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Molly Eaton, MD; Milton T. Cohen, MD; David R. Shlim, MD
CIWEC Clinic Kathmandu, Nepal

Bruce Innes, MD
Armed Forces Research Institute of Medical Sciences Bangkok, Thailand

JAMA. 1989;262(6):772-773.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor. —

Ciprofloxacin is a quinolone antibiotic that is effective against a variety of bacterial pathogens. In vitro activity against Rickettsiaceae has been documented,^1,2 but there are few successful case reports of treatment.³ We present two cases of rickettsial disease in which fever and constitutional symptoms resolved within 72 hours of starting ciprofloxacin therapy. These diagnoses were established by indirect immunoperoxidase antirickettsial immunoassays⁴ on paired serum samples performed at the Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand.

Report of Cases.— CASE 1.—

A 33-year-old Dutch man working in Nepal presented with 6 days of fever (temperature as high as 39.5°C), severe headaches, and myalgias. Ten days before the onset of symptoms he stayed with a Nepalese family and sustained multiple bites from insects in their straw mattress.

His temperature was 38.6°C, his pulse rate was 104 beats per minute, and his blood . . . [Full Text PDF of this Article]

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