1921
Volume 79, Issue 3
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

Doxycycline is the recommended antibiotic for acute Q fever, scrub typhus, and murine typhus and defervescence often occurs within 3 days of treatment. Patients with delayed defervescence (> 3 days) are troublesome for clinicians. To investigate the characteristics of such patients, 18 and 88 cases with and without delayed defervescence, respectively, were studied. By univariate analysis, absence of headache ( = 0.004), jaundice ( = 0.030), icteric sclera ( = 0.030), relative bradycardia ( = 0.003), and pulmonary involvement on chest x-ray ( = 0.028) were significant findings in patients with delayed defervescence. By multivariate analysis, absence of headache (odds ratio [OR] = 8.310; 95% confidence interval [CI] = 1.990–34.706, = 0.004), jaundice (OR = 6.242; 95% CI = 1.374–28.365, = 0.018), and relative bradycardia (OR = 10.449; 95% CI = 2.137–51.088, = 0.004) were the independent characteristics of patients with delayed defervescence. In treating acute Q fever, scrub typhus, and murine typhus with doxycycline, clinicians should be aware that delayed defervescence may occur in patients presenting with jaundice, relative bradycardia, and absence of headache.

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  • Received : 13 Apr 2008
  • Accepted : 11 Jun 2008

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