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Rickettsioses as Underrecognized Cause of Hospitalization for Febrile Illness, Uganda
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Rickettsioses as Underrecognized Cause of Hospitalization for Febrile Illness, Uganda
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Journal Article
Rickettsioses as Underrecognized Cause of Hospitalization for Febrile Illness, Uganda
2025
Overview
The complexity of rickettsial serodiagnostics during acute illness has limited clinical characterization in Africa. We used archived samples from sepsis (n = 259) and acute febrile illness (n = 70) cohorts in Uganda to identify spotted fever and typhus group rickettsiae by using immunofluorescence assay and clinically validated rRNA reverse transcription PCR (RT-PCR). Among 329 participants, 10.0% had rickettsial infections (n = 33; n = 20 identified with immunofluorescence assay and n = 13 by RT-PCR). Serum rRNA RT-PCR was 75.0% (95% CI 42.8-94.5%) sensitive and 91.2% (95% CI 85.8-95.1%) specific. Thrombocytopenia was more common among patients with rickettsial infections than with other nonmalarial infections (adjusted odds ratio 3.7; p = 0.003). No participants were on a tetracycline antimicrobial drug at admission. rRNA RT-PCR is a promising diagnostic strategy for identifying acute rickettsial infections. Doxycycline should be included in empiric antimicrobial drug regimens for nonmalarial febrile illness in this region.
Publisher
U.S. National Center for Infectious Diseases,Centers for Disease Control and Prevention
Subject
/ Adult
/ Anti-Bacterial Agents - therapeutic use
/ bacteria
/ Blood
/ Child
/ Doxycycline - therapeutic use
/ Female
/ Fever
/ Hospitalization - statistics & numerical data
/ Humans
/ Infant
/ Malaria
/ Male
/ Reverse Transcriptase Polymerase Chain Reaction
/ Rickettsia - isolation & purification
/ Rickettsia Infections - diagnosis
/ Rickettsia Infections - epidemiology
/ Rickettsia Infections - microbiology
/ RNA
/ Sepsis
/ Serology
/ Typhus
