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The difference in clinical characteristics between acute Q fever and scrub typhus in southern Taiwan.
Int J Infect Dis 2009; 13(3):387-93IJ

Abstract

OBJECTIVE

To identify the differences in clinical characteristics between acute Q fever and scrub typhus in southern Taiwan.

METHODS

A prospective observational study was conducted in which serological tests for acute Q fever and scrub typhus were performed simultaneously regardless of which disease was suspected clinically. From April 2004 to December 2007, 80 and 40 cases of serologically confirmed acute Q fever and scrub typhus, respectively, were identified and included in the study for comparison.

RESULTS

By univariate analysis, being male (p<0.001) and having an alanine aminotransferase (ALT) >88U/l (p=0.015) were more common in acute Q fever, whereas residence or travel in a mountainous region or offshore island of Taiwan (p<0.001), skin rash (p<0.001), eschar (p<0.001), lymphadenopathy (p=0.04), leukocytosis (p=0.002), and pulmonary involvement on chest X-ray (p=0.003) were more common in scrub typhus. In the multivariate analysis, being male (odds ratio (OR) 10.883, 95% confidence interval (CI) 2.079-56.441, p=0.005) was an independent characteristic of acute Q fever, while residence or travel in a mountainous region or offshore island (OR 0.073, 95% CI 0.019-0.275, p<0.001) and skin rash (OR 0.152, 95% CI 0.024-0.945, p=0.043) were independent characteristics of scrub typhus. The response to doxycycline treatment was not different.

CONCLUSIONS

In southern Taiwan, sex, area of residence, travel history, and physical examination are important in the differentiation of acute Q fever from scrub typhus.

Authors+Show Affiliations

Division of Infectious Diseases, Department of Internal Medicine, E-Da Hospital/I-Shou University, 1 E-Da Road, Jiau-Shu Tsuen, Yan-Chau Shiang, Kaohsiung County, 824 Taiwan, Republic of China.No 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

18977677

Citation

Lai, Chung-Hsu, et al. "The Difference in Clinical Characteristics Between Acute Q Fever and Scrub Typhus in Southern Taiwan." International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases, vol. 13, no. 3, 2009, pp. 387-93.
Lai CH, Huang CK, Weng HC, et al. The difference in clinical characteristics between acute Q fever and scrub typhus in southern Taiwan. Int J Infect Dis. 2009;13(3):387-93.
Lai, C. H., Huang, C. K., Weng, H. C., Chung, H. C., Liang, S. H., Lin, J. N., ... Lin, H. H. (2009). The difference in clinical characteristics between acute Q fever and scrub typhus in southern Taiwan. International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases, 13(3), pp. 387-93. doi:10.1016/j.ijid.2008.07.020.
Lai CH, et al. The Difference in Clinical Characteristics Between Acute Q Fever and Scrub Typhus in Southern Taiwan. Int J Infect Dis. 2009;13(3):387-93. PubMed PMID: 18977677.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The difference in clinical characteristics between acute Q fever and scrub typhus in southern Taiwan. 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, Y1 - 2008/11/01/ PY - 2008/04/14/received PY - 2008/07/17/revised PY - 2008/07/29/accepted PY - 2008/11/4/pubmed PY - 2009/7/18/medline PY - 2008/11/4/entrez SP - 387 EP - 93 JF - International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases JO - Int. J. Infect. Dis. VL - 13 IS - 3 N2 - OBJECTIVE: To identify the differences in clinical characteristics between acute Q fever and scrub typhus in southern Taiwan. METHODS: A prospective observational study was conducted in which serological tests for acute Q fever and scrub typhus were performed simultaneously regardless of which disease was suspected clinically. From April 2004 to December 2007, 80 and 40 cases of serologically confirmed acute Q fever and scrub typhus, respectively, were identified and included in the study for comparison. RESULTS: By univariate analysis, being male (p<0.001) and having an alanine aminotransferase (ALT) >88U/l (p=0.015) were more common in acute Q fever, whereas residence or travel in a mountainous region or offshore island of Taiwan (p<0.001), skin rash (p<0.001), eschar (p<0.001), lymphadenopathy (p=0.04), leukocytosis (p=0.002), and pulmonary involvement on chest X-ray (p=0.003) were more common in scrub typhus. In the multivariate analysis, being male (odds ratio (OR) 10.883, 95% confidence interval (CI) 2.079-56.441, p=0.005) was an independent characteristic of acute Q fever, while residence or travel in a mountainous region or offshore island (OR 0.073, 95% CI 0.019-0.275, p<0.001) and skin rash (OR 0.152, 95% CI 0.024-0.945, p=0.043) were independent characteristics of scrub typhus. The response to doxycycline treatment was not different. CONCLUSIONS: In southern Taiwan, sex, area of residence, travel history, and physical examination are important in the differentiation of acute Q fever from scrub typhus. SN - 1878-3511 UR - https://www.unboundmedicine.com/medline/citation/18977677/The_difference_in_clinical_characteristics_between_acute_Q_fever_and_scrub_typhus_in_southern_Taiwan_ L2 - http://linkinghub.elsevier.com/retrieve/pii/S1201-9712(08)01497-5 DB - PRIME DP - Unbound Medicine ER -