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Am J Trop Med Hyg. 2014 Sep;91(3):451-60. doi: 10.4269/ajtmh.14-0191. Epub 2014 Jun 23.

Rickettsial infections in Southeast Asia: implications for local populace and febrile returned travelers.

Author information

1
Department of Infectious Diseases and Microbiology, Alfred Hospital, Melbourne, Victoria, Australia; Monash University, Melbourne, Victoria, Australia; Department of Infectious Diseases and Microbiology and Pathwest Laboratory Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia; School of Pathology and Laboratory Medicine, University of Western Australia, Perth, Western Australia, Australia; Australian Rickettsial Reference Laboratory Foundation, Geelong Hospital, Geelong, Victoria, Australia; New South Wales Health Pathology, Newcastle, New South Wales, Australia; University of Newcastle, Newcastle, New South Wales, Australia a.aung@alfred.org.au.
2
Department of Infectious Diseases and Microbiology, Alfred Hospital, Melbourne, Victoria, Australia; Monash University, Melbourne, Victoria, Australia; Department of Infectious Diseases and Microbiology and Pathwest Laboratory Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia; School of Pathology and Laboratory Medicine, University of Western Australia, Perth, Western Australia, Australia; Australian Rickettsial Reference Laboratory Foundation, Geelong Hospital, Geelong, Victoria, Australia; New South Wales Health Pathology, Newcastle, New South Wales, Australia; University of Newcastle, Newcastle, New South Wales, Australia.

Abstract

Rickettsial infections represent a major cause of non-malarial febrile illnesses among the residents of Southeast Asia and returned travelers from that region. There are several challenges in recognition, diagnosis, and management of rickettsioses endemic to Southeast Asia. This review focuses on the prevalent rickettsial infections, namely, murine typhus (Rickettsia typhi), scrub typhus (Orientia tsutsugamushi), and members of spotted fever group rickettsiae. Information on epidemiology and regional variance in the prevalence of rickettsial infections is analyzed. Clinical characteristics of main groups of rickettsioses, unusual presentations, and common pitfalls in diagnosis are further discussed. In particular, relevant epidemiologic and clinical aspects on emerging spotted fever group rickettsiae in the region, such as Rickettsia honei, R. felis, R. japonica, and R. helvetica, are presented. Furthermore, challenges in laboratory diagnosis and management aspects of rickettsial infections unique to Southeast Asia are discussed, and data on emerging resistance to antimicrobial drugs and treatment/prevention options are also reviewed.

PMID:
24957537
PMCID:
PMC4155544
DOI:
10.4269/ajtmh.14-0191
[Indexed for MEDLINE]
Free PMC Article

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