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Volume 24, Number 9—September 2018
Synopsis

Distinguishing Japanese Spotted Fever and Scrub Typhus, Central Japan, 2004– 2015

Eiichiro Sando, Motoi SuzukiComments to Author , Shungo Katoh, Hiromi Fujita, Masakatsu Taira, Makito Yaegashi, and Koya Ariyoshi
Author affiliations: Nagasaki University, Nagasaki, Japan (E. Sando, M. Suzuki, S. Katoh, K. Ariyoshi); Kameda Medical Center, Kamogawa, Japan (E. Sando, M. Yaegashi); Mahara Institute of Medical Acarology, Anan, Japan (H. Fujita); Chiba Prefectural Institute of Public Health, Chiba, Japan (M. Taira)

Main Article

Table 2

Clinical characteristics of patients with JSF, ST, and nonrickettsial diseases, central Japan, 2004–2015*

             Characteristic
              JSF, 
no. (%), n = 31
              ST, 
no. (%), 
n = 188
              Non-R, no. (%), n = 97
             JSF vs. non-R†
              ST vs. non-R†
              JSF vs. ST‡
             OR (95% CI)
              p value
              OR (95% CI)
              p value
              OR (95% CI)
              p value
             Chief complaint
             Fever              26 (84)              135 (72)              78 (80)              1.3 (0.4–3.7)              0.668              0.6 (0.3–1.1)              0.115              2.0 (0.7–5.6)              0.165
             Rash              14 (45)              52 (28)              17 (18)              3.9 (1.6–9.3)              0.003              1.8 (1.0–3.3)              0.06              2.2 (1.0–4.7)              0.053
             Eschar              0 (0)              5 (3)              1 (1)              Not applicable              1.000§              2.6 (0.3–22.8)              0.382              Not applicable              1.000§
             Headache              1 (3)              29 (15)              5 (5)              0.6 (0.1–5.5)              0.661              3.4 (1.3–9.0)              0.016              0.2 (0–1.4)              0.101
             Fatigue
              3 (10)
              35 (19)
              6 (6)
              1.6 (0.4–6.9)
              0.511
             3.5 (1.4–8.6)
              0.007
             0.5 (0.1–1.6)
              0.233
             At history collection
             Fever              27 (87)              148 (82)              81 (84)              1.3 (0.4–4.1)              0.712              0.8 (0.4–1.6)              0.586              1.5 (0.5–4.6)              0.473
             Rash              18 (60)              74 (44)              24 (26)              4.3 (1.8–10.1)              0.001              2.2 (1.3–3.8)              0.099              2.0 (0.9–4.3)              0.664
             Eschar              1 (4)              20 (12)              5 (6)              0.6 (0.1–5.5)              0.664              2.1 (0.8–5.9)              0.141              0.3 (0–2.2)              0.232
             Headache              4 (25)              75 (56)              27 (59)              0.2 (0.1–0.8)              0.026              0.9 (0.5–1.8)              0.748              0.3 (0.1–0.9)              0.026
             Fatigue
              17 (94)
              97 (84)
              32 (94)
              1.1 (0.1–12.6)
              0.962
             0.3 (0.1–1.4)
              0.138
             3.3 (0.4–26.5)
              0.256
             Physical examination findings
             BT >37.5°C              23 (74)              132 (73)              53 (59)              2.0 (0.8–5.0)              0.132              1.9 (1.1–3.2)              0.02              1.1 (0.4–2.5)              0.883
             Hypotension¶              8 (26)              12 (6)              5 (5)              6.4 (1.9–21.4)              0.003              1.3 (0.4–3.7)              0.679              5.1 (1.9–13.8)              0.001
             Heart rate 
>120 bpm              2 (7)              13 (8)              6 (7)              0.9 (0.2–4.9)              0.942              1.2 (0.4–3.2)              0.777              0.8 (0.2–3.8)              0.793
             Respiratory rate 
>20/min              13 (54)              40 (39)              23 (45)              1.4 (0.5–3.8)              0.464              0.8 (0.4–1.5)              0.457              1.9 (0.8–4.6)              0.174
             Altered mental 
status              5 (16)              14 (7)              15 (15)              1.1 (0.3–3.2)              0.929              0.4 (0.2–1.0)              0.038              2.4 (0.8–7.2)              0.121
             Rash              30 (100)              181 (96)              52 (57)              Not applicable              <0.001§              19.4 (8.2–45.9)              <0.001              Not applicable              0.597§
             Localized              0              3 (2)              6 (12)              Not applicable              0.079§              0.1 (0–0.5)              0.004              Not applicable              1.000§
             Purpura              11 (44)              4 (2)              7 (8)              8.9 (2.9– 26.8)              <0.001              0.2 (0.1–0.9)              0.028              36.1 
(10.1–128.3)              <0.001
             Palms/soles              21 (84)              13 (7)              4 (5)              101.1 
(23.3– 438.4)              0.001              1.4 (0.5–4.6)              0.537              70.3 
(21.0–235.3)              <0.001
             Eschar              24 (89)              163 (87)              18 (22)              28.0 
(7.6– 103.7)              <0.001              23.8 
(12.1–46.8)              <0.001              1.2 (0.3–4.2)              0.801
             Lung involvment#              8 (26)              21 (11)              9 (9)              3.4 (1.2–9.8)              0.023              1.2 (0.5–2.8)              0.622              2.8 (1.1–7.0)              0.031

             *BT, body temperature; involve, involvement; JSF, Japanese spotted fever; non-R, nonrickettsial diseases; OR, odds ratio; ST, scrub typhus.
             †Non-R = reference.
             ‡ST = reference.
             §Fisher exact tests.
             ¶Systolic blood pressure <90 mm Hg or vasopressor usage.
             #Lung rales with pulmonary infiltrative shadow.

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Page created: August 17, 2018
Page updated: August 17, 2018
Page reviewed: August 17, 2018
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