller, M. E. (2020). Rickettsioses as major etiologies of unrecognized acute febrile illness, Sabah, East Malaysia. Emerging Infectious Diseases, 26(7), 1409-1419. doi:10.3201/eid2607.191722
Journal: Emerging Infectious Diseases
Abstract: Orientia tsutsugamushi, spotted fever group rickettsioses, and typhus group rickettsioses (TGR) are reemerging causes of acute febrile illness (AFI) in Southeast Asia. To further delineate extent, we enrolled patients >4 weeks of age with nonmalarial AFI in Sabah, Malaysia, during 2013-2015. We confirmed rickettsioses (past or acute, IgG titer >160) in 126/354 (36%) patients. We confirmed acute rickettsioses (paired 4-fold IgG titer rise to >160) in 38/145 (26%) patients: 23 O. tsutsugamushi, 9 spotted fever group, 4 TGR, 1 O. tsutsugamushi/spotted fever group, and 1 O. tsutsugamushi/TGR. PCR results were positive in 11/319 (3%) patients. Confirmed rickettsioses were more common in male adults; agricultural/plantation work and recent forest exposure were risk factors. Dizziness and acute hearing loss but not eschars were reported more often with acute rickettsioses. Only 2 patients were treated with doxycycline. Acute rickettsioses are common (>26%), underrecognized, and untreated etiologies of AFI in East Malaysia; empirical doxycycline treatment should be considered.
ISSN: 1080-6040
DOI: 10.3201/eid2607.191722
Rights: © 2020 The Author(s) (published by Public Domain). This is an open-access article distributed under the terms of the Creative Commons Attribution License.
Fulltext Permission: open
Fulltext Availability: With Fulltext
Appears in Collections:LKCMedicine Journal Articles

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