Murine Typhus and Leptospirosis as Causes of Acute Undifferentiated Fever, Indonesia

Gasem, Muhammad Hussein; Wagenaar, Jiri F. P.; Goris, Marga G. A.; Adi, Mateus Sakundarno; Isbandrio, Bambang; Hartskeerl, Rudy A.; Rolain, Jean‐Marc; Raoult, Didier; Gorp, Eric C. M. Van

doi:10.3201/eid1506.081405

Cited by 47 publications

(45 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…4,11,12 In this country, recent investigations of 137 patients with fever have led to the diagnosis of murine typhus in 6.5% of cases. 16 Tunisia is also known to pose a risk for autochthonous murine typhus, although the disease is underdiagnosed or frequently misdiagnosed. 7 Others destinations have also been associated with murine typhus in travelers, including Mediterranean countries such as Crete, Spain, Italy, Cyprus, and Egypt.…”

Section: Discussionmentioning

confidence: 99%

“…However, in 22% of the travelers, the fever was classified as an unspecified febrile illness. 10 Murine typhus has been described as a major cause of acute undifferentiated fever in Indonesia 16 and as a cause of fever of unknown origin. A 2-year prospective study conducted in Vientiane, Laos, identified acute rickettsial infections as the cause of fever in 27% of adults who were both blood-culture and malariasmear negative.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Murine Typhus in Returned Travelers: A Report of Thirty-Two Cases

Walter¹,

Botelho-Nevers²,

Socolovschi³

et al. 2012

The American Society of Tropical Medicine and Hygiene

Self Cite

View full text Add to dashboard Cite

Abstract. Murine typhus, caused by Rickettsia typhi and transmitted mainly by the rat fleas, Xenopsylla cheopis, has emerged in the field of travel medicine. We analyzed retrospectively the epidemiological, clinical, and biological characteristics of the 32 murine typhus cases that were diagnosed during the past 3 years at the World Health Organization Collaborative Center for Rickettsial diseases, Marseille, France. All of the cases occurred in travelers and most of them had returned from Africa (N = 13 of 32) and South-east Asia (N = 12 of 32). Exposure to rats was reported only in a few (N = 2 of 32) patients. Almost half of the cases were diagnosed in August and September. Only four patients presented the classic triad: fever, rash, and headache. Moreover, we report the first known cases of a hemophagocytic syndrome associated with this disease. Murine typhus must be considered as an etiologic agent of febrile illness in returning travelers, particularly in those with unspecific symptoms.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Murine Typhus in Returned Travelers: A Report of Thirty-Two Cases

Walter¹,

Botelho-Nevers²,

Socolovschi³

et al. 2012

The American Society of Tropical Medicine and Hygiene

Self Cite

View full text Add to dashboard Cite

show abstract

“…Some ceratophyllid fleas are vectors of zoonotic pathogens such as Rickettsia typhi , which causes murine (=endemic or flea‐borne) typhus and/or Yersinia pestis , which causes plague (Traub et al ., ). Foci for both of these diseases exist in Java (Baltazard & Bahmanyar, ; Gasem et al ., ). While it is unlikely that any of the new species of Macrostylophora described in this paper would bite humans, they could serve as enzootic vectors of these pathogens between ground squirrels (and perhaps also between murid rodents).…”

Section: Discussionmentioning

confidence: 97%

Three new species of fleas belonging to the genus Macrostylophora from the three‐striped ground squirrel, Lariscus insignis, in Java

Durden

Beaucournu

2014

Medical Vet Entomology

View full text Add to dashboard Cite

Three new species of fleas belonging to the genus Macrostylophora (Siphonaptera, Ceratophyllidae) are described from the three-striped ground squirrel, Lariscus insignis, from Tjibodas, West Java (Jawa Barat), Indonesia at an elevation of 1500 m. Macrostylophora larisci sp. n. is described from three male specimens, Macrostylophora debilitata sp. n. is described from one male and Macrostylophora wilsoni sp. n. is described from one female. Non-genital morphological characters of the female specimen, including ctenidial spine shapes and lengths, show that it is not the corresponding female for either M. larisci sp. n. or M. debilitata sp. n. It is unusual for three different species of congeneric fleas to parasitize the same host species in the same geographical location. These three new species represent the first known records of Macrostylophora from Java and they could be enzootic vectors between rodents of flea-borne zoonotic pathogens such as Rickettsia typhi and Yersinia pestis, both of which are established on Java. A list is provided of the 43 known species and 12 subspecies of Macrostylophora together with their known geographical distributions and hosts. A map depicting the distributions of known Indonesian (and Bornean) species of Macrostylophora is also included.

show abstract

“…A hospital- hospitals. It is unclear if these cases were due to R. typhi (10). As part of a dengue vaccine study,…”

Section: Discussionmentioning

confidence: 99%

Underdiagnoses of Rickettsia in patients hospitalized with acute fever in Indonesia: Observational study results

Lokida¹,

Hadi

Lau

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Reports of human rickettsial infection in Indonesia are limited. This study sought to characterize the epidemiology of human rickettsioses amongst patients hospitalized with fever at 8 tertiary hospitals in Indonesia. Methods: Acute and convalescent blood from 975 hospitalized non-dengue patients was tested for Rickettsia IgM and IgG by ELISA. Specimens from cases with seroconversion or increasing IgM and/or IgG titers were tested for Rickettsia IgM and IgG by IFA and Rickettsia genomes using primers for Rickettsia (R.) sp , R . typhi , and Orientia tsutsugamushi . Testing was performed retrospectively on stored specimens; results did not inform patient management. Results: R . typhi, R. rickettsii , and O. tsutsugamushi IgG antibodies were identified in 269/872 (30.8%), 36/634 (5.7%), and 19/504 (3.8%) of samples, respectively. For the 103/975 (10.6%) nondengue patients diagnosed with acute rickettsial infection, presenting symptoms included nausea (72%), headache (69%), vomiting (43%), lethargy (33%), anorexia (32%), arthralgia (30%), myalgia (28%), chills (28%), epigastric pain (28%), and rash (17%). No acute rickettsioses cases were suspected during hospitalization. Discharge diagnoses included typhoid fever (44), dengue fever (20), respiratory infections (7), leptospirosis (6), unknown fever (6), sepsis (5), hepatobiliary infections (3), UTI (3), and others (9). Fatalities occurred in 7 (6.8%) patients, mostly with co-morbidities.Conclusions: Rickettsial infections are consistently misdiagnosed, often as leptospirosis, dengue, or Salmonella typhi infection. Clinicians should include rickettsioses in their differential diagnosis of fever to guide empiric management; laboratories should support evaluation for rickettsial etiologies;and public policy should be implemented to reduce burden of disease.

show abstract

Murine Typhus and Leptospirosis as Causes of Acute Undifferentiated Fever, Indonesia

Cited by 47 publications

References 14 publications

Murine Typhus in Returned Travelers: A Report of Thirty-Two Cases

Murine Typhus in Returned Travelers: A Report of Thirty-Two Cases

Three new species of fleas belonging to the genus Macrostylophora from the three‐striped ground squirrel, Lariscus insignis, in Java

Underdiagnoses of Rickettsia in patients hospitalized with acute fever in Indonesia: Observational study results

Contact Info

Product

Resources

About