Tropical Medicine and Infectious Disease最新文献

{"title":"COVID-19 Clinical Predictors in Patients Treated via a Telemedicine Platform in 2022.","authors":"Liliane de Fátima Antonio Oliveira, Lúcia Regina do Nascimento Brahim Paes, Luiz Claudio Ferreira, Gabriel Garcez de Araújo Souza, Guilherme Souza Weigert, Layla Lorena Bezerra de Almeida, Rafael Kenji Fonseca Hamada, Lyz Tavares de Sousa, Andreza Pain Marcelino, Cláudia Maria Valete","doi":"10.3390/tropicalmed10080213","DOIUrl":"10.3390/tropicalmed10080213","url":null,"abstract":"<p><p>Coronavirus disease (COVID-19) is an infectious disease caused by the SARS-CoV-2 virus, whose 2020 outbreak was characterized as a pandemic by the World Health Organization. Restriction measures changed healthcare delivery, with telehealth providing a viable alternative throughout the pandemic. This study analyzed a telemedicine platform database with the goal of developing a diagnostic prediction model for COVID-19 patients. This is a longitudinal study of patients seen on the Conexa Saúde telemedicine platform in 2022. A multiple binary logistic regression model of controls (negative confirmation for COVID-19 or confirmation of other influenza-like illness) versus COVID-19 was developed to obtain an odds ratio (OR) and a 95% confidence interval (CI). In the final binary logistic regression model, six factors were considered significant: presence of rhinorrhea, ocular symptoms, abdominal pain, rhinosinusopathy, and wheezing/asthma and bronchospasm were more frequent in controls, thus indicating a greater chance of flu-like illnesses than COVID-19. The presence of tiredness and fatigue was three times more prevalent in COVID-19 cases (OR = 3.631; CI = 1.138-11.581; <i>p</i>-value = 0.029). Our findings suggest potential predictors associated with influenza-like illness and COVID-19 that may distinguish between these infections.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"10 8","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12390043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144970356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic Review of the Ovitrap Surveillance of <i>Aedes</i> Mosquitoes in Brazil (2012-2022).","authors":"Raquel Fernandes Silva Chagas do Nascimento, Alexandre da Silva Xavier, Tania Ayllón Santiago, Daniel Cardoso Portela Câmara, Izabel Cristina Dos Reis, Edson Delatorre, Patrícia Carvalho de Sequeira, Vitor Henrique Ferreira-de-Lima, Tamara Nunes Lima-Camara, Nildimar Alves Honório","doi":"10.3390/tropicalmed10080212","DOIUrl":"10.3390/tropicalmed10080212","url":null,"abstract":"<p><p><b>Background:</b> Arthropod-borne diseases primarily affect tropical and subtropical regions, exhibiting seasonal patterns that peak during hot and rainy months when conditions favor mosquito vector proliferation. Factors such as high temperatures, elevated humidity, rainfall, urbanization, and the abundance of natural and artificial breeding sites influence <i>Aedes</i> vector dynamics. In this context, arboviruses pose significant public health challenges, likely worsened by global warming. In Brazil, <i>Aedes</i> (<i>Stegomyia</i>) <i>aegypti</i> (Linnaeus, 1762) is the primary vector for yellow fever, dengue, chikungunya, and Zika. <i>Aedes</i> (<i>Stegomyia</i>) <i>albopictus</i> (Skuse, 1894) is an important global arbovirus vector and is considered a potential vector in Brazil. Entomological surveillance of these species often uses oviposition traps targeting immature stages. Evaluating studies that use ovitraps to collect <i>Ae. aegypti</i> and <i>Ae. albopictus</i> egg is essential for improving mosquito surveillance strategies. This study systematically reviewed peer-reviewed articles on ovitrap-based surveillance of <i>Aedes</i> mosquitoes in Brazil, published in Portuguese and English from 2012 to 2022. The findings suggest that ovitraps are an effective method for detecting the presence or absence of <i>Ae. aegypti</i> and <i>Ae. albopictus</i>, serving as a reliable proxy for estimating mosquito abundance in Brazilian contexts.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"10 8","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12390002/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144970626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Molecular Detection of Mutations in the <i>penA</i> and 23S rRNA Genes of <i>Neisseria gonorrhoeae</i> Related to Decreased Cephalosporin and Azithromycin Susceptibility in Rectal Specimens from Men Who Have Sex with Men (MSM) in Lima, Peru.","authors":"Francesca Vasquez, Maria Eguiluz, Silver K Vargas, Jazmin Qquellon, Carlos F Caceres, Jeffrey D Klausner, Kelika A Konda","doi":"10.3390/tropicalmed10080211","DOIUrl":"10.3390/tropicalmed10080211","url":null,"abstract":"<p><p><i>Neisseria gonorrhoeae</i>, the causative agent of gonorrhea, represents a major public health concern due to its increasing antimicrobial resistance. While often asymptomatic-particularly in extragenital infections-untreated cases can lead to severe complications and further transmission. Despite global efforts to monitor antimicrobial resistance, data on the molecular determinants underlying decreased susceptibility in <i>N. gonorrhoeae</i> remain scarce in Peru. This study aimed to detect mutations in the <i>penA</i> and 23S rRNA genes, which confer decreased susceptibility to cephalosporins and azithromycin resistance. We extracted DNA from 124 <i>N. gonorrhoeae</i>-positive clinical rectal specimens collected in Aptima Combo 2 transport tubes from MSM patients. These DNA samples were then screened using the Mismatch Amplification Mutation Assay-based real-time PCR (MAMA-qPCR) to identify mutations in the 23S rRNA and <i>penA</i> genes. Each sample underwent separate reactions to detect A2059G and C2611T mutations in the 23S rRNA gene, and 86 of these samples were further tested in individual qPCR assays for the <i>penA</i> D345 deletion (D345del) or G545S mutations. Sanger sequencing was performed on all DNA samples positive for 23S rRNA mutations by MAMA-qPCR assay, and on 27 DNA samples that yielded sufficient <i>penA</i> amplicons for additional sequencing. Using the MAMA-qPCR assay for the 23S rRNA gene, 64 of 124 samples amplified in the A2059G reaction: 2 (3.1%) carried the mutation, and 62 were classified as wild type. In the C2611T reaction, 42 of 124 samples amplified, and none of them carried the mutation. Using the MAMA-qPCR assay for the <i>penA</i> gene, we only analyzed 86 samples, as the remaining 38 samples had insufficient DNA yield. A total of 44 of the 86 samples amplified in the D345del reaction: 5 (11.4%) carried the D345del, and 39 were classified as wild type. In the G545S reaction, 4 (6.4%) carried the mutation, and 58 were classified as wild type. Finally, sequencing of the <i>penA</i> gene in the 27 samples revealed mutations related to decreased susceptibility to cephalosporins. This study identified genetic mutations conferring resistance to azithromycin and decreased susceptibility to cephalosporins, providing an overview of the circulating mutations conferring resistance in <i>N. gonorrhoeae</i> strains in Peru.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"10 8","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12390473/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144970509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond the Usual Suspects: <i>Weeksella virosa</i> as a Potential Human and Animal Pathogen.","authors":"Ioana Alina Colosi, Dan Alexandru Toc, Vlad Sever Neculicioiu, Paul-Ștefan Panaitescu, Pavel Șchiopu, Adrian-Gabriel Pană, Razvan Vlad Opris, Alina Mihaela Baciu, George Berar, Alexandru Botan, Carmen Costache","doi":"10.3390/tropicalmed10080210","DOIUrl":"10.3390/tropicalmed10080210","url":null,"abstract":"<p><p><i>Weeksella virosa</i> (<i>W. virosa</i>) is a rare, non-saccharolytic Gram-negative bacterium initially described in the 1970s, later proposed as a distinct genus in 1986. The genus <i>Weeksella</i> currently contains two species, namely <i>W. virosa</i> and <i>W. massiliensis.</i> Although primarily considered non-pathogenic, recent evidence has linked <i>W. virosa</i> to a limited number of clinical infections, mostly in immunocompromised patients. This review aims to consolidate the current body of knowledge on <i>W. virosa</i>, encompassing its microbiological and biochemical characteristics, involvement in human and animal infections, antimicrobial susceptibility profiles, and a critical evaluation of existing diagnostic methodologies. This review includes 13 case reports detailing 16 human cases retrieved from multiple databases, highlighting diagnostic inconsistencies and a lack of standardized antimicrobial susceptibility testing. Although <i>W. virosa</i> is generally susceptible to most antibiotics with the exception of aminoglycosides, recent reports seem to suggest a possible emerging resistance trend. The presence of this organism in hospital environments raises concerns about its potential transmission within healthcare settings. While biochemical testing appears to offer reasonably accurate identification of <i>W. virosa</i>, molecular confirmation may be warranted in some cases mainly due to the organism's rarity. The reliability of MALDI-TOF MS for the identification of <i>W. virosa</i> remains currently uncertain. Further studies, including electron microscopy and genome-wide analysis, are urgently needed to clarify the pathogenic potential of this bacterium and guide clinical management. This review underscores the necessity for awareness among clinicians and microbiologists regarding this underrecognized pathogen.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"10 8","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12390210/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144970339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Retrospective Cohort Study of Leptospirosis in Crete, Greece.","authors":"Petros Ioannou, Maria Pendondgis, Eleni Kampanieri, Stergos Koukias, Maria Gorgomyti, Kyriaki Tryfinopoulou, Diamantis Kofteridis","doi":"10.3390/tropicalmed10080209","DOIUrl":"10.3390/tropicalmed10080209","url":null,"abstract":"<p><strong>Introduction: </strong>Leptospirosis is an under-recognized zoonosis that affects both tropical and temperate regions. While it is often associated with exposure to contaminated water or infected animals, its presentation and epidemiology in Mediterranean countries remain incompletely understood. This retrospective cohort study investigates the clinical and epidemiological profile of leptospirosis in Crete, Greece, a region where data are scarce.</p><p><strong>Methods: </strong>All adult patients with laboratory-confirmed leptospirosis admitted to three major public hospitals in Crete, Greece, between January 2019 and December 2023 were included in the analysis. Diagnosis was made through serologic testing along with compatible clinical symptoms.</p><p><strong>Results: </strong>A total of 17 patients were included. Their median age was 48 years, with a predominance of males (70.6%). Notably, more than half of the patients had no documented exposure to classic risk factors such as rodents or standing water. Clinical presentations were varied but commonly included fever, fatigue, acute kidney injury, and jaundice. Of the patients who underwent imaging, most showed hepatomegaly. The median delay from symptom onset to diagnosis was 11 days, underscoring the diagnostic challenge in non-endemic areas. Ceftriaxone was the most frequently administered antibiotic (76.5%), often in combination with tetracyclines or quinolones. Despite treatment, three patients (17.6%) died, all presenting with severe manifestations such as ARDS, liver failure, or shock. A concerning increase in cases was noted in 2023.</p><p><strong>Conclusions: </strong>Leptospirosis can present with severe and potentially fatal outcomes even in previously healthy individuals and in regions not traditionally considered endemic. The relatively high mortality and disease frequency noted emphasize the importance of maintaining a high index of suspicion. Timely diagnosis and appropriate antimicrobial therapy are essential to improving patient outcomes. Additionally, the need for enhanced public health awareness, diagnostic capacity, and possibly environmental surveillance to control this neglected but impactful disease better, should be emphasized.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"10 8","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12390392/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144970679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and Risk of Meningococcal Disease or Carriage During Mass Gatherings and Associated Travel: Systematic Review and Meta-Analysis.","authors":"Mohammed Samannodi, Hassan Alwafi, Jihad Muglan, Abdullah Tawakul, Rami M Algahtani, Hani M Almoallim, Ismail Ahmad Alghamdi, Majed Sameer Obaid, Amar Mohammad A Alkhotani, Aous Sami Hayat Alhazmi, Heba M Adly, Anas A Khan, Fahad A Alamri, Mohammed A Garout","doi":"10.3390/tropicalmed10080207","DOIUrl":"10.3390/tropicalmed10080207","url":null,"abstract":"<p><strong>Background: </strong>While efforts have been made to control meningococcal disease or carriage during mass gatherings (MGs), it is still a significant problem. This meta-analysis aims to assess the prevalence and predictors of meningitis carriage during MGs and travel.</p><p><strong>Methodology: </strong>PubMed, Scopus, Embase, and Cochrane were searched from their conception to January 2025. Cohort and cross-sectional studies assessing the prevalence of meningitis carriage and its serotype related to MGs and/or travel, and risk factors associated with its spread, were considered. The Newcastle-Ottawa scale was used for the quality assessment of studies.</p><p><strong>Results: </strong>Out of 1301 studies, 25 were considered for this meta-analysis. The largest geographic area involved was Saudi Arabia. A meta-analysis of 24 studies identified a pooled prevalence rate of meningococcal disease or carriage of 15.9% (95%CI: 4.45-27.4%) and the most frequent infecting organisms to be Serotype C (13.9%; 95%CI: -14.7 to 42.5; 4 studies) and A (11.5%; 95%CI: -2.13 to 25.2; 9 studies) among those at MGs or traveling. Age, gender, smoking history, and the vaccination status did not affect the infection risk.</p><p><strong>Conclusions: </strong>There is an increased prevalence of meningococcal disease and carriage, especially Serogroups A and C, associated with MGs and travel. New interventions and methodologies should be undertaken to control and prevent meningococcal disease or carriage transmission during such events.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"10 8","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12389967/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144970540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Severe Scrub Typhus with Acute Kidney Injury: Urine PCR Evidence from an East Coast Malaysian Cluster.","authors":"Siti Roszilawati Ramli, Nuridayu Arifin, Mohd Fahmi Ismail, Shirley Yi Fen Hii, Nur Suffia Sulaiman, Ernieenor Faraliana Che Lah, Nik Abdul Hadi Nik Abdul Aziz","doi":"10.3390/tropicalmed10080208","DOIUrl":"10.3390/tropicalmed10080208","url":null,"abstract":"<p><p><b>Background:</b> Scrub typhus (ST) is caused by <i>Orientia tsutsugamushi</i> (OT) infection, which is transmitted to humans through the bites of infected chiggers. The clinical presentations range from mild to life-threatening multi-organ dysfunction. This report describes a cluster of ST cases involving five oil palm estate workers in Pekan district, Pahang, Malaysia. <b>Methods:</b> The clinical history, laboratory, and entomological investigation were conducted on the patients, including the index case and four suspected cases in the cluster. Polymerase chain reaction (PCR) tests for OT and genotyping were performed on the patients' blood and urine samples. Serological testing by indirect immunoperoxidase (IIP) test against Rickettsial diseases was also conducted. <b>Principal Findings:</b> Patients presented with fever, myalgia, headache, rash, cough, and eschar. The index case developed severe ST complicated by acute kidney injury (AKI) and respiratory distress, requiring intubation and ventilation at the intensive care unit of a tertiary hospital. ST was confirmed through PCR analysis of a urine sample, showcasing a novel diagnostic approach. The other four cases were confirmed by a four-fold rise in immunoglobulin G (IgG) antibody titers. <b>Conclusions:</b> Oil palm estate workers are at high risk for chigger exposure in Malaysia. Awareness among clinicians and the public of ST is crucial for effective prevention, accurate diagnosis, and optimal management.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"10 8","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12389770/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144970585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the Gaps in the Diagnosis and Treatment in Extra-Pulmonary Tuberculosis Patients Under National Tuberculosis Elimination Programme (NTEP) Guidelines: A Multicentric Cohort Study.","authors":"Sanjeev Sinha, Renuka Titiyal, Prasanta R Mohapatra, Rajesh K Palvai, Itishree Kar, Baijayantimala Mishra, Anuj Ajayababu, Akanksha Sinha, Sourin Bhuniya, Shivam Pandey","doi":"10.3390/tropicalmed10080206","DOIUrl":"10.3390/tropicalmed10080206","url":null,"abstract":"<p><p>Extra-pulmonary tuberculosis (EPTB) can affect any organ of the body, producing a wide variety of clinical manifestations that make the diagnosis and treatment of EPTB challenging. The optimum treatment varies depending on the site of EPTB, its severity, and response to treatment. There is often uncertainty about the best management practices, with a significant departure from national guidelines. This study aims to identify gaps and barriers in adhering to the national guidelines for the diagnosis and treatment of EPTB. We included 433 patients having EPTB and followed up at predefined intervals of 2 months, 6 months, 9 months, and 12 months. Questionnaire-based interviews of the treating physician and the patients in different departments were conducted. For confirmatory diagnosis, heavy dependence on clinical-radiological diagnosis without microbiological support was observed, which is a deviation from National Tuberculosis Elimination Programme (NTEP) guidelines and raises concerns about the potential for misdiagnosis and overtreatment. Apart from patient delays, long health system delays in EPTB were observed. The median patient delay, health system delay, and total treatment delay times were 4.2, 4, and 10.1 weeks, respectively. To enhance EPTB diagnosis and management, there is a pressing need for improved access to microbiological testing, enhanced physician training on adherence to NTEP guidelines, and greater utilisation of imaging and histopathological techniques.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"10 8","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12390147/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144970369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rickettsioses Seropositivity in Malaysia: A Six-Year Trend, 2016-2021.","authors":"Bee Yong Tay, Fashihah Sherina Abdul Hadi Sabri, Zamtira Seman, Norlela Othman, Haida Subakir, Zahrul Laili Abd Hadi, Adilahtul Bushro Zaini, Norli Anida Abdullah, Nur Anisah Mohamed, Mohammad Yazid Abdad, Siti Roszilawati Ramli","doi":"10.3390/tropicalmed10080205","DOIUrl":"10.3390/tropicalmed10080205","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Rickettsioses are diseases caused by obligate intracellular non-motile coccobacilli transmitted via arthropods. The most common rickettsioses are scrub typhus (ST), typhus group rickettsioses (TGR), and spotted fever group rickettsioses (SFGR). This study aims to provide information and insight into rickettsioses seropositivity among suspected patients in East and Peninsular Malaysia over a six-year period from 2016 to 2021.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methodology/principal findings: &lt;/strong&gt;Data obtained from four state hospitals and one national research institute providing rickettsial serological testing were analyzed using the IBM SPSS (Statistical Package for the Social Sciences) software program. The six-year analysis revealed that ST had the highest number of seropositivity cases, followed by TGR, and SFGR, for both immunoglobulin M (IgM) and immunoglobulin G (IgG) antibodies. Of the 3228 samples, 21.6%, 16.1%, and 13.9% of suspected patients were IgM seropositive for ST, TGR, and SFGR, respectively. IgG seropositivity for ST was 21.9%, followed by TGR at 21.4%, and SFGR at 17.2% among suspected rickettsioses cases. All regions in Malaysia were significantly associated with IgM seropositivity for ST, TGR, and SFGR. IgM seropositivity for SFGR was significantly higher in females. Age group 41-65 years was highly associated with IgG seropositivity for ST, TGR, and SFGR.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions/significance: &lt;/strong&gt;Analysis of six-year data on ST, TGR, and SFGR seropositivity in Malaysia revealed variations across regions, age groups, and genders. This seropositivity study underscores ST, TGR, and SFGR as possible causes of acute febrile illness among patients suspected of rickettsial disease in Malaysia. The findings contributed to the awareness of reemerging rickettsioses and warrant public health interventions that may reduce the incidence of rickettsioses in Malaysia. Abstract summary: Scrub typhus (ST), typhus group rickettsioses (TGR), and spotted fever group rickettsioses (SFGR) are significant global public health concerns. Our results showed that the highest number of IgM and IgG seropositivity cases was observed for ST, followed by TGR and SFGR. All regions in Malaysia were significantly associated with IgM seropositivity for ST, TGR, and SFGR. East Malaysia exhibited significantly higher seropositivity for ST, TGR, and SFGR than other regions in Malaysia. IgM seropositivity for SFGR was significantly higher in females. The age group 41-65 years was highly associated with IgG seropositivity for ST, TGR, and SFGR. This study highlights the value of serological data in uncovering the hidden burden of disease in Malaysia. In addition, the findings contributed to bridging knowledge gaps on the limited data from Malaysia spanning extended periods, despite being one of the countries in the endemic Tsutsugamushi Triangle. The findings from this study may direct future research on rickettsioses and warrant public heal","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"10 8","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12390281/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144970602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond the Fever: A Serial Report on Moderate to Severe Murine Typhus Cases and Diagnostic Hurdles in Indonesia.","authors":"Velma Herwanto, Sandra Utami Widiastuti, Gunawan, Khie Chen Lie","doi":"10.3390/tropicalmed10080204","DOIUrl":"10.3390/tropicalmed10080204","url":null,"abstract":"<p><p>(1) Background: Murine typhus, caused by <i>Rickettsia typhi</i>, is a neglected rickettsial disease and an underdiagnosed cause of acute febrile illness (AFI), particularly in endemic regions such as Indonesia. (2) Case description: We report a case series of four patients presenting with AFI of less than seven days in duration. Three patients were admitted with moderate disease, while one presented with septic shock with the macrophage activation-like syndrome (MALS) phenotype. Common clinical features included myalgia and headache; additional symptoms included cough, sore throat, and abdominal pain. Laboratory findings revealed bicytopenia, elevated transaminases, and raised inflammatory and bacterial infection markers. Common tropical infections-dengue, typhoid fever, and leptospirosis-and other potential sources of infection were excluded early during hospitalization. Diagnosis was confirmed by nucleic acid amplification testing (NAAT), which detected <i>R. typhi</i> in all patients. Doxycycline was initiated following confirmation, leading to defervescence within 36-48 h. (3) Conclusions: Murine typhus remains an underrecognized cause of febrile illness in Indonesia. In the near future, the inclusion of rickettsial testing in the diagnostic protocol of AFI will be crucial, as it enables timely administration of effective, low-cost treatment.</p>","PeriodicalId":23330,"journal":{"name":"Tropical Medicine and Infectious Disease","volume":"10 8","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12390629/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144970323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}