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

Publication ,  Journal Article
Murdoch, DR; Woods, CW; Zimmerman, MD; Dull, PM; Belbase, RH; Keenan, AJ; Scott, RM; Basnyat, B; Archibald, LK; Reller, LB
Published in: Am J Trop Med Hyg
June 2004

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.

Duke Scholars

Published In

Am J Trop Med Hyg

ISSN

0002-9637

Publication Date

June 2004

Volume

70

Issue

6

Start / End Page

670 / 675

Location

United States

Related Subject Headings

  • Tropical Medicine
  • Streptococcus pneumoniae
  • Salmonella typhi
  • Salmonella paratyphi A
  • Rickettsia typhi
  • Orientia tsutsugamushi
  • Nepal
  • Middle Aged
  • Male
  • Leptospira
 

Citation

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Murdoch, D. R., Woods, C. W., Zimmerman, M. D., Dull, P. M., Belbase, R. H., Keenan, A. J., … Reller, L. B. (2004). The etiology of febrile illness in adults presenting to Patan hospital in Kathmandu, Nepal. Am J Trop Med Hyg, 70(6), 670–675.
Murdoch, David R., Christopher W. Woods, Mark D. Zimmerman, Peter M. Dull, Ram Hari Belbase, Andrew J. Keenan, Robert Mcnair Scott, Buddha Basnyat, Lennox K. Archibald, and L Barth Reller. “The etiology of febrile illness in adults presenting to Patan hospital in Kathmandu, Nepal.Am J Trop Med Hyg 70, no. 6 (June 2004): 670–75.
Murdoch DR, Woods CW, Zimmerman MD, Dull PM, Belbase RH, Keenan AJ, et al. The etiology of febrile illness in adults presenting to Patan hospital in Kathmandu, Nepal. Am J Trop Med Hyg. 2004 Jun;70(6):670–5.
Murdoch, David R., et al. “The etiology of febrile illness in adults presenting to Patan hospital in Kathmandu, Nepal.Am J Trop Med Hyg, vol. 70, no. 6, June 2004, pp. 670–75.
Murdoch DR, Woods CW, Zimmerman MD, Dull PM, Belbase RH, Keenan AJ, Scott RM, Basnyat B, Archibald LK, Reller LB. The etiology of febrile illness in adults presenting to Patan hospital in Kathmandu, Nepal. Am J Trop Med Hyg. 2004 Jun;70(6):670–675.

Published In

Am J Trop Med Hyg

ISSN

0002-9637

Publication Date

June 2004

Volume

70

Issue

6

Start / End Page

670 / 675

Location

United States

Related Subject Headings

  • Tropical Medicine
  • Streptococcus pneumoniae
  • Salmonella typhi
  • Salmonella paratyphi A
  • Rickettsia typhi
  • Orientia tsutsugamushi
  • Nepal
  • Middle Aged
  • Male
  • Leptospira