Biomaterial Database

Rickettsioses as Major Etiologies of Unrecognized Acute Febrile Illness, Sabah, East Malaysia. 2020

Matthew J Grigg, and Timothy William, and Emily G Clemens, and Kaajal Patel, and Arjun Chandna, and Christopher S Wilkes, and Bridget E Barber, and Nicholas M Anstey, and J Stephen Dumler, and Tsin W Yeo, and Megan E Reller

Orientia tsutsugamushi, spotted fever group rickettsioses, and typhus group rickettsioses (TGR) are reemerging causes of acute febrile illness (AFI) in Southeast Asia. To further delineate extent, we enrolled patients >4 weeks of age with nonmalarial AFI in Sabah, Malaysia, during 2013-2015. We confirmed rickettsioses (past or acute, IgG titer >160) in 126/354 (36%) patients. We confirmed acute rickettsioses (paired 4-fold IgG titer rise to >160) in 38/145 (26%) patients: 23 O. tsutsugamushi, 9 spotted fever group, 4 TGR, 1 O. tsutsugamushi/spotted fever group, and 1 O. tsutsugamushi/TGR. PCR results were positive in 11/319 (3%) patients. Confirmed rickettsioses were more common in male adults; agricultural/plantation work and recent forest exposure were risk factors. Dizziness and acute hearing loss but not eschars were reported more often with acute rickettsioses. Only 2 patients were treated with doxycycline. Acute rickettsioses are common (>26%), underrecognized, and untreated etiologies of AFI in East Malaysia; empirical doxycycline treatment should be considered.

UI	MeSH Term	Description	Entries
D008296	Malaysia	A parliamentary democracy with a constitutional monarch in southeast Asia, consisting of 11 states (West Malaysia) on the Malay Peninsula and two states (East Malaysia) on the island of BORNEO. It is also called the Federation of Malaysia. Its capital is Kuala Lumpur. Before 1963 it was the Union of Malaya. It reorganized in 1948 as the Federation of Malaya, becoming independent from British Malaya in 1957 and becoming Malaysia in 1963 as a federation of Malaya, Sabah, Sarawak, and Singapore (which seceded in 1965). The form Malay- probably derives from the Tamil malay, mountain, with reference to its geography. (From Webster's New Geographical Dictionary, 1988, p715 & Room, Brewer's Dictionary of Names, 1992, p329)	Federation of Malaya,Malay Federation,Malay Peninsula,Malaya,Malaya Federation,Sabah,Sarawak
D008297	Male		Males
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328	Adult	A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available.	Adults
D012281	Rickettsia	A genus of gram-negative, aerobic, rod-shaped bacteria often surrounded by a protein microcapsular layer and slime layer. The natural cycle of its organisms generally involves a vertebrate and an invertebrate host. Species of the genus are the etiological agents of human diseases, such as typhus.
D012282	Rickettsia Infections	Infections by the genus RICKETTSIA.	Infections, Rickettsia,Rickettsial Diseases,Rickettsiosis,Infection, Rickettsia,Rickettsia Infection,Rickettsial Disease,Rickettsioses
D012285	Orientia tsutsugamushi	A gram-negative, rod-shaped to coccoid bacterium. It is the etiologic agent of SCRUB TYPHUS in humans and is transmitted by mites from rodent reservoirs.	Rickettsia tsutsugamushi
D012612	Scrub Typhus	An acute infectious disease caused by ORIENTIA TSUTSUGAMUSHI. It is limited to eastern and southeastern Asia, India, northern Australia, and the adjacent islands. Characteristics include the formation of a primary cutaneous lesion at the site of the bite of an infected mite, fever lasting about two weeks, and a maculopapular rash.	Tsutsugamushi Disease,Typhus, Scrub,Orientia tsutsugamushi Infection,Tsutsugamushi Fever,Disease, Tsutsugamushi,Diseases, Tsutsugamushi,Fever, Tsutsugamushi,Fevers, Tsutsugamushi,Infection, Orientia tsutsugamushi,Infections, Orientia tsutsugamushi,Orientia tsutsugamushi Infections,Tsutsugamushi Diseases,Tsutsugamushi Fevers