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Revisiting the Overlooked Infection: Rickettsioses
Khie Chen Lie1, Erni Juwita Nelwan, Adeline Pasaribu
11. Division of Tropical and Infectious Disease, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, Indonesia. 2. Member of Antimicrobial Stewardship Committee, Cipto Mangunkusumo Hospital, Jakarta, Indonesia. drkhiechen@gmail.com.
Acta Medica Indonesiana
|January 10, 2023
Summary
Human Rickettsioses in Indonesia is likely underestimated, with a 10% prevalence in acute fever patients. Early diagnosis and doxycycline treatment are crucial to prevent severe outcomes like sepsis and death.
Area of Science:
- Infectious Diseases
- Medical Entomology
- Public Health
Background:
- Human Rickettsioses prevalence in Indonesia is largely unknown and potentially underestimated.
- High seroprevalence of Rickettsia sp. observed in Indonesian small mammals (vectors) and humans.
- A recent study indicated a 10% prevalence of Rickettsioses among Indonesian patients presenting with acute fever.
Purpose of the Study:
- To highlight the diagnostic challenges and clinical significance of Rickettsioses in Indonesia.
- To emphasize the need for accurate diagnostic tools and appropriate treatment strategies.
- To underscore the importance of raising healthcare provider awareness regarding Rickettsioses.
Main Methods:
- Review of existing literature and recent study findings on Rickettsioses in Indonesia.
- Analysis of diagnostic limitations, including misdiagnosis with other febrile illnesses.
- Evaluation of treatment recommendations, emphasizing macrolides like doxycycline.
Main Results:
- Rickettsioses cases are frequently misdiagnosed as dengue, enteric fever, or leptospirosis due to overlapping symptoms.
- Limited availability of point-of-care diagnostic tests hinders accurate confirmation.
- Untreated Rickettsioses can lead to severe complications, including meningitis, sepsis, and mortality.
Conclusions:
- Accurate diagnosis and prompt treatment, preferably with doxycycline, are essential for managing Rickettsioses.
- Improving healthcare practitioner awareness and diagnostic test availability are critical for disease control.
- Effective management strategies are necessary to prevent severe outcomes and reduce the burden of Rickettsioses in Indonesia.
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