Emerging rickettsial infections in Sri Lanka: the pattern in the hilly Central Province
Open Access
- 28 August 2003
- journal article
- research article
- Published by Wiley in Tropical Medicine & International Health
- Vol. 8 (9), 803-811
- https://doi.org/10.1046/j.1365-3156.2003.01108.x
Abstract
Summary Objectives To identify different rickettsial infections using a specific immunofluorescent technique in patients clinically diagnosed as ‘typhus fever’ in the Central Province of Sri Lanka, and to define the clinical picture, assess the severity of infection and to determine the pattern of geographical distribution of the infections of the hospital‐based patients. Methods A specific indirect immunofluorescent antibody technique was used on the sera of two groups of patients in laboratories in Japan and Thailand. Results We serodiagnosed infections with Orientia tsutsugamushi, Rickettsia typhi and spotted fever group in 56 of 118 clinically investigated patients. There were eight infections with O. tsutsugamushi, two with R. typhi and 10 spotted fever group patients with IgM antibodies suggestive of acute infection. Nineteen patients had antibodies against these three rickettsial species, suggestive of past exposure, co‐infection or cross‐reactivity of antigens. Discrete, erythematous maculopapular rash was common to all three types of infection except for five patients who had no rash. Five patients positive for spotted fever antibodies developed fern‐leaf type skin necrosis with severe illness. Duration of the febrile period ranged from 4 to 23 days with defervescence occurring after specific antibiotic treatment. Conclusions The study has shown the presence of different types of rickettsial infections in the Central Province of Sri Lanka. The characterization of the clinical picture and the severity of infection provide useful information for the proper management of the patients in the future.Keywords
This publication has 8 references indexed in Scilit:
- Short report: Thai tick typhus, Rickettsia honei, and a unique rickettsia detected in Ixodes granulatus (Ixodidae: Acari) from Thailand.The American Journal of Tropical Medicine and Hygiene, 2001
- First Documentation ofRickettsia conoriiInfection (Strain Indian Tick Typhus) in a TravelerEmerging Infectious Diseases, 2001
- Rickettsial diseases: the typhus group of fevers—a reviewPublished by Oxford University Press (OUP) ,2000
- Laboratory diagnosis of rickettsioses: current approaches to diagnosis of old and new rickettsial diseasesJournal of Clinical Microbiology, 1997
- Rickettsioses as paradigms of new or emerging infectious diseasesClinical Microbiology Reviews, 1997
- Comparative evaluation of four serodiagnostic tests for scrub typhus in ThailandTransactions of the Royal Society of Tropical Medicine and Hygiene, 1997
- Antigenic Diversity of Rickettsia ConoriiThe American Journal of Tropical Medicine and Hygiene, 1992