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Scrub typhus and rickettsial diseases in international travelers: a review

Edward F Hendershot1, Daniel J Sexton

  • 1Division of Infectious Diseases, Box 3281, Duke University Medical Center, Durham, NC 27710, USA. ted.hendershot@duke.edu

Current Infectious Disease Reports
|December 20, 2008
PubMed

Insights

Diagnosing rickettsial diseases in febrile travelers is challenging due to varied symptoms and diagnostic limitations. Early recognition and prompt treatment are crucial for better outcomes in imported rickettsial infections.

Area of Science:

  • Infectious Diseases
  • Travel Medicine
  • Rickettsial Infections

Background:

  • Physicians face challenges diagnosing over 16 rickettsial diseases in febrile travelers.
  • Current diagnostic tools lack the timeliness needed for effective intervention.
  • Distinguishing rickettsial from non-rickettsial illnesses is critical for patient management.

Purpose of the Study:

  • To review the English-language literature on imported rickettsial diseases in international travelers.
  • To outline key clinical principles for diagnosing and treating these illnesses.
  • To aid clinicians in managing febrile returned travelers.

Main Methods:

  • Systematic review of English-language literature.
  • Analysis of clinical features, diagnostic challenges, and treatment strategies.
  • Focus on imported rickettsial diseases in international travelers.

Main Results:

  • Rickettsial disease onset is typically shortly before or after travel.
  • Illnesses starting over 18 days post-travel are less likely rickettsial.
  • Absence of rash or vector exposure does not rule out rickettsial disease.

Conclusions:

  • Consider rickettsial disease in febrile travelers, even without typical signs.
  • If empiric therapy fails to reduce fever within 48 hours, consider alternative diagnoses.
  • Timely diagnosis and treatment are essential for managing imported rickettsial infections.

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