Febrile Illness in Malaysia— an Analysis of 1,629 Hospitalized Patients

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  • U.S. Army Medical Research Unit and Division of Bacteriology, Institute for Medical Research, U.S. Army Medical Component, Armed Forces Research Institute of Medical Sciences, Kuala Lumpur, Malaysia
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We studied 1,629 febrile patients from a rural area of Malaysia, and made a laboratory diagnosis in 1,025 (62.9%) cases. Scrub typhus was the most frequent diagnosis (19.3% of all illnesses) followed by typhoid and paratyphoid (7.4%); flavivirus infection (7.0%); leptospirosis (6.8%); and malaria (6.2%). The hospital mortality was very low (0.5% of all febrile patients). The high prevalence of scrub typhus in oil palm laborers (46.8% of all febrile illnesses in that group) was confirmed. In rural Malaysia, therapy with chlor-amphenicol or a tetracycline would be appropriate for undiagnosed patients in whom malaria has been excluded. Failure to respond to tetracycline within 48 hours would usually suggest a diagnosis of typhoid, and indicate the need for a change in therapy.

Author Notes

Present address: Glaxo Group Research Ltd., Greenford, Middlesex, U.K.

Lt. Col., RAAMC. Present address: 1st Malaria Research Unit, Ingleburn, N.S.W., Australia.

Present address: “Kerwood House,” Eaton, Retford, Notts. DN 22-OPS, England.

Present address: U.S. Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, Maryland 21701.