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Table 1 Clinical and laboratory features of patients diagnosed with murine typhus (patient 1 and 2) and scrub typhus (patients 3 and 4) at the Institute of Tropical Medicine/University Hospital, Antwerp between 2013 and 2015

From: Acute-phase diagnosis of murine and scrub typhus in Belgian travelers by polymerase chain reaction: a case report

Patient 1 2 3 4
Age (years) 37 34 23 23
Gender F F F F
Visited country(ies) Indonesia Ethiopia Vietnam-Cambodia Thailand -Cambodia
Dates of travel (duration in days) 26/07–18/08/2013 (24) 05–13/02/2015 (8) 28/09–28/10/2015 (30) 03/10–10/11/2015 (37)
Date of fever onset (days post-travel) 28/08/2013 (10) 21/02/2015 (8) 29/10/2015 (1) 13/11/2015 (3)
Date of first-line medical evaluation (days after fever onset) 01/09/2013 (3) 27/02/2015 (6) 1/11/2015 (4) 16/11/2015 (3)
Antibiotic received before 1st contact ITM NA NA ciprofloxacin NA
Date of first contact with ITM (days after fever onset) 05/09/2013 (8) 27/02/2015 (6) 4/11/2015 (5) 16/11/2015 (3)
Date of admission at UHA (days after fever onset) 06/09/2013 (9) 28/02/2015 (7) 4/11/2015 (5) 18/11/2015 (5)
Duration of hospital stay (days) 7 13 6 3
Symptoms and signs (at admission)
Headache yes yes yes no
Muscle and/or joint pain yes yes yes yes
Dyspnoea yes no no no
Dry cough yes yes yes yes
Abdominal pain yes no yes no
Nausea yes no no no
Fever yes yes yes yes
Rash yes yes yes no
Eschar no no yes no
Laboratory results (normal value range)
WBC (3500–9000 /μL) 8110 8800 10560 3800
Platelets (150-450 × 103/mL) 148 113 161 99
CRP (<10 mg/L) 147 182 238 10
AST (17–59 IU/L) 276 147 1237 39
ALT (21–72 IU/L) 222 184 1491 42
LDH (313–618 IU/L) 2822 640 3115 247
Diagnostic work-up for other pathogens negative negative negative negative
Polymerase Chain Reaction (PCR) results
Pathogen Rickettsia typhi Rickettsia typhi O tsutsugamushi O tsutsugamushi
Sample type serum serum whole blood/eschar whole blood
Cycle threshold value (Ct) Ct 38.67 Ct 35.65 Ct 31.73/Ct 25,42 Ct 36.33
Date of sampling (days after fever onset) 6/09/2013 (9) 5/03/2015 (12) 4/11/2015 (6) 18/11/2015 (5)
Serological results (IgG titer)
R. typhi acute serum (days after fever onset) 1/128 (9) 1/256 (12) negative negative
R.typhi convalescent serum (days after fever onset) 1/1024 (23) 1/1024 (26) negative negative
O. tsutsugamushi acute serum ND ND ND ND
O. tsutsugamushi convalescent (days after fever onset) ND ND negative (28) negative (19)
R. conorii (acute-convalescent) negative-negative negative-ND negative-negative negative-negative
C. burneti (acute-convalescent) negative-negative ND-ND negative-negative ND-ND
Diagnosis
Interval hospital admission - PCR diagnosis (days) 13 20 9 8
Interval hospital admission - seroconversion (days) 21 27 NA NA
  1. ITM Institute of Tropical Medicine, UHA University Hospital Antwerp, NA not applicable, ND not done