Fever is common, but causes may not

Tahsin a ten years old boy is my regular patient. Recently he came to me with fever, cough, malaise and headache for seven days. There was no specific signs and according to history fever was not very characteristic for any specific disease. He was given paracetamol and asked to come back after three days if problem still persisted.

I requested Tahsin's mother to make a temperature chart. After three days they came back with a temperature chart. Mother was a bit worried as there was no improvement of the symptoms. Temperature chart showed irregular fever. This time I asked for some lab tests including Febrile antigen. Rickettsial infection was found positive. After administration of Doxicycline he was cured.

Fever is a common symptoms of many disease and sometimes pinpoint diagnosis even after many lab tests cannot be ascertain. So suspicion of some rare diseases to be kept in mind.

Now a days occasionally we get rickettsial infections. There are various types of rickettsial diseases. These are spread by some arthropod like ticks, mites, lice, fleas etc. History of bite or mark of bite are often missed if there is no sore at the site of bite. Usually symptoms are fever, headache, cough, malaise, rash etc. that mimics many diseases. Incubation period is three to ten days. Infections are not transmitted from person to person. It is a vector borne disease.

Treatment by antibiotics can cure the disease. There is no vaccine yet for rickettsia. Personal protection from bites of arthropod wearing long sleeved clothes, cleaning the kitchen, bed rooms and surrounding bushes may help. Isolation of infected person from kids is helpful.

Please take care of your beloved Kids.

The author is a Professor of Paediatrics at Community Based Medical College, Mymensingh.

E-mail: mmukkhan@gmail.com