OBJECTIVES: To identify different rickettsial infections using a specific immunofluorescent technique in patients clinically diagnosed as 'typhus fever' in the Central Province of Sri Lanka, and to define the clinical picture, assess the severity of infection and to determine the pattern of geographical distribution of the infections of the hospital-based patients. METHODS: A specific indirect immunofluorescent antibody technique was used on the sera of two groups of patients in laboratories in Japan and Thailand. RESULTS: We serodiagnosed infections with Orientia tsutsugamushi, Rickettsia typhi and spotted fever group in 56 of 118 clinically investigated patients. There were eight infections with O. tsutsugamushi, two with R. typhi and 10 spotted fever group patients with IgM antibodies suggestive of acute infection. Nineteen patients had antibodies against these three rickettsial species, suggestive of past exposure, co-infection or cross-reactivity of antigens. Discrete, erythematous maculopapular rash was common to all three types of infection except for five patients who had no rash. Five patients positive for spotted fever antibodies developed fern-leaf type skin necrosis with severe illness. Duration of the febrile period ranged from 4 to 23 days with defervescence occurring after specific antibiotic treatment. CONCLUSIONS: The study has shown the presence of different types of rickettsial infections in the Central Province of Sri Lanka. The characterization of the clinical picture and the severity of infection provide useful information for the proper management of the patients in the future.
OBJECTIVES: To identify different rickettsial infections using a specific immunofluorescent technique in patients clinically diagnosed as 'typhus fever' in the Central Province of Sri Lanka, and to define the clinical picture, assess the severity of infection and to determine the pattern of geographical distribution of the infections of the hospital-based patients. METHODS: A specific indirect immunofluorescent antibody technique was used on the sera of two groups of patients in laboratories in Japan and Thailand. RESULTS: We serodiagnosed infections with Orientia tsutsugamushi, Rickettsia typhi and spotted fever group in 56 of 118 clinically investigated patients. There were eight infections with O. tsutsugamushi, two with R. typhi and 10 spotted fever group patients with IgM antibodies suggestive of acute infection. Nineteen patients had antibodies against these three rickettsial species, suggestive of past exposure, co-infection or cross-reactivity of antigens. Discrete, erythematous maculopapular rash was common to all three types of infection except for five patients who had no rash. Five patients positive for spotted fever antibodies developed fern-leaf type skin necrosis with severe illness. Duration of the febrile period ranged from 4 to 23 days with defervescence occurring after specific antibiotic treatment. CONCLUSIONS: The study has shown the presence of different types of rickettsial infections in the Central Province of Sri Lanka. The characterization of the clinical picture and the severity of infection provide useful information for the proper management of the patients in the future.
Authors: Nalika De Silva; Sarojini Wijesundara; Veranja Liyanapathirana; Vasanthi Thevanesam; John Stenos Journal: Am J Trop Med Hyg Date: 2012-08 Impact factor: 2.345
Authors: Emmanouil Angelakis; Aruna Munasinghe; Iranga Yaddehige; Veranja Liyanapathirana; Vasanthi Thevanesam; Anne Bregliano; Cristina Socolovschi; Sophie Edouard; Pierre Edouard Fournier; Didier Raoult; Philippe Parola Journal: Am J Trop Med Hyg Date: 2012-04 Impact factor: 2.345
Authors: Julie Vallée; Thaksinaporn Thaojaikong; Catrin E Moore; Rattanaphone Phetsouvanh; Allen L Richards; Marc Souris; Florence Fournet; Gérard Salem; Jean-Paul J Gonzalez; Paul N Newton Journal: PLoS Negl Trop Dis Date: 2010-12-07
Authors: R Premaratna; T G A N Chandrasena; R P V J Rajapakse; M E Eremeeva; G A Dasch; N K B K R G W Bandara; H J de Silva Journal: Clin Rheumatol Date: 2009-03-25 Impact factor: 2.980
Authors: Devathri M Nanayakkara; R P V J Rajapakse; Susiji Wickramasinghe; Senanayaka A M Kularatne Journal: Vector Borne Zoonotic Dis Date: 2013-05-13 Impact factor: 2.133
Authors: Rahul Pradhan; Umesh Shrestha; Samir C Gautam; Stephen Thorson; Kabindra Shrestha; Bharat K Yadav; Dominic F Kelly; Neelam Adhikari; Andrew J Pollard; David R Murdoch Journal: PLoS One Date: 2012-10-24 Impact factor: 3.240