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Volume 11, Number 12—December 2005
Dispatch

Human Rickettsia felis Infection, Canary Islands, Spain

Jose-Luis Pérez-Arellano*†1, Florence Fenollar‡1, Alfonso Angel-Moreno*†, Margarita Bolaños*†, Michele Hernández*†, Evora Santana*†, Marion Hemmersbach-Miller*†, Antonio-M Martín*†, and Didier Raoult‡Comments to Author 
Author affiliations: *Hospital Universitario Insular de Las Palmas, Canary Islands, Spain; †Universidad de Las Palmas de Gran Canaria, Canary Islands, Spain; ‡Université de la Mediterranée, Marseille, France

Main Article

Table

Clinical, epidemiologic, and biological data between Rickettsia felis group, R. typhi group, and indeterminate rickettsiosis group

Characteristic R. felis R. typhi Indeterminate p value
No. 5 13 13 –
Mean age, y* 45 (16) 29 (14) 40(17) NS†
Sex (M/F) 5/0 10/3 12/1 NS‡
Contact with dogs or cats§ 4/5 11/13 11/13 NS‡
Interval between clinical picture and evaluation, d¶ 12 (9.5–14) 9 (8.5–10.2) 9 (7.9–13.4) <0.05#
Fever§ 5/5 13/13 13/13 NS‡
Maximal temperature (°C)* 39.3 (0.8) 39.6 (0.5) 39.4 (0.5) NS†
Headache§ 4/5 12/13 13/13 NS‡
Conjunctivitis§ 1/5 3/13 2/13 NS‡
Arthralgia/myalgia§ 4/5 6/13 5/13 NS‡
Odynophagia§ 0/5 6/13 0/13 0.01‡
Dry cough§ 3/5 8/13 2/13 0.04‡
Nausea/vomiting§ 0/5 2/13 1/13 NS‡
Abdominal pain§ 1/5 1/13 0/13 NS‡
Rash§ 0/5 9/13 6/13 0.03‡
Past or actual tick bite§ 1/5 2/13 1/13 NS‡
Hepatomegaly§ 1/5 6/13 5/13 NS‡
Splenomegaly§ 0/5 3/13 2/13 NS‡
Anemia (hemoglobin <13 mg/dL) 0/5 3/13 1/13 NS
Normal blood leukocyte counts (4,000–10,000/μL) 5/5 10/13** 11/13†† NS‡
Normal platelet counts (150,000–400,000/mL) 4/5 11/12‡‡ 11/13‡‡ NS‡
Normal ratio prothrombin time (0.8–1.2) 4/4 10/13 11/13 NS‡
Normal ESR (<10 mm/h) 1/4 11/12 3/11 NS‡
Normal creatinine blood level (62–106 mmol/L) 5/5 11/13 10/13 NS‡
Normal sodium blood level (136–144 mmol/L) 2/4 10/13 10/12 NS‡
Elevated AST (>35 IU/L) 4/5 8/13 5/12 NS‡
Mean AST (U/L) 123 254 72 0.01§§
Elevated ALT (>45 IU/L) 5/5 8/13 6/12 NS†
Mean ALT (U/L)¶¶ 185 (71–374) 354 (55–1,368) 86 (34–292) <0.01§§
Elevated GGT (>55 IU/L) 2/5 3/13 4/12 NS‡
Elevated total serum protein concentration (>80 g/L) 0/5 0/12 1/12 NS‡
Elevated gamma globulin concentration (>13 g/L) 2/5 5/12 8/10 NS‡

*Data are expressed as mean (SD). Samples are distributed normally and have similar SD. NS, nonsignificant; ANOVA, analysis of variance test; ESR, erythrocyte sedimentation rate; AST, aspartate aminotransferase; ALT, alanine aminotransferase; GGT, gamma-glutamyl transpeptidase.

†ANOVA.

‡χ2 test.

§No. patients with these epidemiologic or clinical data/no. patients evaluated.

¶Data are expressed as median and 95% confidence intervals; >1 samples have a non-gaussian distribution.

#Significant differences between R. felis and R. typhi groups (p<0.05) with Dunn test.

**Leukopenia in 1 patient (3,700/μL), leukocytosis in 2 patients (11,500/μL and 16,000/μL).

††Leukopenia in 2 patients.

‡‡All patients with an abnormal platelet count presented with thrombocytopenia in all cases.

§§ANOVA; all cases.

¶¶Data are expressed as mean (range values). Samples are distributed normally and have similar SD.

Main Article

1These authors contributed equally to this article.

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