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dc.contributor.authorCorinne N. Thompsonen_US
dc.contributor.authorStuart D. Blacksellen_US
dc.contributor.authorDaniel H. Parisen_US
dc.contributor.authorAmit Arjyalen_US
dc.contributor.authorAbhilasha Karkeyen_US
dc.contributor.authorSabina Dongolen_US
dc.contributor.authorAbhishek Girien_US
dc.contributor.authorChristiane Doleceken_US
dc.contributor.authorNick Dayen_US
dc.contributor.authorStephen Bakeren_US
dc.contributor.authorGuy Thwaitesen_US
dc.contributor.authorJeremy Farraren_US
dc.contributor.authorBuddha Basnyaten_US
dc.contributor.otherUniversity of Oxforden_US
dc.contributor.otherWellcome Trusten_US
dc.contributor.otherMahidol Universityen_US
dc.identifier.citationAmerican Journal of Tropical Medicine and Hygiene. Vol.92, No.4 (2015), 875-878en_US
dc.description.abstractCopyright © 2015 by The American Society of Tropical Medicine and Hygiene. Undifferentiated febrile illnesses (UFIs) are common in low- and middle-income countries.We prospectively investigated the causes of UFIs in 627 patients presenting to a tertiary referral hospital in Kathmandu, Nepal. Patients with microbiologically confirmed enteric fever (218 of 627; 34.8%) randomized to gatifloxacin or ofloxacin treatment were previously reported. We randomly selected 125 of 627 (20%) of these UFI patients, consisting of 96 of 409 (23%) cases with sterile blood cultures and 29 of 218 (13%) cases with enteric fever, for additional diagnostic investigations. We found serological evidence of acute murine typhus in 21 of 125 (17%) patients, with 12 of 21 (57%) patients polymerase chain reaction (PCR)-positive for Rickettsia typhi. Three UFI cases were quantitative PCR-positive for Rickettsia spp., two UFI cases were seropositive for Hantavirus, and one UFI case was seropositive for Q fever. Fever clearance time (FCT) for rickettsial infection was 44.5 hours (interquartile range = 26-66 hours), and there was no difference in FCT between ofloxacin or gatifloxacin. Murine typhus represents an important cause of predominantly urban UFIs in Nepal, and fluoroquinolones seem to be an effective empirical treatment.en_US
dc.rightsMahidol Universityen_US
dc.subjectImmunology and Microbiologyen_US
dc.titleUndifferentiated febrile illness in Kathmandu, Nepalen_US
Appears in Collections:Scopus 2011-2015

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