Rickettsial infections may cause a life-threatening infection that requires intensive care. Lee et al identified risk factors for serious infections in patients in Hong Kong. The authors are from Prince of Wales Hospital and Princess Margaret Hospital in Hong Kong.
Risk factors for a life-threatening rickettsial infection:
(1) scrub typhus (Orientia tsutsugamushi), which is widespread in Asia
(2) delay in therapy with tetracyclines
(3) pulmonary infiltrate
(4) leukocytosis (risk increases with increasing WBC count)
The mortality rate in scrub typhus is up to 35%.
People with serious infections develop multi-organ failure.
The recommendation was to immediately start doxycycline therapy in a patient with an exposure history, rash, eschar, or other reason to suspect a rickettsial infection.
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