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Epidemiology of the acute fevers of unknown origin in South Vietnam: Effect of laboratory support upon clinical diagnosis
Acute fevers among American servicemen in South Vietnam were studied for a two-year period. The population included 524 patients with an acute fever of unknown origin (acute FUO) of at least four days' duration, and 269 patients who were given a tentative diagnosis of leptospirosis, scrub typhus or an arbovirus infection. Fifty-four per cent of the clinical diagnoses were serologically confirmed and 31 % of the patients with acute FUO were found to be infected with these same agents. Leptospirosis accounted for 20% of these acute fevers; scrub typhus and Japanese encephalitis were also common. Results of viral isolations and serologic testing for enteroviruses, rickettsiae, Toxoplasma, and influenza virus were of limited usefulness in the remaining patients. A correlation between the etiology of the acute FUO, seasonal incidence and environmental exposure was established. Epidemiologic data and laboratory reinforcement of clinical impressions resulted in a marked improvement in the accuracy of the attending physician's clinical diagnoses as the study progressed.
Author Notes
Present address: Department of Tropical Medicine and Medical Microbiology, University of Hawaii School of Medicine, 3675 Kilauea Avenue, Honolulu, Hawaii 96816.
Present address: Naval Medical Research Unit-2, Box 14, APO San Francisco 96263.