Lyon DM, 1927. The relation of pulse-rate to temperature in febrile conditions. Q J Med 20 :205–218.
Greisman SE, 1991. Cardiovascular alterations during fever. Mackowiak PA, ed. Fever: Basic Mechanisms and Management. New York: Raven Press, 143–165.
Altschule MD, Freedberg AS, McManus MJ, 1945. Circulation and respiration during an episode of chill and fever in man. J Clin Invest 24 :878–889.
Moser KM, Perry RB, Luchsinger PC, 1963. Cardiopulmonary consequences of pyrogen-induced hyperpyrexia in man. J Clin Invest 42 :626–633.
Suffredini AF, Fromm RE, Parker MM, Brenner M, Kovacs JA, Wesley RA, Parrillo JE, 1989. The cardiovascular response of normal humans to the administration of endotoxin. N Engl J Med 321 :280–287.
Pernerstorfer T, Schmid R, Bieglmayer C, Eichler HG, Kapiotis S, Jilma B, 1999. Acetaminophen has greater antipyretic efficacy than aspirin in endotoxemia: a randomized, double-blind, placebo-controlled trial. Clin Pharmacol Ther 66 :51–57.
El-Newihi HM, Alamy ME, Reynolds TB, 1996. Salmonella hepatitis: analysis of 27 cases and comparison with acute viral hepatitis. Hepatology 24 :516–519.
Ostergaard L, Huniche B, Andersen PL, 1996. Relative bradycardia in infectious diseases. J Infect 33 :185–191.
Wittesjo B, Bjornham A, Eitrem R, 1999. Relative bradycardia in infectious diseases. J Infect 39 :246–247.
Cunha BA, 2000. The diagnostic significance of relative bradycardia in infectious disease. Clin Microbiol Infect 6 :633–634.
Amano K, Tamura A, Ohashi N, Urakami H, Kaya S, Fukushi K, 1987. Deficiency of peptidoglycan and lipopolysaccharide components in Rickettsia tsutsugamushi. Infect Immun 55 :2290–2292.
Machella TE, Forrester JS, 1945. Mite or scrub typhus: a clinical and laboratory study of 64 cases. Am J Med Sci 38 :38–61.
Sayen JJ, Pond HS, Forrester JS, Wood FC, 1946. Scrub typhus in Assam and Burma: a clinical study of 616 cases. Medicine (Baltimore) 25 :155.
Hazlett DR, 1970. Scrub typhus in Vietnam: experience at the 8th Field Hospital. Mil Med 135 :31–34.
Fang RC, Lin WP, Chao PS, Kuo NT, Chen CM, 1975. Clinical observations of scrub typhus on Penghu (the Pescadores Islands). Trop Geogr Med 27 :143–150.
Watt G, Kantipong P, Jongsakul K, Watcharapichat P, Phulsuksombati D, Strickman D, 2000. Doxycycline and rifampicin for mild scrub-typhus infections in northern Thailand: a randomised trial. Lancet 356 :1057–1061.
House D, Chinh NT, Hien TT, Parry CP, Ly NT, Diep TS, Wain J, Dunstan S, White NJ, Dougan G, Farrar JJ, 2002. Cytokine release by lipopolysaccharide-stimulated whole blood from patients with typhoid fever. J Infect Dis 186 :240–245.
Karjalainen J, Viitasalo M, 1986. Fever and cardiac rhythm. Arch Intern Med 146 :1169–1171.
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We investigated 100 febrile patients infected with Orientia tsutsugamushi (the etiologic agent of scrub typhus) for the presence of relative bradycardia, defined as in increase in heart rate of < 10 beats/minutes/1°C increase in temperature. The median heart rate response for the entire febrile scrub typhus population was 9.3 beats/minute/°C and the prevalence of relative bradycardia was 53%. The occurrence of relative bradycardia was independent of patient age or gender. There were no differences in median basal temperature or febrile temperature between those patients exhibiting relative bradycardia and those with a normal febrile pulse increase. However, febrile patients with relative bradycardia had a significantly higher resting pulse rate following recovery from infection than did patients who had a normal pulse increase during their illness. These data demonstrate that relative bradycardia frequently accompanies mild infection with O. tsutsugamushi and that baseline cardiovascular parameters may affect the febrile heart rate response to scrub typhus.