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Volume 13, Number 11—November 2007

Dispatch

Severe Spotted Fever Group Rickettsiosis, Australia

William J.H. McBride*Comments to Author , Joshua P. Hanson†, Robert Miller‡, and Drew Wenck§
Author affiliations: *James Cook University, Cairns, Queensland, Australia; †Wellcome Trust-Mahidol University-Oxford Tropical Medicine Research Programme, Bangkok, Thailand; ‡The Townsville Hospital, Douglas, Queensland, Australia; §Cairns Base Hospital, Cairns, Queensland, Australia

Main Article

Table

Laboratory test results in 3 severe cases of infection with Rickettsia australis, Australia

Test Case 1 Case 2 Case 3 Reference range
Hemoglobin, g/L 124 130 142 115–160
Neutrophil count, cells/L 6.19 11.4 8.8 2.00–8.00 × 109
Lymphocyte count, cells/L 0.39 0.4 1.58 1.00–4.00 × 109
Platelet count, cells/L 63 30 167 140–400 × 109
Sodium, mmol/L 131 135 139 135–145
Urea, mmol/L 9.8 27.8 5.0 3.0–8.0
Creatinine, μmol/L 190 430 100 70–120
Bilirubin, μmol/L 28 105 41 <20
Alkaline phosphatase, U/L 295 250 587 30–120
Gamma-glutamyl transferase, U/L 205 121 877 <50
Alanine aminotransferase, U/L 131 47 404 <40
Aspartate aminotransferase, U/L 178 152 417 <35
Leptospirosis immunoglobulin M Negative Negative Negative
Duration of symptoms before doxycycline treatment, d 17 14 10
R. australis antibody titer* Negative to 2,048 over 9 d 64–1,024 over 8 d Negative to >1,024 over 9 d Negative <64
Positive >64

*By immunofluorescence.

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