14th ICID - Poster Abstracts - International Society for Infectious ...

When citing these abstracts please use the following reference:
Author(s) of abstract. Title of abstract [abstract]. Int J Infect Dis 2010;14S1: Abstract number.
Please note that the official publication of the International Journal of Infectious Diseases 2010, Volume 14, Supplement 1
is available electronically on http://www.sciencedirect.com
Final Abstract Number: 76.004
Session: Emerging Infectious Diseases
Date: Friday, March 12, 2010
Time: 12:30-13:30
Room: Poster & Exhibition Area/Ground Level
Type: Poster Presentation
Etiologic aspects of 341 cases of acute undifferentiated febrile syndrome (AUFS) in southeast
Brazil
P. S. Gonçalves da Costa, L. M. Carvalho valle, M. E. Brigatte
Hospital Monte Sinai & Suprema Medical School, Juiz de Fora MG, MG, Brazil
Background: The etiologic nature of the acute undifferentiated febrile syndromes (AUFS) has
been a challenge everywhere. This last aspect has been overwhelming in developing countries
like Brazil where limited information has been available. We systematically sought the etiology of
AUFS in 341 in and outpatients seen from the city of Juiz de Fora, Minas Gerais State, Brazil,
during a 5 years period.
Methods: Three hundred and forty one consecutive in and outpatients with AUFS were studied.
Serological tests for rickettsial infections were performed by microimmunofluorescence with “in
door” slides using antigens from CDC Atlanta USA: Ehrlichia chaffeensis , Coxiella burnetii ,
Rickettsia typhi , Rickettsia rickettsii, Bartonella henselae and Bartonella quintana.
Rickettsia felis identification was done by PCR in the attacking fleas. Serological tests for
salmonellosis, brucelosis, toxoplasmosis, leptospirosis, CMV, EBV, Mycoplasma pneumonia,
Chlamydia pneumoniae, Lyme’s disease, brucellosis, HIV and dengue fever were performed in
referral commercial laboratories. Influenza antigens tests, Toxocara canis and hantanvirus
serologic tests were performed in patients with specific strong epidemiological and clinical
evidence. Blood and other materials cultures were locally performed.
Results: Dengue fever was the most frequent diagnosis with 78 cases (22.9 %) . Fifth-three
rickettsial infections gave rise to 15.5 % of etiologies leaded by spotted fever group rickettsiosis
with 19 cases (5.6%) 3 of then Rickettsia felis infections (0.9%). Q fever - 14 cases (4.1%),
monocytotropic ehrlichiosis - 12 cases (3.5%), murine typhus - 5 cases (1.5 %) and Bartonella
spp. infection - 3 cases (0.9%) were the other rickettsial causes. EBV infection were 20 cases
(5.7 %). Parvovirus B19, CMV and M. pneumoniae infection, all with 13 cases (3.8% each) were
also frequently diagnosed. Toxoplasmosis cases were 10 (2.9%) and Chlamydia pneumoniae 7
(2%). Influenza, leptospirosis and enteric fever were 6 cases each (1.7%), followed by yellow
fever vaccine reactions (5 cases - 1.5%). Seventy-seven cases (22.6%) remained inconclusive
and a myriad of other disorders was identified in 34 patients (10%).
Conclusion: This study emphasizes the need of investigating a wide array of etiological agents
rather than simplistic syndromic approaches. High frequency of rickettsial infection and dengue
fever were observed in this study.