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Imported rickettsioses in German travelers
A Marschang1, H D Nothdurft, S Kumlien
1Abteilung für Infektions- und Tropenmedizin, Klinikum Innenstadt der Universität, München, Germany.
Infection
|March 1, 1995
Summary
Imported rickettsial diseases like boutonneuse fever and scrub typhus present with fever and lymphadenopathy. Travel history is crucial for diagnosing these challenging rickettsioses.
Area of Science:
- Infectious Diseases
- Travel Medicine
- Clinical Microbiology
Background:
- Rickettsioses are tick- and mite-borne bacterial infections posing diagnostic challenges.
- Imported cases highlight the need for awareness in non-endemic regions.
Purpose of the Study:
- To analyze retrospectively imported rickettsiosis cases in Germany.
- To identify key clinical and laboratory features for diagnosis.
Main Methods:
- Retrospective analysis of 22 imported rickettsiosis cases over 5 years.
- Review of travel histories, symptoms, clinical findings, and laboratory data.
Main Results:
- Boutonneuse fever (18 cases) and scrub typhus (3 cases) were most common.
- Fever (91%), headache (64%), and lymphadenopathy (65%) were prevalent symptoms.
- Eschar (55% for R. conori) and rash (33% for R. conori, 100% for R. tsutsugamushi) were observed.
- Elevated ESR (73%) was common; other lab findings were less consistent.
- Incubation periods ranged from 5-28 days for R. conori and 7-21 days for R. tsutsugamushi.
Conclusions:
- Rickettsiosis diagnosis is challenging due to non-specific symptoms and limited lab utility.
- A detailed travel history is essential for suspecting and diagnosing rickettsial infections.
- Prompt antibiotic treatment (tetracyclines) leads to cure, though relapses can occur.