Tags

Type your tag names separated by a space and hit enter

Epidemiology of acute q Fever, scrub typhus, and murine typhus, and identification of their clinical characteristics compared to patients with acute febrile illness in southern taiwan.
J Formos Med Assoc. 2009 May; 108(5):367-76.JF

Abstract

BACKGROUND/PURPOSE

In Taiwan, acute Q fever, scrub typhus, and murine typhus (QSM diseases) are the most common rickettsioses, but their epidemiology and clinical characteristics have not been clarified. Diagnosis of these three diseases based on clinical manifestations is difficult, and most of their reported characteristics are identified by describing the predominant manifestations, without being compared with other diseases.

METHODS

Serological tests for QSM diseases were examined simultaneously in patients suspected of the three diseases, regardless of which one was suspected. Clinical manifestations were recorded retrospectively from their charts. The characteristics of QSM diseases were identified by comparison with patients who had non-QSM diseases.

RESULTS

From April 2004 to April 2007, a total of 226 cases of suspected QSM diseases were included. One hundred (44.2%) cases were serologically confirmed as QSM diseases (68 acute Q fever, 23 scrub typhus, and 9 murine typhus), and 126 (55.8%) cases were non-QSM diseases. Only 33 cases (33.0%) of QSM diseases were initially suspected at the time of hospital visit, whereas 54 cases (42.9%) of non-QSM diseases were incorrectly suspected as QSM diseases. Cases of Q fever and scrub typhus were distributed over plain and mountain areas, respectively. By multivariate analysis, relative bradycardia (OR [95% CI], 2.885 [1.3-6.4]; p = 0.009), radiographic hepatomegaly (OR [95% CI], 4.454 [1.6-12.3]; p = 0.004), and elevated serum aminotransferases (OR [95% CI], 5.218 [1.2-23.1]; p = 0.029) were independent characteristics for QSM diseases, and leukocytosis (OR [95% CI], 0.167 [0.052-0.534]; p = 0.003) was negative for the diagnosis of QSM diseases.

CONCLUSION

In southern Taiwan, acute Q fever is the most common rickettsiosis. QSM diseases should be suspected in febrile patients who present with relative bradycardia, hepatomegaly, and elevated serum aminotransferases, but without leukocytosis.

Authors+Show Affiliations

Division of Infectious Diseases, Department of Internal Medicine, E-Da Hospital/I-Shou University, Taiwan.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)

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

Language

eng

PubMed ID

19443290

Citation

Lai, Chung-Hsu, et al. "Epidemiology of Acute Q Fever, Scrub Typhus, and Murine Typhus, and Identification of Their Clinical Characteristics Compared to Patients With Acute Febrile Illness in Southern Taiwan." Journal of the Formosan Medical Association = Taiwan Yi Zhi, vol. 108, no. 5, 2009, pp. 367-76.
Lai CH, Huang CK, Chen YH, et al. Epidemiology of acute q Fever, scrub typhus, and murine typhus, and identification of their clinical characteristics compared to patients with acute febrile illness in southern taiwan. J Formos Med Assoc. 2009;108(5):367-76.
Lai, C. H., Huang, C. K., Chen, Y. H., Chang, L. L., Weng, H. C., Lin, J. N., Chung, H. C., Liang, S. H., & Lin, H. H. (2009). Epidemiology of acute q Fever, scrub typhus, and murine typhus, and identification of their clinical characteristics compared to patients with acute febrile illness in southern taiwan. Journal of the Formosan Medical Association = Taiwan Yi Zhi, 108(5), 367-76. https://doi.org/10.1016/S0929-6646(09)60080-2
Lai CH, et al. Epidemiology of Acute Q Fever, Scrub Typhus, and Murine Typhus, and Identification of Their Clinical Characteristics Compared to Patients With Acute Febrile Illness in Southern Taiwan. J Formos Med Assoc. 2009;108(5):367-76. PubMed PMID: 19443290.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Epidemiology of acute q Fever, scrub typhus, and murine typhus, and identification of their clinical characteristics compared to patients with acute febrile illness in southern taiwan. AU - Lai,Chung-Hsu, AU - Huang,Chun-Kai, AU - Chen,Yen-Hsu, AU - Chang,Lin-Li, AU - Weng,Hui-Ching, AU - Lin,Jiun-Nong, AU - Chung,Hsing-Chun, AU - Liang,Shiou-Haur, AU - Lin,Hsi-Hsun, PY - 2009/5/16/entrez PY - 2009/5/16/pubmed PY - 2009/10/7/medline SP - 367 EP - 76 JF - Journal of the Formosan Medical Association = Taiwan yi zhi JO - J Formos Med Assoc VL - 108 IS - 5 N2 - BACKGROUND/PURPOSE: In Taiwan, acute Q fever, scrub typhus, and murine typhus (QSM diseases) are the most common rickettsioses, but their epidemiology and clinical characteristics have not been clarified. Diagnosis of these three diseases based on clinical manifestations is difficult, and most of their reported characteristics are identified by describing the predominant manifestations, without being compared with other diseases. METHODS: Serological tests for QSM diseases were examined simultaneously in patients suspected of the three diseases, regardless of which one was suspected. Clinical manifestations were recorded retrospectively from their charts. The characteristics of QSM diseases were identified by comparison with patients who had non-QSM diseases. RESULTS: From April 2004 to April 2007, a total of 226 cases of suspected QSM diseases were included. One hundred (44.2%) cases were serologically confirmed as QSM diseases (68 acute Q fever, 23 scrub typhus, and 9 murine typhus), and 126 (55.8%) cases were non-QSM diseases. Only 33 cases (33.0%) of QSM diseases were initially suspected at the time of hospital visit, whereas 54 cases (42.9%) of non-QSM diseases were incorrectly suspected as QSM diseases. Cases of Q fever and scrub typhus were distributed over plain and mountain areas, respectively. By multivariate analysis, relative bradycardia (OR [95% CI], 2.885 [1.3-6.4]; p = 0.009), radiographic hepatomegaly (OR [95% CI], 4.454 [1.6-12.3]; p = 0.004), and elevated serum aminotransferases (OR [95% CI], 5.218 [1.2-23.1]; p = 0.029) were independent characteristics for QSM diseases, and leukocytosis (OR [95% CI], 0.167 [0.052-0.534]; p = 0.003) was negative for the diagnosis of QSM diseases. CONCLUSION: In southern Taiwan, acute Q fever is the most common rickettsiosis. QSM diseases should be suspected in febrile patients who present with relative bradycardia, hepatomegaly, and elevated serum aminotransferases, but without leukocytosis. SN - 0929-6646 UR - https://www.unboundmedicine.com/medline/citation/19443290/Epidemiology_of_acute_q_Fever_scrub_typhus_and_murine_typhus_and_identification_of_their_clinical_characteristics_compared_to_patients_with_acute_febrile_illness_in_southern_taiwan_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0929-6646(09)60080-2 DB - PRIME DP - Unbound Medicine ER -