Clinical characteristics of acute Q fever, scrub typhus, and murine typhus with delayed defervescence despite doxycycline treatment

Chung Hsu Lai, Chun Kai Huang, Hui Ching Weng, Hsing Chun Chung, Shiou Haur Liang, Jiun Nong Lin, Chih Wen Lin, Chuan Yuan Hsu, Hsi Hsun Lin

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20 Citations (Scopus)

Abstract

Doxycycline is the recommended antibiotic for acute Q fever, scrub typhus, and murine typhus and defervescence often occurs within 3 days of treatment. Patients with delayed defervescence (> 3 days) are troublesome for clinicians. To investigate the characteristics of such patients, 18 and 88 cases with and without delayed defervescence, respectively, were studied. By univariate analysis, absence of headache (P = 0.004), jaundice (P = 0.030), icteric sclera (P = 0.030), relative bradycardia (P = 0.003), and pulmonary involvement on chest x-ray (P = 0.028) were significant findings in patients with delayed defervescence. By multivariate analysis, absence of headache (odds ratio [OR] = 8.310; 95% confidence interval [CI] = 1.990-34.706, P = 0.004), jaundice (OR = 6.242; 95% CI = 1.374-28.365, P = 0.018), and relative bradycardia (OR = 10.449; 95% CI = 2.137-51.088, P = 0.004) were the independent characteristics of patients with delayed defervescence. In treating acute Q fever, scrub typhus, and murine typhus with doxycycline, clinicians should be aware that delayed defervescence may occur in patients presenting with jaundice, relative bradycardia, and absence of headache.

Original languageEnglish
Pages (from-to)441-446
Number of pages6
JournalAmerican Journal of Tropical Medicine and Hygiene
Volume79
Issue number3
DOIs
Publication statusPublished - 2008 Sep

All Science Journal Classification (ASJC) codes

  • Parasitology
  • Virology
  • Infectious Diseases

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