{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T20:23:59Z","timestamp":1789590239525,"version":"build-2803163510"},"reference-count":41,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2015,5,6]]},"abstract":"<jats:p>A descriptive study on rickettsiosis was conducted at the largest referral hospital in Hanoi, Vietnam, to identify epidemiological and clinical characteristics of specific rickettsiosis. Between March 2001 and February 2003, we enrolled 579 patients with acute undifferentiated fever (AUF), excluding patients with malaria, dengue fever, and typhoid fever, and serologically tested for <jats:italic>Orientia tsutsugamushi<\/jats:italic> and <jats:italic>Rickettsia typhi<\/jats:italic>. Of the patients, 237 (40.9%) and 193 (33.3%) had scrub and murine typhus, respectively, and 149 (25.7%) had neither of them (non\u2013scrub and murine typhus [non-ST\/MT]). The proportion of murine typhus was highest among patients living in Hanoi whereas that of scrub typhus was highest in national or regional border areas. The presence of an eschar, dyspnea, hypotension, and lymphadenopathy was significantly associated with a diagnosis of scrub typhus (OR = 46.56, 10.90, 9.01, and 7.92, respectively). Patients with murine typhus were less likely to have these findings but more likely to have myalgia, rash, and relative bradycardia (OR = 1.60, 1.56, and 1.45, respectively). Scrub typhus and murine typhus were shown to be common causes of AUF in northern Vietnam although the occurrence of spotted fever group rickettsiae was not determined. Clinical and epidemiological information may help local clinicians make clinical diagnosis of specific rickettsioses in a resource-limited setting.<\/jats:p>","DOI":"10.4269\/ajtmh.14-0806","type":"journal-article","created":{"date-parts":[[2015,3,17]],"date-time":"2015-03-17T03:06:50Z","timestamp":1426561610000},"page":"972-978","source":"Crossref","is-referenced-by-count":62,"title":["Clinical and Epidemiological Characteristics of Scrub Typhus and Murine Typhus among Hospitalized Patients with Acute Undifferentiated Fever in Northern Vietnam"],"prefix":"10.4269","volume":"92","author":[{"given":"Sugihiro","family":"Hamaguchi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ngo Chi","family":"Cuong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doan Thu","family":"Tra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yen Hai","family":"Doan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenta","family":"Shimizu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nguyen Quang","family":"Tuan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lay-Myint","family":"Yoshida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Le Quynh","family":"Mai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dang","family":"Duc-Anh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuji","family":"Ando","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiro","family":"Arikawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher M.","family":"Parry","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koya","family":"Ariyoshi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pham Thanh","family":"Thuy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"R1","series-title":"PLoS ONE","first-page":"e44269","article-title":"Mapping the aetiology of non-malarial febrile illness in Southeast Asia through a systematic review\u2014terra incognita impairing treatment policies","volume":"7","author":"Acestor","year":"2012"},{"key":"R2","series-title":"Am J Trop Med Hyg","first-page":"451","article-title":"Rickettsial infections in Southeast Asia: implications for local populace and febrile returned travelers","volume":"91","author":"Aung","year":"2014"},{"key":"R3","series-title":"Clin Dermatol","first-page":"191","article-title":"Tropical rickettsioses","volume":"24","author":"Parola","year":"2006"},{"key":"R4","series-title":"Southeast Asian J Trop Med Public Health","first-page":"666","article-title":"Antibodies to Orientia tsutsugamushi in soldiers in northeastern Thailand","volume":"28","author":"Frances","year":"1997"},{"key":"R5","series-title":"Am J Trop Med Hyg","first-page":"149","article-title":"Prevalence of antibodies to rickettsiae in the human population of suburban Bangkok","volume":"51","author":"Strickman","year":"1994"},{"key":"R6","series-title":"PLoS Negl Trop Dis","first-page":"e909","article-title":"Contrasting spatial distribution and risk factors for past infection with scrub typhus and murine typhus in Vientiane City, Lao PDR","volume":"4","author":"Vallee","year":"2010"},{"key":"R7","series-title":"Infect Genet Evol","first-page":"35","article-title":"Molecular epidemiology of Orientia tsutsugamushi in Cambodia and central Vietnam reveals a broad region-wide genetic diversity","volume":"15","author":"Duong","year":"2013"},{"key":"R8","series-title":"Am J Trop Med Hyg","first-page":"580","article-title":"Serosurveillance of Orientia tsutsugamushi and Rickettsia typhi in Bangladesh","volume":"91","author":"Maude","year":"2014"},{"key":"R9","series-title":"Am J Trop Med Hyg","first-page":"91","article-title":"Seroepidemiologic evidence for murine and scrub typhus in Malang, Indonesia","volume":"57","author":"Richards","year":"1997"},{"key":"R10","series-title":"Ann Intern Med","first-page":"26","article-title":"Scrub typhus in South Vietnam. A study of 87 cases","volume":"79","author":"Berman","year":"1973"},{"key":"R11","series-title":"N Engl J Med","first-page":"1613","article-title":"Scrub typhus after a trip to Vietnam","volume":"336","author":"Thiebaut","year":"1997"},{"key":"R12","series-title":"Trans R Soc Trop Med Hyg","first-page":"739","article-title":"Scrub typhus in the northern provinces of Vietnam: an observational study of admissions to a national referral hospital","volume":"108","author":"Nadjm","year":"2014"},{"key":"R13","series-title":"Ann Trop Med Parasitol","first-page":"363","article-title":"Causes of acute, undifferentiated, febrile illness in rural Thailand: results of a prospective observational study","volume":"100","author":"Suttinont","year":"2006"},{"key":"R14","series-title":"Clin Infect Dis","first-page":"913","article-title":"Murine typhus: an unrecognized suburban vectorborne disease","volume":"46","author":"Civen","year":"2008"},{"key":"R15","series-title":"Trans R Soc Trop Med Hyg","first-page":"1239","article-title":"Simple, rapid and sensitive detection of Orientia tsutsugamushi by loop-isothermal DNA amplification","volume":"102","author":"Paris","year":"2008"},{"key":"R16","series-title":"Am J Trop Med Hyg","first-page":"10","article-title":"Short report: prospective evaluation of a multi-test strip for the diagnoses of scrub and murine typhus, leptospirosis, dengue fever, and Salmonella typhi infection","volume":"72","author":"Watt","year":"2005"},{"key":"R17","series-title":"Am J Trop Med Hyg","first-page":"368","article-title":"Diagnosis of scrub typhus","volume":"82","author":"Koh","year":"2010"},{"key":"R18","series-title":"Am J Trop Med Hyg","first-page":"477","article-title":"Prevalence of relative bradycardia in Orientia tsutsugamushi infection","volume":"68","author":"Aronoff","year":"2003"},{"key":"R19","series-title":"Clin Infect Dis","first-page":"391","article-title":"Scrub typhus serologic testing with the indirect immunofluorescence method as a diagnostic gold standard: a lack of consensus leads to a lot of confusion","volume":"44","author":"Blacksell","year":"2007"},{"key":"R20","series-title":"Am J Trop Med Hyg","first-page":"806","article-title":"Distribution of eschars on the body of scrub typhus patients: a prospective study","volume":"76","author":"Kim","year":"2007"},{"key":"R21","series-title":"Trans R Soc Trop Med Hyg","first-page":"354","article-title":"Paediatric scrub typhus in Thailand: a study of 73 confirmed cases","volume":"98","author":"Silpapojakul","year":"2004"},{"key":"R22","series-title":"Am J Trop Med Hyg","first-page":"615","article-title":"Rickettsial and serologic evidence for prevalent spotted fever rickettsiosis in inner Mongolia","volume":"36","author":"Fan","year":"1987"},{"key":"R23","series-title":"Int J Infect Dis","first-page":"39","article-title":"Clinical profile and improving mortality trend of scrub typhus in South India","volume":"23","author":"Varghese","year":"2014"},{"key":"R24","series-title":"Am J Trop Med Hyg","first-page":"1148","article-title":"Acute respiratory distress syndrome in scrub typhus","volume":"76","author":"Wang","year":"2007"},{"key":"R25","series-title":"Am J Trop Med Hyg","first-page":"801","article-title":"Key differentiating features between scrub typhus and hemorrhagic fever with renal syndrome in northern China","volume":"76","author":"Liu","year":"2007"},{"key":"R26","series-title":"BMC Infect Dis","first-page":"216","article-title":"Clinical significance of hypoalbuminemia in outcome of patients with scrub typhus","volume":"10","author":"Lee","year":"2010"},{"key":"R27","series-title":"Indian J Pediatr","first-page":"1459","article-title":"Clinical profile of scrub typhus in children","volume":"79","author":"Palanivel","year":"2012"},{"key":"R28","series-title":"Am J Trop Med Hyg","first-page":"667","article-title":"Short report: abnormal liver function in scrub typhus","volume":"73","author":"Hu","year":"2005"},{"key":"R29","series-title":"QJM","first-page":"623","article-title":"Liver involvement in murine typhus","volume":"89","author":"Silpapojakul","year":"1996"},{"key":"R30","series-title":"World J Gastroenterol","first-page":"5138","article-title":"Scrub typhus hepatitis confirmed by immunohistochemical staining","volume":"18","author":"Chung","year":"2012"},{"key":"R31","series-title":"Am J Clin Pathol","first-page":"720","article-title":"Histopathology and immunohistologic demonstration of the distribution of Rickettsia typhi in fatal murine typhus","volume":"91","author":"Walker","year":"1989"},{"key":"R32","series-title":"Epidemiol Infect","first-page":"1876","article-title":"A survey of rodent-borne pathogens carried by wild Rattus spp. in northern Vietnam","volume":"141","author":"Koma","year":"2013"},{"key":"R33","series-title":"Int J Environ Health Res","first-page":"25","article-title":"Seaport as a source of hantavirus: a study on isolated isles","volume":"17","author":"Wu","year":"2007"},{"key":"R34","series-title":"Southeast Asian J Trop Med Public Health","first-page":"217","article-title":"The effects of rainfall on trombiculid (Acarina: Trombiculidae) larval populations in peninsular Malaysia","volume":"8","author":"Gentry","year":"1977"},{"key":"R35","series-title":"J Microbiol Immunol Infect","first-page":"33","article-title":"Intravenous minocycline versus oral doxycycline for the treatment of noncomplicated scrub typhus","volume":"44","author":"Tsai","year":"2011"},{"key":"R36","series-title":"Lancet","first-page":"86","article-title":"Scrub typhus infections poorly responsive to antibiotics in northern Thailand","volume":"348","author":"Watt","year":"1996"},{"key":"R37","series-title":"N Engl J Med","first-page":"809","article-title":"Beyond malaria\u2014causes of fever in outpatient Tanzanian children","volume":"370","author":"D'Acremont","year":"2014"},{"key":"R38","series-title":"Lancet Glob Health","first-page":"e46","article-title":"Causes of non-malarial fever in Laos: a prospective study","volume":"1","author":"Mayxay","year":"2013"},{"key":"R39","series-title":"Am J Trop Med Hyg","first-page":"796","article-title":"Epidemiology of the acute fevers of unknown origin in South Vietnam: effect of laboratory support upon clinical diagnosis","volume":"22","author":"Berman","year":"1973"},{"key":"R40","series-title":"Am J Trop Med Hyg","first-page":"108","article-title":"Causes of fever in adults on the Thai-Myanmar border","volume":"74","author":"Ellis","year":"2006"},{"key":"R41","series-title":"Q J Med","first-page":"43","article-title":"Murine typhus in Thailand: clinical features, diagnosis and treatment","volume":"86","author":"Silpapojakul","year":"1993"}],"container-title":["The American Society of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/92\/5\/article-p972.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/92\/5\/article-p972.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/92\/5\/article-p972.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,7]],"date-time":"2024-08-07T19:21:48Z","timestamp":1723058508000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/92\/5\/article-p972.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,5,6]]},"references-count":41,"journal-issue":{"issue":"5"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.14-0806","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,5,6]]}}}