The etiology of febrile illness in adults presenting to Patan hospital in Kathmandu, Nepal.

Published

Journal Article

In Nepal, many infections remain poorly characterized, partly due to limited diagnostic facilities. We studied consecutive febrile adults presenting to a general hospital in Kathmandu, Nepal. Of the 876 patients enrolled, enteric fever and pneumonia were the most common clinical diagnoses. Putative pathogens were identified in 323 (37%) patients, the most common being Salmonella enterica serotype Typhi and S. enterica serotype Paratyphi A (117), Rickettsia typhi (97), Streptococcus pneumoniae (53), Leptospira spp. (36), and Orientia tsutsugamushi (28). Approximately half of the Salmonella isolates were resistant to nalidixic acid. No clinical predictors were identified to reliably distinguish between the different infections. These findings confirm the heavy burden of enteric fever and pneumonia in Kathmandu, and highlight the importance of murine typhus, scrub typhus, and leptospirosis. Given the lack of reliable clinical predictors, the development of cheap and accurate diagnostic tests are likely to be of great clinical utility in this setting.

Full Text

Duke Authors

Cited Authors

  • Murdoch, DR; Woods, CW; Zimmerman, MD; Dull, PM; Belbase, RH; Keenan, AJ; Scott, RM; Basnyat, B; Archibald, LK; Reller, LB

Published Date

  • June 2004

Published In

Volume / Issue

  • 70 / 6

Start / End Page

  • 670 - 675

PubMed ID

  • 15211012

Pubmed Central ID

  • 15211012

Electronic International Standard Serial Number (EISSN)

  • 1476-1645

International Standard Serial Number (ISSN)

  • 0002-9637

Digital Object Identifier (DOI)

  • 10.4269/ajtmh.2004.70.670

Language

  • eng