Table 4.
Clinical presentation and outcome*
| Rickettsia (N = 263) | Coxiella burnetii (N = 10) | Leptospira (N = 2) | Chikungunya (N = 10) | Bartonella (N = 1) | |||
|---|---|---|---|---|---|---|---|
| Typhus group Rickettsia (N = 10) | Spotted fever group Rickettsia (N = 132) | Scrub typhus group Rickettsia (N = 170) | |||||
| Symptoms | |||||||
| Fever | 10 (100) | 132 (100) | 170 (100) | 10 (100) | 2 (100) | 10 (100) | 1 (100) |
| Headache | 7 (70) | 66 (50) | 117 (69) | 5 (50) | 1 (50) | 3 (30) | 0 |
| Bodyache | 3 (30) | 54 (41) | 84 (49) | 4 (40) | 0 | 2 (20) | 0 |
| Muscle pain | 0 | 23 (17) | 38 (22) | 0 | 0 | 0 | 0 |
| Joint pain | 0 | 19 (14) | 46 (27) | 0 | 0 | 10 (100) | 0 |
| Rash | 0 | 1 (1) | 2 (1) | 0 | 0 | 0 | 0 |
| Bleeding | 0 | 2 (2) | 2 (1) | 0 | 0 | 0 | 0 |
| Retro-orbital pain | 0 | 5 (4) | 13 (8) | 0 | 0 | 0 | 0 |
| Eye-redness | 0 | 5 (4) | 5 (3) | 0 | 0 | 0 | 0 |
| Jaundice | 0 | 4 (3) | 8 (5) | 2 (20) | 0 | 0 | 0 |
| Neck stiffness | 0 | 2 (2) | 4 (2) | 0 | 0 | 0 | 0 |
| Low urinary output | 0 | 5 (4) | 3 (2) | 0 | 0 | 1 (10) | 0 |
| Physical findings | |||||||
| Mean Pulse rate | 101 ± 19 | 100 ± 21 | 92 ± 21 | 96 ± 19 | 100 ± 0 | 95 ± 19 | 130 ± 0 |
| Mean Respiratory rate | 20 ± 6 | 26 ± 12 | 23 ± 11 | 22 ± 9 | 28 ± 3 | 26 ± 7 | 26 ± 0 |
| Mean Systolic BP | 115 ± 16 | 108 ± 17 | 110 ± 19 | 101 ± 12 | 110 ± 14 | 103 ± 11 | 110 ± 0 |
| Mean Diastolic BP | 74 ± 8 | 71 ± 10 | 71 ± 12 | 63 ± 9 | 60 ± 0 | 68 ± 9 | 60 ± 0 |
| Mean Temperature | 99.7 ± 1.5 | 100.2 ± 1.7 | 100.1 ± 1.5 | 100.1 ± 1.3 | 102.5 ± 2.1 | 99.8 ± 0.6 | 99 ± 0 |
| Anemia | 1 (10) | 21 (16) | 34 (20) | 3 (30) | 0 | 2 (20) | 0 |
| Jaundice | 0 | 3 (2) | 6 (4) | 1 (10) | 1 (50) | 0 | 0 |
| Edema | 0 | 4 (3) | 6 (4) | 0 | 0 | 0 | 0 |
| Rash | 0 | 2 (2) | 2 (1) | 0 | 0 | 0 | 0 |
| Neck rigidity | 0 | 2 (2) | 5 (3) | 0 | 0 | 0 | 0 |
| Dehydration | 0 | 13 (10) | 23 (14) | 2 (20) | 0 | 0 | 0 |
| Laboratory findings | |||||||
| Mean WBC count | 8000 ± 1732 | 12656 ± 9544 | 10570 ± 3148 | 11225 ± 6352 | 10850 ± 3889 | - | - |
| Mean Neutrophil percent | 63 ± 8 | 68 ± 14 | 66 ± 15 | 67 ± 12 | 71 ± 21 | - | - |
| Mean Platelet count | - | 228733 ± 132686 | 279455 ± 136035 | 226500 ± 37477 | 185000 ± 0 | - | - |
| Mean ESR | 42 ± 20 | 40 ± 20 | 48 ± 29 | 34 ± 10 | 58 ± 3 | 28 ± 0 | - |
| Outcome [N = 557]† | (N = 5) | (N = 94) | (N = 130) | (N = 8) | (N = 1) | (N = 6) | (N = 1) |
| Recovery‡ | 5 (100) | 59 (63) | 76 (58) | 6 (75) | 1 (100) | 3 (50) | 1 (100) |
| Death | 0 | 5 (5) | 7 (5) | 2 (25) | 0 | 0 | 0 |
| Mean recovery days§ | 11 ± 7 | 17 ± 12 | 18 ± 10 | 16 ± 12 | 18 ± 0 | 28 ± 9 | 16 ± 0 |
| Similar Concurrent illness in the family member | 0 | 11 (12) | 8 (6) | 0 | 0 | 2 (33) | 0 |
* Values are n (%) unless otherwise indicated; Mean is reported along with ± Standard deviation
† We could follow up 5 out of 10 typhus group, 94 out of 132 spotted fever, 130 out of 170 scrub typhus group, 8 out of 10 Coxiella burnetii cases and 1 out of 2 leptospirosis, 6 out of 10 Chikungunya and one bartonellosis patients. The remaining patients were not accessible or available on phone follow-up
‡ Recovery is defined as presence of no signs or symptoms of illness or any disability
§ The mean recovery days along with SD indicates how long it took time for the febrile patients to recover from the illnesses