Division of Infectious Diseases, Box 3281, Duke University Medical Center, Durham, NC 27710, USA.
Curr Infect Dis Rep. 2009 Jan;11(1):66-72. doi: 10.1007/s11908-009-0010-x.
Physicians caring for febrile returned travelers face the difficult task of recognizing the typical and atypical features of more than 16 known rickettsial diseases and separating these diseases from potentially serious nonrickettsial diseases. Currently available diagnostic tools are inadequate for timely diagnosis. This review summarizes the English-language literature concerning imported rickettsial diseases in international travelers and describes important clinical principles in diagnosis and treatment of these illnesses. -Travelers with imported rickettsial disease often become sick before or within a few days of return from an endemic region. Illness that begins more than 18 days after return is unlikely to be rickettsial in origin. The absence of a skin rash or exposure to a vector should not dissuade clinicians from considering the possibility of a rickettsial disease in a returned traveler. Finally, if empiric therapy does not result in defervescence within 48 hours, an alternative nonrickettsial illness should be strongly considered.
照顾发热归国旅行者的医生面临着艰巨的任务，需要识别出 16 种以上已知的立克次体病的典型和非典型特征，并将这些疾病与潜在的严重非立克次体病区分开来。目前可用的诊断工具不足以进行及时诊断。本综述总结了有关国际旅行者中输入性立克次体病的英文文献，并描述了这些疾病诊断和治疗的重要临床原则。-患有输入性立克次体病的旅行者通常在从流行地区返回之前或返回后的几天内生病。返回后 18 天以上开始的疾病不太可能是立克次体病引起的。没有皮疹或接触过媒介，不应阻止临床医生考虑返回的旅行者患立克次体病的可能性。最后，如果经验性治疗在 48 小时内未使体温下降，应强烈考虑其他非立克次体病。
