Characteristics of scrub typhus, murine typhus, and Q fever among elderly patients: Prolonged prothrombin time as a predictor for severity.
J Microbiol Immunol Infect
; 52(1): 54-61, 2019 Feb.
Article
in En
| MEDLINE
| ID: mdl-28709838
ABSTRACT
BACKGROUND/PURPOSE:
The clinical manifestations of scrub typhus, murine typhus and acute Q fever in the elderly are not clear.METHODS:
We conducted a retrospective study to identify the characteristics of the elderly aged ≥65 years with a comparison group aged 18-64 years among patients with scrub typhus, murine typhus, or acute Q fever who were serologically confirmed at three hospitals in Taiwan during 2002-2011.RESULTS:
Among 441 cases, including 187 cases of scrub typhus, 166 acute Q fever, and 88 murine typhus, 68 (15.4%) cases were elderly patients. The elderly had a higher severe complication rate (10.3% vs. 3.5%, p = 0.022), but did not have a significantly higher mortality rate (1.47% vs. 0.54%, p = 0.396). Compared with those without severe complications, we found the elderly (p = 0.022), dyspnea (p = 0.006), less relative bradycardia (p = 0.004), less febrile illness (p = 0.004), prolonged prothrombin time (PT) (p = 0.002), higher levels of initial C-reactive protein (p = 0.039), blood leukocyte counts (p = 0.01), and lower platelet counts (p = 0.012) are significantly associated with severe complications. Only prolonged prothrombin time was associated with severe complications in multivariate analysis (p = 0.018, CI 95% 0.01-0.66). Among clinical symptoms and laboratory data, multivariate analysis revealed chills was less frequently occurred in the elderly (p = 0.012, 95% confidence interval [CI] 1.33-9.99).CONCLUSION:
The elderly cases with scrub typhus, murine typhus, or acute Q fever would be more likely to have severe complications, for which prothrombin time prolongation is an important predictor for severe complications.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Prothrombin Time
/
Q Fever
/
Severity of Illness Index
/
Scrub Typhus
/
Typhus, Endemic Flea-Borne
Type of study:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Aged
/
Aged80
/
Female
/
Humans
/
Male
Country/Region as subject:
Asia
Language:
En
Journal:
J Microbiol Immunol Infect
Journal subject:
ALERGIA E IMUNOLOGIA
/
MICROBIOLOGIA
Year:
2019
Document type:
Article