European Journal of Molecular & Clinical Medicine

Abstract

Background: Rickettsial infections are the most covert re-emerging infections in present
times. They are incapacitating and notoriously difficult to diagnose, Weil-Felix (WF) test is
classic serological test which is widely available but not widely acceptable because of its low
sensitivity and specificity. Present study was aimed to study of usefulness of Weil-Felix test
as a simple diagnostic tool for diagnosis of rickettsial fever.
Material and Methods: Present study was single-center, prospective, observational study,
conducted in children < 18 years age, hospitalized with fever and presence of one or more of
the following clinical features: Rash, edema, eschar, hepatosplenomegaly, lymphadenopathy
OR had history of contact with pets or live stocks and history of tick-bite.
Results: In the present study maximum number of cases were from school going age group
(53.5%), male (67.4%), from Rural Areas (88.4%) & Tick bite could be demonstrated in
44.2% cases. Based on clinical features Lymphadenopathy was seen mainly 86.00%,
followed by maculopapular rash (76.7%), rash appearing 48-96 hrs. after fever (72.10%),
conjunctival congestion (55.80%), hepatomegaly (48.80%), rash on palms & soles, pedal
edema (34.9%) & purpura (14%). Out of 43 suspected cases, Weil-Felix test was positive in
31 cases (72.1%) and Negative in 12 cases (27.90%).
Conclusion: Rickettsial disease must be strongly suspected with a triad of fever, rash and
lymphadenopathy or having history of tick exposure/ bite and when the cause of fever cannot
be established. Weil Felix test can be carried out for early detection of suspicious casein
resource limited set up.