Study of rickettsia infection in patients suffering from fever of unknown origin

Abstract

Pyrexia of Unknown Origin) is referred to when temperature is observed above 38.3 0 C (101 0 F) on many occasions over a period of > 3 weeks and unable to diagnose despite 1week of thorough investigations. Different studies reported diagnosis of malaria in 5 to 50% cases; leptospirosis in 3 to 10% cases and influenza in 8 to 12% cases Dengue fever and malaria are arthropod born diseases and endemic in many parts of India during the monsoon season. Leptospirosis and scrub typhus are zoonotic infections and are widely prevalent in areas with heavy monsoon and agrarian way of life. Aim : To evaluate the study of various Rickettsia infections in patients suffering from Fever Of Unknown Origin. Objectives: To understand the occurrence of infections caused by rickettsial species in suspected cases of FUO. To increase awareness and clinical suspicion among doctors for these infections. Materials and Methods: The assay was performed using P.vulgaris OX19, OX2, OXK strains according to manufacture's instructions by tube method. Serum will be diluted from 1/20 to 1/640 titer. A single Weil Felix titer of >1:160 or fourfold rise in titers on repeat testing starting from 1:40 will be accepted as a positive result. Result: A total 100 cases were including in my study in which 28 cases were positive. Out of 28 positive rickettsial samples, females were 17 and males were 11. Spotted Fever(9), Endemic Fever(8), Epidemic Fever(7), Scrub Typhus Fever(4). Conclusion:With the growing number of cases detected in India, scrub typhus is fast emerging as a public health threat and also due to limited diagnostics leading to underreporting, Weil Felix test could be used in adjunct with Enzyme-linked immunosorbent assay and blood parameters in the diagnosis of rickettsial diseases.