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-
1
Tsai C, Kuo C, Chen P, Changcheng C, 1991. Upper gastrointestinal bleeding in dengue fever. Am J Gastroenterol 86 :33–36.
-
2
Bunyavejchevin S, Tanawattanacharoen S, Taechakraichana N, Thisyakorn U, Tannirandorn Y, Limpaphayom K, 1997. Dengue hemorrhagic fever during pregnancy: antepartum, intrapartum and postpartum management. J Obstet Gynaecol Res 23 :445–448.
-
3
Solomon T, Dung NM, Vaughn DW, Kneen R, Thao LT, Raengsakulrach B, Loan HT, Day NP, Farrar J, Myint KS, Warrell MJ, James WS, Nisalak A, White NJ, 2000. Neurological manifestations of dengue infections. Lancet 355 :1053–1059.
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4
Levett PN, Branch SL, Edwards CN, 2000. Detection of dengue infection in patients investigated for leptospirosis in Barbados. Am J Trop Med Hyg 62 :112–114.
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5
Silarug N, Foy HM, Kupradinon S, Rojanasuphol S, Nisalak A, Pongsuwant Y, 1990. Epidemic of fever of unknown origin in rural Thailand, caused by influenza A (H1N1) and dengue fever. Southeast Asian J Trop Med Public Health 21 :61–67.
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6
Silpapojakul K, 1997. Scrub typhus in the Western Pacific region. Ann Acad Med Singapore 26 :794–800.
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7
Innis BL, Nisalak A, Nimmannitya S, Kusalerdchariya S, Chongswasdi V, Suntayakorn S, Puttisri P, Hoke CH, 1989. An enzyme-linked immunosorbent assay to characterize dengue infections where dengue and Japanese encephalitis co-circulate. Am J Trop Med Hyg 40 :418–427.
-
8
Suto T, 1980. Rapid serologic diagnosis of tsutsugamushi disease employing the immunoperoxidase reaction with cell cultured rickettsia. Clin Virol 8 :425–429.
-
9
Nimmannitya S, 1987. Clinical spectrum and management of dengue haemorrhagic fever. Southeast Asian J Trop Med Public Health 18 :392–397.
-
10
Tsay RW, Chang FY, 1998. Serious complications in scrub typhus. J Microbiol Immunol Infect 31 :240–244.
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11
Watt G, Chouriyagune C, Ruangweerayud R, Watcharapichat P, Phulsuksombati D, Jongsakul K, Teja-Isavadharm P, Bhodhidatta D, Corcoran KD, Dasch GA, Strickman D, 1996. Scrub typhus infections poorly responsive to antibiotics in northern Thailand. Lancet 348 :86–89.
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DIFFERENTIATING DENGUE VIRUS INFECTION FROM SCRUB TYPHUS IN THAI ADULTS WITH FEVER
GEORGE WATT
GEORGE WATT
Department of Retrovirology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand; Department of Internal Medicine, Chiangrai Regional Hospital, Chiangrai, Thailand
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KRISADA JONGSAKUL
KRISADA JONGSAKUL
Department of Retrovirology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand; Department of Internal Medicine, Chiangrai Regional Hospital, Chiangrai, Thailand
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CHAROEN CHOURIYAGUNE
CHAROEN CHOURIYAGUNE
Department of Retrovirology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand; Department of Internal Medicine, Chiangrai Regional Hospital, Chiangrai, Thailand
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ROBERT PARIS
ROBERT PARIS
Department of Retrovirology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand; Department of Internal Medicine, Chiangrai Regional Hospital, Chiangrai, Thailand
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Dengue fever and scrub typhus are common infections in Asia that often present as acute febrile illness of unclear etiology. We prospectively evaluated febrile adults presenting to the outpatient department of a hospital in northern Thailand to attempt to identify distinguishing characteristics between the two infections. Fifty-four patients were infected with scrub typhus and 35 were infected with dengue virus. Dengue virus infection was associated with hemorrhagic manifestations, particularly bleeding from the gums, which was reported by 27% of the dengue patients, but by none of the scrub typhus patients (P < 0.001, by Fisher’s exact test). A low platelet count (< 140,000/mm3) and low white blood cell count (< 5,000/mm3) were strongly associated with dengue infections: odds ratio = 26.3 (95% confidence interval [CI] = 7.4–93.2) for platelet count and 8.2 (95% CI = 2.6–25.5) for leukocyte count. Prospective evaluations of the usefulness of these simple criteria to differentiate scrub typhus from dengue infection are needed in other areas, particularly where rapid confirmatory diagnostic tests are not available.
Author Notes
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
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-
1
Tsai C, Kuo C, Chen P, Changcheng C, 1991. Upper gastrointestinal bleeding in dengue fever. Am J Gastroenterol 86 :33–36.
-
2
Bunyavejchevin S, Tanawattanacharoen S, Taechakraichana N, Thisyakorn U, Tannirandorn Y, Limpaphayom K, 1997. Dengue hemorrhagic fever during pregnancy: antepartum, intrapartum and postpartum management. J Obstet Gynaecol Res 23 :445–448.
-
3
Solomon T, Dung NM, Vaughn DW, Kneen R, Thao LT, Raengsakulrach B, Loan HT, Day NP, Farrar J, Myint KS, Warrell MJ, James WS, Nisalak A, White NJ, 2000. Neurological manifestations of dengue infections. Lancet 355 :1053–1059.
-
4
Levett PN, Branch SL, Edwards CN, 2000. Detection of dengue infection in patients investigated for leptospirosis in Barbados. Am J Trop Med Hyg 62 :112–114.
-
5
Silarug N, Foy HM, Kupradinon S, Rojanasuphol S, Nisalak A, Pongsuwant Y, 1990. Epidemic of fever of unknown origin in rural Thailand, caused by influenza A (H1N1) and dengue fever. Southeast Asian J Trop Med Public Health 21 :61–67.
-
6
Silpapojakul K, 1997. Scrub typhus in the Western Pacific region. Ann Acad Med Singapore 26 :794–800.
-
7
Innis BL, Nisalak A, Nimmannitya S, Kusalerdchariya S, Chongswasdi V, Suntayakorn S, Puttisri P, Hoke CH, 1989. An enzyme-linked immunosorbent assay to characterize dengue infections where dengue and Japanese encephalitis co-circulate. Am J Trop Med Hyg 40 :418–427.
-
8
Suto T, 1980. Rapid serologic diagnosis of tsutsugamushi disease employing the immunoperoxidase reaction with cell cultured rickettsia. Clin Virol 8 :425–429.
-
9
Nimmannitya S, 1987. Clinical spectrum and management of dengue haemorrhagic fever. Southeast Asian J Trop Med Public Health 18 :392–397.
-
10
Tsay RW, Chang FY, 1998. Serious complications in scrub typhus. J Microbiol Immunol Infect 31 :240–244.
-
11
Watt G, Chouriyagune C, Ruangweerayud R, Watcharapichat P, Phulsuksombati D, Jongsakul K, Teja-Isavadharm P, Bhodhidatta D, Corcoran KD, Dasch GA, Strickman D, 1996. Scrub typhus infections poorly responsive to antibiotics in northern Thailand. Lancet 348 :86–89.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 516 | 379 | 65 |
| Full Text Views | 717 | 9 | 0 |
| PDF Downloads | 324 | 7 | 0 |