Volume 9, Number 5—May 2003
Dispatch
Emerging Rickettsioses of the Thai-Myanmar Border1
Philippe Parola*†‡, R. Scott Miller*, Philip McDaniel§, Sam R. Telford‡, Jean-Marc Rolain†, Chansuda Wongsrichanalai*, and Didier Raoult†
Table
Clinical and laboratory data of patients with rickettsioses on the Thai-Myanmar border.
| Patient no. | Age/sex | A. bite | Clinical signs accompanying fever | Immunofluorescence serologic testinga IgG/IgM early IgG/IgM late | ||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| R |
E |
N |
Other |
SFG rickettsia antigens |
R. typhi antigen |
Orientia tsutsugamushi |
||||||||||||||
| Rh |
Rc |
Rjap |
Rhon |
Rslo |
AT1 |
Rheil |
Rfel |
G |
Kw |
Kp |
K |
|||||||||
| Scrub typhus |
||||||||||||||||||||
| 1 |
29/M |
Not noticed |
No |
No |
Yes |
Headache, stupor, meningism, thrombocytopenia,
↑ALT |
0/16
0/16 |
0/0
0/0 |
0/16
0/16 |
0/8
0/8 |
0/0
0/0 |
0/0
0/0 |
0/0
0/0 |
0/0
0/0 |
0/0
0/0 |
0/32
256/32 |
0/8
0/8 |
0/8
256/32 |
0/0
0/0 |
|
| 2 |
50/F |
Yes |
Yesb |
Yes |
No |
Chills, myalgia, vomiting, thrombocytopenia,
↑GGT ↑ALT |
0/32
0/32 |
0/0
0/0 |
0/32
0/32 |
0/16
0/16 |
0/0
0/0 |
0/0
0/0 |
0/0
0/0 |
0/0
0/0 |
0/0
0/0 |
128/64
128/16 |
0/0
0/0 |
0/0
0/0 |
0/0
0/0 |
|
| 3 |
32/M |
Yes |
No |
No |
Yes |
Headache, myalgia, cough, thrombocytopenia,
↑GGT ↑ALT |
0/16
16/16 |
0/0
0/0 |
0/0
16/16 |
0/8
0/8 |
0/0
0/0 |
0/0
0/0 |
0/0
0/0 |
0/0
0/0 |
0/0
0/0 |
0/0
512/128 |
0/0
0/0 |
0/0
512/0 |
0/0
0/0 |
|
| Murine typhus |
||||||||||||||||||||
| 4 |
28/F |
No |
No |
No |
Chills, headache, vomiting, myalgia, cough, thrombocytopenia |
16/128e
16/64e |
16/64
16/64 |
16/8
0/0 |
16/16
16/64 |
16/16
16/8 |
0/0
0/0 |
0/32
0/8 |
0/0
0/0 |
64/128e
32/32e |
0/0
0/0 |
0/0
0/0 |
0/0
0/0 |
0/0
0/0 |
||
| 5 |
35/M |
Not noticed |
No |
No |
No |
Chills, headache,
↑ALT |
0/64
16/128 |
0/64
16/256 |
0/8
0/8 |
0/64
0/64 |
0/0
0/0 |
0/0
0/0 |
0/32
0/128 |
0/0
0/0 |
16/256
512/256 |
0/0
0/0 |
0/0
0/0 |
0/0
0/0 |
0/0
0/0 |
|
| 6 |
37/F |
Not noticed |
No |
No |
No |
Chills, headache, myalgia, vomiting, thrombocytopenia,
↑GGT ↑ALT |
16/64
128/64 |
32/8
32/0 |
0/0
32/0 |
16/0
128/0 |
16/0
128/8 |
0/0
32/8 |
0/0
32/0 |
0/0
0/0 |
64/8
512/256 |
0/0
0/0 |
0/0
0/0 |
0/0
0/0 |
0/0
0/0 |
|
| 7 |
20/F |
Not noticed |
No |
No |
No |
Headache, back pain |
0/128
16/64 |
0/64
0/64 |
0/0
0/64 |
0/32
0/64 |
0/0
0/164 |
0/0
0/8 |
0/0
0/0 |
0/0
0/0 |
0/64
128/256 |
0/0
0/0 |
0/0
0/0 |
0/0
0/0 |
0/0
0/0 |
|
| SFG rickettsioses |
||||||||||||||||||||
| 8 |
70/F |
No |
No |
No |
Chills, headache, vomiting, hepatomegaly, leukopenia |
0/32
32/32 |
0/32
32/32 |
0/0
0/0 |
0/8
16/8 |
0/0
0/0 |
0/0
0/0 |
0/0
0/0 |
0/0
1024/256d |
0/0
0/256d |
0/0
0/0 |
0/0
0/0 |
0/0
0/0 |
0/0
0/0 |
||
| 9 |
50/M |
Not noticed |
Yesc |
Yes |
Yes |
Chills, abdominal
pain, confusion, thrombocytopenia |
64/8d
64/16 |
128/16d
128/16 |
32/0d
32/0 |
32/0d
64/0 |
32/0d
128/0 |
0/0
0/0 |
16/0d
32/8 |
0/0
0/0 |
0/0
0/0 |
0/0
0/0 |
0/0
0/0 |
0/0
0/0 |
0/0
0/0 |
|
| 10 |
45/M |
No |
No |
Yes |
Vomiting, diarrhea, hepato-splenomegaly |
16/32d
64/32 |
64/32d
64/32 |
16/32d
32/16 |
16/0d
32/16 |
16/16d
16/16 |
0/0
0/0 |
16/8d
32/16 |
0/0
0/0 |
0/16d
16/32 |
0/0
0/0 |
0/0
0/0 |
0/0
0/0 |
0/0
0/0 |
||
| 11 |
35/M |
Tick bite |
No |
Yes |
No |
Chills, headache, vomiting, myalgia, cough, splenomegaly,
↑GGT ↑ALT |
64/256
16/128 |
0/16
16/32 |
16/8
0/8 |
16/256
16/128 |
0/64
0/64 |
0/32
16/8 |
32/32
0/16 |
0/0
0/0 |
0/256
0/256 |
0/0
0/0 |
0/0
0/0 |
0/0
0/0 |
0/0
0/0 |
|
| 12 |
37/F |
A. removed from ear |
No |
No |
No |
Chills, headache, vomiting, myalgia, cough, ↑GGT ↑ALT |
0/16
128/32 |
0/0
0/0 |
0/0
64/0 |
0/0
32/16 |
0/0
16/32 |
0/8
0/0 |
0/8
32/16 |
0/0
0/0 |
0/32
0/64 |
0/0
0/0 |
0/0
0/0 |
0/0
0/0 |
0/0
0/0 |
|
| 13 |
20/F |
Tick bite |
No |
Yes |
No |
Headache, chills, myalgia |
32/16d
64/16 |
32/0d
32/0 |
32/0d
64/0 |
64/0d
128/0 |
32/8d
64/8 |
0/0
0/0 |
0/0
0/0 |
32/0d
64/0 |
0/0 |
512/0
512/0 |
0/0 |
0/0 |
0/0 |
|
| 14 |
55/F |
No |
No |
No |
Chills, headache, myalgia, diarrhea, thrombocytopenia |
16/32
128/16 |
16/16
16/16 |
16/16
16/16 |
16/16
16/16 |
16/16
64/0 |
16/16
16/16 |
16/0
64/0 |
32/0
64/0 |
0/0
0/0 |
0/0
0/0 |
0/0
0/0 |
0/0
0/0 |
0/0
0/0 |
||
| 15 | 29/M | Yesb | No | No | Chills, headache, myalgia, cough, thrombocytopenia, ↑GGT ↑ALT | 16/16 64/64d | 16/16 32/32d | 32/16 32/32d | 32/16 32/32d | 16/0 64/64d | 32/16 32/32d | 16/0 64/64d | 16/16 64/64d | 0/0 0/0 | 256/0 256/0 | 256/0 256/0 | 0/0 0/0 | 0/0 0/0 | ||
Abbreviations: A., arthropod; Ig, immunoglobulin; R, rash; E, eschar; N, nodes; Rh, Rickettsia helvetica; Rc, R. conorii Indian; Rjap, R. japonica; Rhon, R. honei; Rslo, R. slovaca; AT1, Rickettsia strain AT1 from Japan; Rheil, “R. heilongjiangii”; Rfel, R. felis; G, strain Gilliam; Kw, strain Kawazaki; Kp, strain Karp; Ko, strain Kato.
aImmunofluorescence assay was completed by Western blot and cross-adsorption as described in the text. For typhus and spotted fever group antigens, the rickettsia considered potentially responsible for the infection are in bold type.
bMaculopapular over chest and back.
cVesiculous on the legs.
dAntigens and sera used for Western blot assays.
eAntigens and sera used for Western blot and cross-adsorption assays.
1These results were presented in part at the 3rd International Conference on Emerging Infectious Diseases, March 24–27, 2002, Atlanta, Georgia, USA.
Page created: December 08, 2010
Page updated: December 08, 2010
Page reviewed: December 08, 2010
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