Clinical, laboratory characteristics, and outcomes of murine typhus patients in Vietnam: A multicenter prospective cohort study

https://doi.org/10.52322/jocmbmh.07.en.06

Introduction: Murine typhus was difficult to diagnose at most of the cases in clinical practices due to the non-specific symptoms and unavailable of confirmation testing.

Objectives: This paper aims to assess the clinical, laboratory characteristics and outcomes of patients with confirmation of murine typhus in Vietnam.

Material and methods: We conducted a multicenter prospective cohort study in 26 hospitals across Vietnam from 2016 to 2019. Murine typhus patients were confirmed by RT-PCR testing. A total of 56 patients were enrolled to study. All the data were prospectively collected by trained staff at study sites.

Results: Among 56 patients, the mean age was 40.1 ± 14.5 years old and 62.5% male. The most common symptoms of murine typhus patients in the study were fever (100%), headache (94.6%), muscle pain (62.5%) and joint pain (28.6%). Common manifestations on the skin and mucous membranes in R. typhi infected patients, including skin congestion (78.6%), conjunctival congestion (50.0%) and skin rash (41.1%). The rate of macule rash was 52.2% and 4.4% had purpura rash. Rash symptoms usually appeared within the first week (42.5%) after onset. Only 31/56 patients were given appropriate antibiotics as initiation treatment (55.4%) and only 47.3% were given appropriate antibiotics within 01 day after admission. The average duration of antibiotic treatment was 6.0 ± 2.1 days. At the end of follow-up, the proportion of alive patients and discharged from the hospital was 89.3%.

Conclusion: This is the first study in Vietnam that described the clinical and outcomes of patients with confirmation of R. typhi infected in Vietnam, which might be useful for the clinicians in the real-life practices.

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