First Identification and Description of Rickettsioses and Q Fever as Causes of Acute Febrile Illness in Nicaragua.

Journal Article (Journal Article)


Rickettsial infections and Q fever present similarly to other acute febrile illnesses, but are infrequently diagnosed because of limited diagnostic tools. Despite sporadic reports, rickettsial infections and Q fever have not been prospectively studied in Central America.

Methodology/principal findings

We enrolled consecutive patients presenting with undifferentiated fever in western Nicaragua and collected epidemiologic and clinical data and acute and convalescent sera. We used ELISA for screening and paired sera to confirm acute (≥4-fold rise in titer) spotted fever and typhus group rickettsial infections and Q fever as well as past (stable titer) infections. Characteristics associated with both acute and past infection were assessed.


We enrolled 825 patients and identified acute rickettsial infections and acute Q fever in 0.9% and 1.3%, respectively. Clinical features were non-specific and neither rickettsial infections nor Q fever were considered or treated. Further study is warranted to define the burden of these infections in Central America.

Full Text

Duke Authors

Cited Authors

  • Reller, ME; Chikeka, I; Miles, JJ; Dumler, JS; Woods, CW; Mayorga, O; Matute, AJ

Published Date

  • December 30, 2016

Published In

Volume / Issue

  • 10 / 12

Start / End Page

  • e0005185 -

PubMed ID

  • 28036394

Pubmed Central ID

  • PMC5201229

Electronic International Standard Serial Number (EISSN)

  • 1935-2735

International Standard Serial Number (ISSN)

  • 1935-2727

Digital Object Identifier (DOI)

  • 10.1371/journal.pntd.0005185


  • eng