First Cases of Spotted Fever Group Rickettsiosis in Thailand

Thira SirisanthanaFaculty of Medicine, Chiang Mai University, Armed Forces Research Institute of Medical Sciences, Naval Medical Research Institute, Chiang Mai, Thailand

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Virat PinyopornpanitFaculty of Medicine, Chiang Mai University, Armed Forces Research Institute of Medical Sciences, Naval Medical Research Institute, Chiang Mai, Thailand

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Virat SirisanthanaFaculty of Medicine, Chiang Mai University, Armed Forces Research Institute of Medical Sciences, Naval Medical Research Institute, Chiang Mai, Thailand

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Daniel StrickmanFaculty of Medicine, Chiang Mai University, Armed Forces Research Institute of Medical Sciences, Naval Medical Research Institute, Chiang Mai, Thailand

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Daryl J. KellyFaculty of Medicine, Chiang Mai University, Armed Forces Research Institute of Medical Sciences, Naval Medical Research Institute, Chiang Mai, Thailand

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Gregory A. DaschFaculty of Medicine, Chiang Mai University, Armed Forces Research Institute of Medical Sciences, Naval Medical Research Institute, Chiang Mai, Thailand

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The first three cases of spotted fever group rickettsiosis from Thailand are reported. The patients presented with fever, headache, lymphadenopathy, and petechial maculopapular rash. One patient also had an eschar and overt evidence of confusion. An indirect fluorescent antibody test, an indirect immunoperoxidase test, and an enzyme-linked immunosorbent assay demonstrated a broad, strong reactions of the sera of the patients with spotted fever group rickettsia antigens of many species, but not with antigens of typhus or scrub typhus rickettsiae. All three patients responded to treatment with a single dose of doxycycline.

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