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Correction published on 13 July 2022, see Trop. Med. Infect. Dis. 2022, 7(7), 134.
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Article

Rickettsial Infections Are Neglected Causes of Acute Febrile Illness in Teluk Intan, Peninsular Malaysia

by
Muhamad Yazli Yuhana
1,2,
Borimas Hanboonkunupakarn
1,*,
Ampai Tanganuchitcharnchai
3,
Pimpan Sujariyakul
3,
Piengchan Sonthayanon
4,
Kesinee Chotivanich
1,
Sasithon Pukrittayakamee
1,
Stuart D. Blacksell
3,5 and
Daniel H. Paris
6,7
1
Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
2
Department of Infectious Diseases and Tropical Medicine, School of Medicine, Universiti Teknologi MARA (UiTM), Sg Buloh Campus, Sungai Buloh 40600, Selangor, Malaysia
3
Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
4
Department of Molecular Tropical Medicine and Genetics, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
5
Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Churchill Hospital, Oxford OX3 7FZ, UK
6
Faculty of Medicine, University of Basel, 4003 Basel, Switzerland
7
Department of Medicine, Swiss Tropical and Public Health Institute, 4123 Allschwil, Switzerland
*
Author to whom correspondence should be addressed.
Trop. Med. Infect. Dis. 2022, 7(5), 77; https://doi.org/10.3390/tropicalmed7050077
Submission received: 21 April 2022 / Revised: 13 May 2022 / Accepted: 15 May 2022 / Published: 18 May 2022 / Corrected: 13 July 2022
(This article belongs to the Special Issue The Past and Present Threat of Rickettsial Diseases (Volume II))
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Abstract

Rickettsial infections are among the leading etiologies of acute febrile illness in Southeast Asia. However, recent data from Malaysia are limited. This prospective study was conducted in Teluk Intan, Peninsular Malaysia, during January to December 2016. We recruited 309 hospitalized adult patients with acute febrile illness. Clinical and biochemistry data were obtained, and patients were stratified into mild and severe infections based on the sepsis-related organ failure (qSOFA) scoring system. Diagnostic assays including blood cultures, real-time PCR, and serology (IFA and MAT) were performed. In this study, pathogens were identified in 214 (69%) patients, of which 199 (93%) patients had a single etiology, and 15 (5%) patients had >1 etiologies. The top three causes of febrile illness requiring hospitalization in this Malaysian study were leptospirosis (68 (32%)), dengue (58 (27%)), and rickettsioses (42 (19%)). Fifty-five (18%) patients presented with severe disease with a qSOFA score of ≥2. Mortality was documented in 38 (12%) patients, with the highest seen in leptospirosis (16 (42%)) followed by rickettsiosis (4 (11%)). While the significance of leptospirosis and dengue are recognized, the impact of rickettsial infections in Peninsular Malaysia remains under appreciated. Management guidelines for in-patient care with acute febrile illness in Peninsular Malaysia are needed.
Keywords: rickettsial; Malaysia; acute febrile illness rickettsial; Malaysia; acute febrile illness

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MDPI and ACS Style

Yuhana, M.Y.; Hanboonkunupakarn, B.; Tanganuchitcharnchai, A.; Sujariyakul, P.; Sonthayanon, P.; Chotivanich, K.; Pukrittayakamee, S.; Blacksell, S.D.; Paris, D.H. Rickettsial Infections Are Neglected Causes of Acute Febrile Illness in Teluk Intan, Peninsular Malaysia. Trop. Med. Infect. Dis. 2022, 7, 77. https://doi.org/10.3390/tropicalmed7050077

AMA Style

Yuhana MY, Hanboonkunupakarn B, Tanganuchitcharnchai A, Sujariyakul P, Sonthayanon P, Chotivanich K, Pukrittayakamee S, Blacksell SD, Paris DH. Rickettsial Infections Are Neglected Causes of Acute Febrile Illness in Teluk Intan, Peninsular Malaysia. Tropical Medicine and Infectious Disease. 2022; 7(5):77. https://doi.org/10.3390/tropicalmed7050077

Chicago/Turabian Style

Yuhana, Muhamad Yazli, Borimas Hanboonkunupakarn, Ampai Tanganuchitcharnchai, Pimpan Sujariyakul, Piengchan Sonthayanon, Kesinee Chotivanich, Sasithon Pukrittayakamee, Stuart D. Blacksell, and Daniel H. Paris. 2022. "Rickettsial Infections Are Neglected Causes of Acute Febrile Illness in Teluk Intan, Peninsular Malaysia" Tropical Medicine and Infectious Disease 7, no. 5: 77. https://doi.org/10.3390/tropicalmed7050077

APA Style

Yuhana, M. Y., Hanboonkunupakarn, B., Tanganuchitcharnchai, A., Sujariyakul, P., Sonthayanon, P., Chotivanich, K., Pukrittayakamee, S., Blacksell, S. D., & Paris, D. H. (2022). Rickettsial Infections Are Neglected Causes of Acute Febrile Illness in Teluk Intan, Peninsular Malaysia. Tropical Medicine and Infectious Disease, 7(5), 77. https://doi.org/10.3390/tropicalmed7050077

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