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Rickettsial infections and fever, Vientiane, Laos
Authors:Phongmany Simaly  Rolain Jean-Marc  Phetsouvanh Rattanaphone  Blacksell Stuart D  Soukkhaseum Vimone  Rasachack Bouachanh  Phiasakha Khamphong  Soukkhaseum Surn  Frichithavong Khamthavi  Chu Vang  Keolouangkhot Valy  Martinez-Aussel Bertrand  Chang Ko  Darasavath Chirapha  Rattanavong Oudayvone  Sisouphone Siho  Mayxay Mayfong  Vidamaly Sisouphane  Parola Philippe  Thammavong Changpeng  Heuangvongsy Mayboun  Syhavong Bounkong  Raoult Didier  White Nicholas J  Newton Paul N
Institution:Mahosot Hospital, Vientiane, Laos.
Abstract:Rickettsial diseases have not been described previously from Laos, but in a prospective study, acute rickettsial infection was identified as the cause of fever in 115 (27%) of 427 adults with negative blood cultures admitted to Mahosot Hospital in Vientiane, Laos. The organisms identified by serologic analysis were Orientia tsutsugamushi (14.8%), Rickettsia typhi (9.6%), and spotted fever group rickettsia (2.6% 8 R. helvetica, 1 R. felis, 1 R. conorii subsp. indica, and 1 Rickettsia "AT1"]). Patients with murine typhus had a lower frequency of peripheral lymphadenopathy than those with scrub typhus (3% vs. 46%, p<0.001). Rickettsioses are an underrecognized cause of undifferentiated febrile illnesses among adults in Laos. This finding has implications for the local empiric treatment of fever.
Keywords:Laos  typhus  fever  Orientia tsutsugamushi  Rickettsia typhi  Rickettsia helvetica  Rickettsia felis  Rickettsia conorii  Rickettsia AT1
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