Satish Talikoti, Nijora Deka
BACKGROUND We wanted to analyse the clinical profile of Rickettsial cases with an emphasis on epidemiology, clinical features, diagnosis and management issues of these infections, in a major tertiary referral medical college hospital in Vijayapur. METHODS We have summarized the data from 113 hospitalized patients who were laboratory confirmed for Rickettsial infection at Al Ameen Hospital, Vijaypur. Patients were treated as per recommendations of Tick-Borne Rickettsial Diseases Working Group of Centre for Disease Control (CDC), Atlanta, for management of Rickettsial infections. RESULTS 312 cases from June 2017 to December 2018 were studied retrospectively for patient’s demography, clinical presentation, treatment and outcome. Patients with history of fever of 2-4 weeks and positive Weil-Felix test, a negative malaria, chikungunya and dengue serology were diagnosed as probable rickettsial disease positive. Four patients had skin rashes. 3 persons had eschar at presentation. Number of males affected was marginally higher in number. 44 cases belonged to the rural areas surrounding Vijayapur city. No deaths were recorded. CONCLUSIONS Rickettsial fever is not a common diagnosis for fever because of nonspecific signs and symptoms, and absence of widely available sensitive and specific diagnostic tests. Failure of timely diagnosis leads to significant morbidity and mortality. Some patients with rickettsial diseases might initially receive an alternative diagnosis, and be empirically treated with antibiotics inactive against rickettsia. However, treatment for this disease is easy, affordable and often successful with good response if diagnosed with a higher index of suspicion than is being warranted at the present juncture.
