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Volume 10, Number 5—May 2004


Acute Tick-borne Rickettsiosis Caused by Rickettsia heilongjiangensis in the Russian Far East

Oleg Y. Mediannikov*†‡Comments to Author , Yuri Sidelnikov†, Leonid Ivanov§, Eugenia Mokretsova†, Pierre-Edouard Fournier‡, Irina Tarasevich*, and Didier Raoult‡
Author affiliations: *Gamaleya Research Institute of Epidemiology and Microbiology, Moscow, Russia; †Far Eastern State Medical University, Khabarovsk, Russia; ‡Université de la Méditerranée, Marseille, France; §Khabarovsk Plague Control Station of Ministry of Health of Russian Federation, Khabarovsk, Russia

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Table 4

Epidemiologic, clinical and laboratory data of 13 patients with rickettsiosis.

Feature or sign Value (n = 13)
Sex, male/female 8/5
Age, y, mean 52 (18–66)
Mean period between onset and hospitalization, d 4.6
Mean stay at the hospital, d 5.7
Primary diagnosis of rickettsiosis at admission 9
History of tick bite 6
Incubation period, d, median (range) 5.5 (4–7)
Antibiotics taken before hospitalization 2
Chills 13
Malaise 13
Headache 13
Dizziness 11
Myalgias, arthralgias 13
Nausea 2
Anorexia 13
Maculopapular rash 12
Rash appearance after onset of disease, d, median 3.6
Duration of rash, d, median (range) 5.5 (4–7)
Presence of eschar 12
Lymphadenopathy regional to the eschar 10
Subcutaneous lymphangitis, leading to regional lymph nodes 2
Hepatomegaly 5
Splenomegaly 2
Sleep disturbances 7
Leukocytosis at admission, (>9,000/mm3) 6
Leukopenia at admission, (<4,000/mm3) 2
Increased ESR (>15 mm/h for men, >20 mm/h for women) 12
Thrombocytopenia, (<150,000/mm3) 3
Proteinuria (>0.033 g/L) 1
Increased ALT activity, >1.5 times 6
Increased AST activity, >1.5 times 2
Doxycycline treatment, 100 mg twice daily for 14 d 13

aESR, erythrocyte sedimentation rate; ALT, alanine aminotransferase; AST, aspartate aminotransferase.

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