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Rickettsial infections in Southeast Asia: implications for local populace and febrile returned travelers.
[scrub typhus]
Rickettsial
infections
represent
a
major
cause
of
non-malarial
febrile
illnesses
among
the
residents
of
Southeast
Asia
and
returned
travelers
from
that
region
.
There
are
several
challenges
in
recognition
,
diagnosis
,
and
management
of
rickettsioses
endemic
to
Southeast
Asia
.
This
review
focuses
on
the
prevalent
rickettsial
infections
,
namely
,
murine
typhus
(
Rickettsia
typhi
)
,
scrub
typhus
(
Orientia
tsutsugamushi
)
,
and
members
of
spotted
fever
group
rickettsiae
.
Information
on
epidemiology
and
regional
variance
in
the
prevalence
of
rickettsial
infections
is
analyzed
.
Clinical
characteristics
of
main
groups
of
rickettsioses
,
unusual
presentations
,
and
common
pitfalls
in
diagnosis
are
further
discussed
.
In
particular
,
relevant
epidemiologic
and
clinical
aspects
on
emerging
spotted
fever
group
rickettsiae
in
the
region
,
such
as
Rickettsia
honei
,
R
.
felis
,
R
.
japonica
,
and
R
.
helvetica
,
are
presented
.
Furthermore
,
challenges
in
laboratory
diagnosis
and
management
aspects
of
rickettsial
infections
unique
to
Southeast
Asia
are
discussed
,
and
data
on
emerging
resistance
to
antimicrobial
drugs
and
treatment
/
prevention
options
are
also
reviewed
.
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