Bengaluru: It is not just dengue and dengue-like fever that is baffling doctors at the government-run Vanivilas Hospital. Another fever that mimics dengue, called the Rickettsial fever, has made the diagnoses difficult for the doctors.
“Riekettsial fever is more progressive and prolonged and it mimics dengue. Surprisingly, the clinical symptoms are the same as dengue," explained Dr Mallesh K., professor and in-charge HoD, Paediatrics at Vanivilas Hospital. The hospital witnessed some 100 admissions which not only included dege fever cases, but also Reikettsial fever, he said.
The biggest challenge, however, for the clinicians is the diagnostic dilemma posed by these infections early in their clinical course. “For the patients, whose tests come dengue negative, we zero down to Riekettsial fever and then we get the Weil-Felix test done which is easily available for diagnosis. If the clinical score is 14 or more on the proposed scoring system, then it has very high sensitivity and specificity for the diagnosis of spotted fever group of rickettsial diseases," he explained.
Confirmed cases of fever for more than seven days are given the full course of anti-rickettsial antibiotics and supportive therapy. The doctors prefer doxycycline or azithromycin as the drug of choice. “Doxycycline is the drug of choice. It can be used for treatment of rickettsial diseases in children of any age. Treatment must be initiated empirically in suspected cases without awaiting laboratory confirmation, as morbidity and mortality escalate rapidly with each day of treatment delay. Also, treatment should not be discontinued solely on the basis of a negative test result," he warned.