Etiologies of Acute Undifferentiated Febrile Illness in Bangkok, Thailand

• DOI: 10.4269/ajtmh.18-0407
• Publication Date: 2019-01-08T07:23:42Z
• Authors: Viravarn Luvira; Udomsak Silachamroon; Watcharapong Piya...; Saranath Lawpoolsri; Wirongrong Chierakul; Pornsawan Leaungw...; Charin Thawornkuno; Yupaporn Wattanagoon
• Keywords: Etiology; Bacteremia

Acute undifferentiated febrile illness (AUFI) has been a diagnostic dilemma in the tropics. Without accurate point-of-care tests, information on local pathogens and clinical parameters is essential for presumptive diagnosis. A prospective hospital-based study was conducted at Bangkok Hospital Tropical Diseases from 2013 to 2015 determine common etiologies of AUFI. total 397 adult AUFI cases, excluding malaria by blood smear, were enrolled. Rapid tests tropical infections performed admission, acute convalescent samples tested confirm Etiologies could be identified 271 (68.3%) cases. Dengue most cause, with 157 cases (39.6%), followed murine typhus (20 cases; 5.0%), leptospirosis (16 4.0%), influenza (14 3.5%), bacteremia (six 1.5%). Concurrent infection least two reported 37 (9.3%). Furthermore, characteristics dengue bacterial (including rickettsioses) compared facilitate triage, initiate early antibiotic treatment, minimize unnecessary use antibiotics. In conclusion, pathogen urban Thailand. However, not uncommon. Empirical treatment using doxycycline or azithromycin might more appropriate, but cost–benefit studies are required. Physicians should recognize causes their localities laboratory clues provisional diagnosis provide appropriate while awaiting confirmation.