Participants |
Inclusion criteria
Adults 18 years of age or older
Fever higher than 37.5˚C
Concurrent presence of eschar or a maculopapular skin rash; and clear presence of more than 2 symptoms such as headache, malaise, myalgia, coughing, nausea, and abdominal discomfort
Patients hospitalized between 2006 and 2009 at Chosun University Hospital in Gwangju, South Korea, or at one of its 2 community‐based affiliated hospitals, all of which are located in southwestern Korea
Exclusion criteria
Inability to take oral medications
Pregnancy
Hypersensitivity to trial drugs
Previous drug therapy with potential anti‐rickettsial activity (for example, rifampicin, chloramphenicol, macrolides, fluoroquinolones, tetracyclines) within 48 hours before admission
Severe scrub typhus (shock requiring vasopressor therapy for longer than 1 hour)
Stuporous or comatose level of consciousness
Respiratory failure requiring mechanical ventilation or renal failure requiring immediate dialysis
For the differential diagnosis of scrub typhus from other diseases with similar symptoms (for example, murine typhus, leptospirosis, haemorrhagic fever with renal syndrome, systemic lupus erythematosus), patients underwent diagnostic tests. We thus excluded patients with concurrent infections at risk for causing different outcomes
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