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Clinical characteristics of acute Q fever, scrub typhus, and murine typhus with delayed defervescence despite doxycycline treatment.
Am J Trop Med Hyg. 2008 Sep; 79(3):441-6.AJ

Abstract

Doxycycline is the recommended antibiotic for acute Q fever, scrub typhus, and murine typhus and defervescence often occurs within 3 days of treatment. Patients with delayed defervescence (> 3 days) are troublesome for clinicians. To investigate the characteristics of such patients, 18 and 88 cases with and without delayed defervescence, respectively, were studied. By univariate analysis, absence of headache (P = 0.004), jaundice (P = 0.030), icteric sclera (P = 0.030), relative bradycardia (P = 0.003), and pulmonary involvement on chest x-ray (P = 0.028) were significant findings in patients with delayed defervescence. By multivariate analysis, absence of headache (odds ratio [OR] = 8.310; 95% confidence interval [CI] = 1.990-34.706, P = 0.004), jaundice (OR = 6.242; 95% CI = 1.374-28.365, P = 0.018), and relative bradycardia (OR = 10.449; 95% CI = 2.137-51.088, P = 0.004) were the independent characteristics of patients with delayed defervescence. In treating acute Q fever, scrub typhus, and murine typhus with doxycycline, clinicians should be aware that delayed defervescence may occur in patients presenting with jaundice, relative bradycardia, and absence of headache.

Authors+Show Affiliations

Section of Infectious Diseases, Department of Internal Medicine, E-Da Hospital/I-Shou University, Kaoshiung County, Taiwan, Republic of China. laich6363@yahoo.com.twNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18784240

Citation

Lai, Chung-Hsu, et al. "Clinical Characteristics of Acute Q Fever, Scrub Typhus, and Murine Typhus With Delayed Defervescence Despite Doxycycline Treatment." The American Journal of Tropical Medicine and Hygiene, vol. 79, no. 3, 2008, pp. 441-6.
Lai CH, Huang CK, Weng HC, et al. Clinical characteristics of acute Q fever, scrub typhus, and murine typhus with delayed defervescence despite doxycycline treatment. Am J Trop Med Hyg. 2008;79(3):441-6.
Lai, C. H., Huang, C. K., Weng, H. C., Chung, H. C., Liang, S. H., Lin, J. N., Lin, C. W., Hsu, C. Y., & Lin, H. H. (2008). Clinical characteristics of acute Q fever, scrub typhus, and murine typhus with delayed defervescence despite doxycycline treatment. The American Journal of Tropical Medicine and Hygiene, 79(3), 441-6.
Lai CH, et al. Clinical Characteristics of Acute Q Fever, Scrub Typhus, and Murine Typhus With Delayed Defervescence Despite Doxycycline Treatment. Am J Trop Med Hyg. 2008;79(3):441-6. PubMed PMID: 18784240.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical characteristics of acute Q fever, scrub typhus, and murine typhus with delayed defervescence despite doxycycline treatment. AU - Lai,Chung-Hsu, AU - Huang,Chun-Kai, AU - Weng,Hui-Ching, AU - Chung,Hsing-Chun, AU - Liang,Shiou-Haur, AU - Lin,Jiun-Nong, AU - Lin,Chih-Wen, AU - Hsu,Chuan-Yuan, AU - Lin,Hsi-Hsun, PY - 2008/9/12/pubmed PY - 2008/10/8/medline PY - 2008/9/12/entrez SP - 441 EP - 6 JF - The American journal of tropical medicine and hygiene JO - Am J Trop Med Hyg VL - 79 IS - 3 N2 - Doxycycline is the recommended antibiotic for acute Q fever, scrub typhus, and murine typhus and defervescence often occurs within 3 days of treatment. Patients with delayed defervescence (> 3 days) are troublesome for clinicians. To investigate the characteristics of such patients, 18 and 88 cases with and without delayed defervescence, respectively, were studied. By univariate analysis, absence of headache (P = 0.004), jaundice (P = 0.030), icteric sclera (P = 0.030), relative bradycardia (P = 0.003), and pulmonary involvement on chest x-ray (P = 0.028) were significant findings in patients with delayed defervescence. By multivariate analysis, absence of headache (odds ratio [OR] = 8.310; 95% confidence interval [CI] = 1.990-34.706, P = 0.004), jaundice (OR = 6.242; 95% CI = 1.374-28.365, P = 0.018), and relative bradycardia (OR = 10.449; 95% CI = 2.137-51.088, P = 0.004) were the independent characteristics of patients with delayed defervescence. In treating acute Q fever, scrub typhus, and murine typhus with doxycycline, clinicians should be aware that delayed defervescence may occur in patients presenting with jaundice, relative bradycardia, and absence of headache. SN - 1476-1645 UR - https://www.unboundmedicine.com/medline/citation/18784240/Clinical_characteristics_of_acute_Q_fever_scrub_typhus_and_murine_typhus_with_delayed_defervescence_despite_doxycycline_treatment_ L2 - http://www.ajtmh.org/cgi/pmidlookup?view=long&pmid=18784240 DB - PRIME DP - Unbound Medicine ER -