东南亚的立克次体感染：对当地民众和发热归国旅行者的影响
Rickettsial infections in Southeast Asia: implications for local populace and febrile returned travelers.
作者信息
Aung Ar Kar, Spelman Denis W, Murray Ronan J, Graves Stephen
机构信息
Department of Infectious Diseases and Microbiology, Alfred Hospital, Melbourne, Victoria, Australia; Monash University, Melbourne, Victoria, Australia; Department of Infectious Diseases and Microbiology and Pathwest Laboratory Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia; School of Pathology and Laboratory Medicine, University of Western Australia, Perth, Western Australia, Australia; Australian Rickettsial Reference Laboratory Foundation, Geelong Hospital, Geelong, Victoria, Australia; New South Wales Health Pathology, Newcastle, New South Wales, Australia; University of Newcastle, Newcastle, New South Wales, Australia
Department of Infectious Diseases and Microbiology, Alfred Hospital, Melbourne, Victoria, Australia; Monash University, Melbourne, Victoria, Australia; Department of Infectious Diseases and Microbiology and Pathwest Laboratory Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia; School of Pathology and Laboratory Medicine, University of Western Australia, Perth, Western Australia, Australia; Australian Rickettsial Reference Laboratory Foundation, Geelong Hospital, Geelong, Victoria, Australia; New South Wales Health Pathology, Newcastle, New South Wales, Australia; University of Newcastle, Newcastle, New South Wales, Australia.
出版信息
Am J Trop Med Hyg. 2014 Sep;91(3):451-60. doi: 10.4269/ajtmh.14-0191. Epub 2014 Jun 23.
Rickettsial infections represent a major cause of non-malarial febrile illnesses among the residents of Southeast Asia and returned travelers from that region. There are several challenges in recognition, diagnosis, and management of rickettsioses endemic to Southeast Asia. This review focuses on the prevalent rickettsial infections, namely, murine typhus (Rickettsia typhi), scrub typhus (Orientia tsutsugamushi), and members of spotted fever group rickettsiae. Information on epidemiology and regional variance in the prevalence of rickettsial infections is analyzed. Clinical characteristics of main groups of rickettsioses, unusual presentations, and common pitfalls in diagnosis are further discussed. In particular, relevant epidemiologic and clinical aspects on emerging spotted fever group rickettsiae in the region, such as Rickettsia honei, R. felis, R. japonica, and R. helvetica, are presented. Furthermore, challenges in laboratory diagnosis and management aspects of rickettsial infections unique to Southeast Asia are discussed, and data on emerging resistance to antimicrobial drugs and treatment/prevention options are also reviewed.
立克次体感染是东南亚居民和从该地区返回的旅行者中非疟疾发热性疾病的主要病因。东南亚特有的立克次体病在识别、诊断和管理方面存在若干挑战。本综述聚焦于常见的立克次体感染，即鼠型斑疹伤寒（伤寒立克次体）、恙虫病（恙虫东方体）和斑点热群立克次体成员。分析了立克次体感染的流行病学信息和地区患病率差异。进一步讨论了主要立克次体病组的临床特征、不寻常表现及诊断中的常见误区。特别介绍了该地区新兴的斑点热群立克次体，如霍氏立克次体、猫立克次体、日本立克次体和瑞士立克次体的相关流行病学和临床方面。此外，还讨论了东南亚特有的立克次体感染在实验室诊断和管理方面的挑战，并回顾了抗菌药物新出现的耐药性数据以及治疗/预防方案。
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