Abstract

: Rickettsial infections are the most covert re-emerging infections of the present times. They are considered one of the important causes of Pyrexia of Unknown origin (PUO). They are often under diagnosed due to low index of suspicion, nonspecific signs and symptoms and absence of widely available sensitive and specific diagnostic tests. These diseases have a high mortality, which can be averted if diagnosed and treated early. Weil- Felix test is the cheapest and widely used test for diagnosis in India.The present study was undertaken with the objective of evaluating the patients with Febrile illness, for rickettsial infection using Weil- Felix test and study their demographic and clinical profile.: Weil-Felix test was done on serum samples of 120 patients with fever since 7-10 days, from October 2017 to October 2019 and evaluated for Rickettsial infection. Detailed history, signs, symptoms were recorded.: Out the 120 patients, 25 showed a titre of >1:80 in OX2, OX19 and 5 cases showed titre of >1:160 in OX K. The disease was more common in children and in the cooler months. Fever, rash, headache, vomiting and pain abdomen were common symptoms. Most common signs were rash (27 cases) and conjunctival congestion (19 cases).: Though the sensitivity and specificity of Weil-Felix test is low, it is done even today as it is the most convenient and economical test available for the diagnosis of Rickettsial infections. Prevalence of Rickettsial diseases is significant in this region and greater clinical awareness in the differential diagnosis of fevers is required for early diagnosis and treatment.

Highlights

  • Rickettsial infections are the most covert re-emerging infections of the present times

  • All 30 patients diagnosed with Rickettsial infection were started on Doxycycline and 20 of them showed improvement without any sequelae, 10 did not come for follow up

  • Inspite of all its drawbacks, Weil-Felix test still serves as an economical and useful diagnostic tool for laboratory diagnosis of rickettsial diseases provided the test is interpreted in the correct clinical context. 3

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Summary

Introduction

Rickettsial infections are the most covert re-emerging infections of the present times They are considered one of the important causes of Pyrexia of Unknown origin (PUO). They are often under diagnosed due to low index of suspicion, nonspecific signs and symptoms and absence of widely available sensitive and specific diagnostic tests. These diseases have a high mortality, which can be averted if diagnosed and treated early. Conclusion: Though the sensitivity and specificity of Weil-Felix test is low, it is done even today as it is the most convenient and economical test available for the diagnosis of Rickettsial infections. Infection in man occurs by infected vector bite or exposure to reservoir host

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