Volume 20, Number 8—August 2014
Letter
Rickettsia felis Infections and Comorbid Conditions, Laos, 2003–2011
Table
Clinical and laboratory findings of 3 patients with Rickettsia felis infections, Laos*
Patient characteristics | Signs and symptoms | Molecular findings | Serologic findings | Other laboratory findings |
---|---|---|---|---|
Male, 50 y, Vientiane City, central Laos
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Fever, severe headache A- 7 d; contact with cats and dogs 14 d before admission; HIV/AIDS (CD4-count: 34 cell/I1/4L)
|
qPCR: Orientia tsutsugamushi (CSF, blood): negative; Rickettsia spp. (CSF): positive; Rickettsia spp. (blood): negative; R. typhi (CSF, blood): negative –Conventional PCR and sequencing (CSF):Rickettsia spp. 17 kDa; GenBank accession no: KF489454
|
Scrub/murine typhus: IgM/IgG static titers (<1:100; negative)–Spotted fever group: IgM/IgG static titers (1:200; negative) –R. felis: IgM/IgG static titers (<1:128; negative)
|
Increased intracranial pressure (>40 cm H20)–CSF: clear –CSF cellularity: 5 leukocytes/I1/4L (100% lymphocytes) –CSF glucose: 1.1 mmol/L; CSF/blood glucose ratio: 1:5 –CSF protein: 80 mg/L;–CSF Cryptococcus culture: positive/serotyping (PCR/RFLP) C. neoformans var. grubii –HIV rapid tests;† positive
|
Female, 39 y, Luang Namtha, northern Laos
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Fever A- 7 d; diabetes mellitus, treated with glibenclamide; HIV status: unknown
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qPCR: O. tsutsugamushi (eschar, blood): positive; Rickettsia spp. (eschar): positive; R. typhi (eschar): negative –Conventional PCR and sequencing (eschar): Rickettsia spp. 17kDa and sca4; GenBank accession no: KF489455, KF489457
|
Scrub typhus: dynamic IgM/IgG 4-fold rise (1:3,200/1:12,800)–Murine typhus: IgM/IgG static titers (<1:100; negative)–Spotted fever group: IgM/IgG static titers (1:200; negative); –R. felis: IgM/IgG static titers (<1:128; negative)
|
None
|
Male, 13 y, Salavan, southern Laos | Fever A- 7 d, contact with cat, rat, and fleas 14 d before admission; HIV status: unknown | qPCR: O. tsutsugamushi (blood): negative; Rickettsia spp. (blood): positive R. typhi (blood): negative –Conventional PCR and sequencing (blood): Rickettsia spp. 17 kDa GenBank accession no: KF489456 | Data not available | Malaria microscopy: P. falciparum; –Malaria rapid test: P. falciparum ICT Malaria Combo Cassette Test‡: P. falciparum –PCR: dengue fever positive reverse transcription qPCR: positive–Dengue genotyping PCR: serotype 4 |
*qPCR, quantitative PCR; CSF, cerebrospinal fluid; leukocyte; RFLP, restriction fragment length polymorphism; ICT, immunochromatographic test.–†Uni-GoldTM HIV, Trinity Biotech, Ireland; Alere Determine HIV-1/2 Ag/Ab Combo, Alere Medical, Japan.–‡ICT Diagnostics, Cape Town, South Africa.