Two of the fatal cases involved delayed antirickettsial
therapy after the patients were misdiagnosed with group A streptococcus.
elephantina listed in literature include anthelmintic [58-60], antibacterial [21, 28, 41, 43, 50, 61], antifungal [21, 41, 50, 61], anti-inflammatory and antinociceptive , antiplasmodial , antioxidant , and antibabesial and antirickettsial
[64, 65] activities.
Interferon-y and rickettsia-induced killing of macrophage-like cells is inhibited by antirickettsial
antibodies and does not require the respiratory burst.
All patients with clinically suspected scrub typhus received antirickettsial
drugs (doxycycline and/ or azithromycin) empirically.
The use of mosquito inoculation system for testing the efficacy of antirickettsial
In addition, rickettsial bacteria, whereas susceptible to OTC, often require higher therapeutic doses of OTC than other antirickettsial
compounds (Coetzee et al.
"Children generally improve markedly after starting antirickettsial
therapy--as demonstrated by, on average, defervescence within 2 days and hospital discharge within 5 days.
Before the discovery of effective antirickettsial
drugs, 13% of children with RMSF died .
Detection of growing rickettsiae was monitored by using Gimenez staining and an immunofluorescence assay of cells collected after centrifuging the medium and staining with rabbit antirickettsial
hyperimmunserum and Alexa Fluor 488 goat antirabbit immunoglobulin (Ig) G (H+L) conjugate (Invitrogen, Carlsbad, CA, USA) as secondary antibody (Figure).
The GeoSentinel questionnaire does not contain queries about case management, but in December 2008 all sites were requested to estimate the percentage of their patients with rickettsial diseases who received treatment with antirickettsial
drugs (e.g., doxycycline) during the study period.
antimicrobial agents were not given at any stage during the illness.