OBJECTIVES: To identify different @entity281 using a specific immunofluorescent technique in @entity1 clinically diagnosed as ' @entity221 ' in the Central Province of @entity3595 Lanka, and to define the clinical picture, assess the severity of @entity281 and to determine the pattern of geographical distribution of the infections of the hospital-based @entity1 . METHODS: A specific indirect immunofluorescent antibody technique was used on the sera of two groups of @entity1 in laboratories in Japan and Thailand. RESULTS: We serodiagnosed infections with @entity9557 , @entity13167 and spotted @entity221 group in 56 of 118 clinically investigated @entity1 . There were eight infections with @entity9557 , two with @entity13167 and 10 spotted @entity221 group @entity1 with IgM antibodies suggestive of @entity697 . Nineteen patients had antibodies against these three rickettsial species, suggestive of past exposure, @entity325 or cross-reactivity of antigens. Discrete, @entity1910 was common to all three types of @entity281 except for five @entity1 who had no rash. Five @entity1 positive for spotted @entity221 antibodies developed fern-leaf type @entity39 with severe @entity221 . Duration of the febrile period ranged from 4 to 23 days with defervescence occurring after specific antibiotic treatment. CONCLUSIONS: The study has shown the presence of different types of @entity281 in the Central Province of @entity3595 Lanka. The characterization of the clinical picture and the severity of @entity281 provide useful information for the proper management of the @entity1 in the future.

@entity281 in XXXX Lanka: the pattern in the hilly Central Province.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity697 :: ('MESH:D000208', 'Disease') :: ['acute infection'] @entity1910 :: ('MESH:D005076', 'Disease') :: ['erythematous maculopapular rash'] @entity39 :: ('MESH:D009336', 'Disease') :: ['skin necrosis'] @entity13167 :: ('785', 'Species') :: ['Rickettsia typhi', 'R. typhi'] @entity281 :: ('MESH:D007239', 'Disease') :: ['infection', 'rickettsial infections'] @entity9557 :: ('784', 'Species') :: ['O. tsutsugamushi', 'Orientia tsutsugamushi'] @entity3595 :: ('6717', 'Gene') :: ['Sri'] @entity325 :: ('MESH:D060085', 'Disease') :: ['co-infection'] @entity221 :: ('MESH:D005334', 'Disease') :: ['typhus fever', 'illness', 'fever']
@entity3595 :: (6717,Gene) :: ['Sri']
