[SEROLOGICAL RESEARCH ON RICKETTSIAL AND PARARICKETTSIAL DISEASES IN ANIMALS AND MAN IN SEVERAL EPIZOOTIC FOCI].
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Animals↗
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Results for “RICKETTSIAL DISEASES”
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[Chemotherapy in perspective; chemotherapy of rickettsial and virus diseases].
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Rickettsia Infections↗
Red eyes and red rash with fever: an uncommon initial presentation for staphylococcal obturator abscess with adjacent ischial osteomyelitis.
"Red eyes and red rash with fever" is a common pediatric complaint; however, it is an uncommon initial presentation for staphylococcal obturator abscess with adjacent ischial osteomyelitis. The case of a 13-year-old boy who was admitted to the hospital with conjunctivitis, erythematous maculopapular lesions, and fever and had this final diagnosis is reported. The differential diagnosis included various bacterial diseases, several viral illnesses, and rickettsial disease.
Abscess↗
[A case of Tsutsugamushi disease as an imported infection].
Tsutsugamushi disease is widely spread throughout Japan. A case of tsutsugamushi disease was seen in October, 1996. A 64-year-old male developed typical symptoms of tsutsugamushi disease with Rickettsia tsutsugamushi, after he returned to Japan from Cheju Island, Korea. Not only in Japan but also in other Asian countries including Korea, China, Taiwan, and Thailand, tsutsugamushi disease is one of the most important rickettsial diseases carried by ticks or mites. If a traveller returning from an Asian country has symptoms such as high fever, skin eruption, and lymphadenitis, we should suspect that he is suffering from tsutsugamushi disease and should search if he has an eschar on any area of his body. We should not forget that tsutsugamushi disease is an imported disease. Patients of tsutsugamushi disease often have hematological disorders. They are sometimes referred to the hematological section of the hospital. Hematologists should be familiar with this disease.
Anti-Bacterial Agents↗
Current concepts on the transmission of bacteria and parasites by blood components.
Several bacterial and parasite transfusion-transmitted diseases have been described in the medical literature. This review deals with the main bacterial (Syphilis, Lyme disease, Gram positive and Gram negative agents), parasite (Chagas disease, malaria, leishmaniasis, toxoplasmosis and babesiosis) and rickettsial diseases that are carried by blood products. Preventional aspects (e.g. storage, screening tests, use of leukocyte-depleted components), diagnosis, geographical distribution and the incidence of these transfusional hazards are also discussed.
Babesiosis↗
Zoonoses and bats: a look from human health viewpoint.
Bats are the most abundant and most widely distributed mammals on the Earth after humans. Except Antarctica and some small remote islands, they are prevalent worldwide. Although the actual role played by bats as reservoir or in disseminating zoonoses is still enigmatic a multitude of zoonotic diseases are known to be associated with bats. Such diseases including viral, bacterial, parasitic, fungal and rickettsial diseases, reported from all over the world including India have been briefed in this article as an informative approach because dramatically increased and diversified human activities during the last few decades perturbing natural ecosystems are enough to compel public health personnel to have an investigative look at these flying mammals.
Animals↗
Fever in travelers returning from tropical areas: prospective observational study of 613 cases hospitalised in Marseilles, France, 1999-2003.
BACKGROUND: Febrile travelers may pose a diagnostic challenge for Western physicians who are frequently involved in the assessment of these patients but unfamiliar with tropical diseases. Evaluation of this situation requires an understanding of the common etiologies, which are associated with the demographics of travelers and the destinations. METHODS: We conducted a 5-year prospective observational study on the etiologies of fever in travelers returning from the tropics admitted to the infectious and tropical diseases unit of a university teaching hospital in Marseilles, France. RESULTS: A total of 613 patients were enrolled, including 364 migrants (59.4%), 126 travelers (20.6%), 37 visitors (6%), 24 expatriates (3.9%), and 62 patients (10.1%) who could not be classified. Malaria was the most common diagnosis (75.2%), with most cases (62%) acquired by migrants from the Comoros archipelago and who had traveled to these islands to visit friends and relatives. Agents of food-borne and water-borne infections (3.9%) and respiratory tract infections (3.4%) were also frequently identified as the cause of fever. Other infections included emerging diseases such as gnathostomiasis, hepatitis E infection and rickettsial diseases, as well as common infections or exotic diseases. CONCLUSIONS: Although we have identified here various causes of imported fever, 8.2% of the fevers remained unexplained. An improved approach to diagnosis may allow for the discovery of new diseases in travelers in the future.
Adult↗
[INVESTIGATIONS OF THE ROLE OF RICKETTSIAL AND PARA-RICKETTSIAL INFECTIONS IN HUMAN EYE DISEASES].
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Eye Diseases↗
Buerger's disease: is it a rickettsiosis?
A serologic study using the direct seroagglutinate method described by Babudieri and Zardi was carried out in 31 patients affected by Buerger's disease, to determine the positive antibody reaction level against rickettsial disease. In 41.9% of the cases there was a positive test for R. burnetii, in 6.4% a positive test for R. mooserii, and in one a positive test for R. conorii. The results lead us to believe that these pathogenic agents are largely responsible for the development of thromboangiitis obliterans.
Adult↗
Rickettsiosis-associated hyponatremia.
Two patients with hyponatremia (130 mEq/l and 122 mEq/l, respectively), and rickettsial disease are described. The causes of hyponatremia were attributed to rickettsial vasculitis and increased capillary permeability in the first patient and to the syndrome of inappropriate anti-diuretic hormone (ADH) secretion in the second patient. The differentiation between the mechanisms was established by measurement of urinary sodium excretion which was low in the first patient (7 mEq/l) and high in the second patient (60 mEq/l), and levels of ADH that were inappropriately high in the second patient (7-9 pg/ml) in the presence of low plasma osmolality. The differentiation between these causes of hyponatremia has important therapeutic implications.
Adolescent↗
Prevalence and distribution of spotted fever and typhus infections in Sierra Leone and Ivory Coast.
A serosurvey for evidence of rickettsial infections was conducted in the rural populations of several tropical rain forest areas in Sierra Leone and Ivory Coast. Seropositivity rates were surprisingly high in both countries, with more than 7% of the individuals in some districts having antibodies to spotted fever-group rickettsiae. No significant difference was found in the overall prevalence of diagnostic antibody titers to spotted fever-group rickettsiae in Sierra Leone (5.3%) and Ivory Coast (6.2%). However, there was a significant difference (p less than 0.001) in the prevalence of diagnostic antibody titers to typhus rickettsiae in the two countries. There were no marked geographic differences within either country in overall prevalence of rickettsial infections, but there were possible area differences in specific seropositivity rates to typhus- and spotted fever-group rickettsiae in Sierra Leone. In both countries, age and sex differences were important in determining seropositivity, but there was no indication of an age-sex interaction. In Sierra Leone, 59 of the 80 positive sera (73.8%) were from persons age 15 or above (p less than 0.001), and 50 of the 80 (62.5%) were from males (p = 0.05). In Ivory Coast, 33 of the 37 positive sera (89.2%) were from the greater than or equal to 15-age group, and 28 of the 37 (75.7%) were from males (p less than 0.001 for both age and sex). The identification of specific areas endemic for these rickettsial diseases should facilitate the diagnosis and treatment of patients with rickettsial illnesses in West Africa.
Adolescent↗
Rickettsial vaccines: the old and the new.
In the past century vaccine development for prevention of rickettsial diseases has been prolific. However, in the past 20 years no new rickettsial vaccine has been manufactured and there are currently no new or old rickettsial vaccines licensed. Early rickettsial vaccines were difficult, expensive and very hazardous to produce. Molecular biology techniques of today are currently being used to develop new rickettsial vaccines that are standardized, inexpensive, nonhazardous and efficacious.
Animals↗
Fever in the returned traveler.
The most important cause of fever in the returned traveler is malaria. All febrile patients in which malaria is epidemiologically possible require urgent evaluation for P. falciparum malaria, which can be rapidly fatal in the nonimmune patient. Early diagnosis and therapy can prevent severe morbidity and mortality. Other less common causes of undifferentiated fever include acute schistosomiasis, the enteric fevers, rickettsial diseases, leptospirosis, and dengue fever. Early empiric therapy for suspected leptospirosis and the rickettsial infections is encouraged to decrease morbidity and mortality. About a quarter of febrile patients do not have an etiologic agent determined for their illness but recover without sequelae. Patients with fever and hemorrhagic manifestations within 3 weeks of their return need to be isolated for the remote possibility of a highly transmissible agent. Although the febrile traveler is always a challenge, the real world differential diagnosis is limited and a systematic approach via the history, physical examination, and selected laboratory tests is usually sufficient to confirm the diagnosis or eliminate potentially serious infections.
Dengue↗
Murine and scrub typhus at Thai-Kampuchean border displaced persons camps.
Rickettsial infections are considered a major cause of illness among inmates of Thai-Kampuchean border displaced persons camps. In the absence of sophisticated laboratory support, it had become common practice to treat patients with obscure fevers with tetracycline as a 'diagnostic' test for typhus. This study evaluated a group of 67 randomly selected camp inmates who presented with fever and had findings that indicated a specific diagnosis. Differential blood counts, malaria smears, hemoglobin determinations, blood cultures, dengue and Japanese encephalitis virus and rickettsial IgM and IgG antibody titers were determined. Patients were then treated with tetracycline and followed. They could be divided into six groups after data were analyzed. Those with no final diagnosis comprised 14 cases (21%), 4 patients (6%) were found to have dengue fever, 6 (9%) scrub typhus and 39 (58%) had murine (endemic) typhus. None of the bacterial blood cultures drawn from this group grew any organisms and no tick typhus or Japanese encephalitis was diagnosed. Analysis of symptoms and signs did not allow clinical differentiation between groups. All patients became afebrile and well within 1-5 days of starting tetracycline therapy. We conclude that rickettsial disease is a major health problem in the Thai-Kampuchean border camps. The incidence of murine typhus increased during the dry season and was more prevalent among males. The use of tetracycline as a 'therapeutic test' did not distinguish between rickettsial, viral and undiagnosed febrile diseases.
Cambodia↗
Rickettsial infections and fever, Vientiane, Laos.
Rickettsial diseases have not been described previously from Laos, but in a prospective study, acute rickettsial infection was identified as the cause of fever in 115 (27%) of 427 adults with negative blood cultures admitted to Mahosot Hospital in Vientiane, Laos. The organisms identified by serologic analysis were Orientia tsutsugamushi (14.8%), Rickettsia typhi (9.6%), and spotted fever group rickettsia (2.6% [8 R. helvetica, 1 R. felis, 1 R. conorii subsp. indica, and 1 Rickettsia "AT1"]). Patients with murine typhus had a lower frequency of peripheral lymphadenopathy than those with scrub typhus (3% vs. 46%, p<0.001). Rickettsioses are an underrecognized cause of undifferentiated febrile illnesses among adults in Laos. This finding has implications for the local empiric treatment of fever.
Adolescent↗
The role of rodents as reservoirs for some diseases in new reclaimed areas in north Sinai.
In a trial to determine the role of Sinai rodents as reservoirs to rickettsial diseases, the IFA technique was used to detect the presence of R. typhi and spotted fever group in blood of some commensal and wild rodent species collected in Sinai during the last five years (1985-1989). Out of 277 Rattus spp. collected in El Arish (47.3%) were positive to R. typhi and only (5.9%) of 35 Mus musculus were positive to R. typhi. As for Gerbillus spp. only (1.5%) of 206 animals were positive for R. typhi. The positive cases of spotted fever group were (34.6%) in Rattus spp. and (18.8%) in Gerbillus spp.
Animals↗
Central nervous system involvement in patients with scrub typhus.
Scrub typhus, which is caused by Orientia tsutsugamushi, is a systemic illness that causes generalized vasculitis. The central nervous system (CNS) is the most crucial target in other rickettsial diseases; however, there have been several reports of encephalitis or meningitis without direct evidence of rickettsial invasion of the CNS in cases of scrub typhus. To investigate CNS involvement in cases of scrub typhus, we analyzed the CSF profiles (cell count and levels of protein and glucose) and amplified rickettsial DNA in CSF specimens by means of nested polymerase chain reaction (PCR) for 25 patients with the infection. Mild pleocytosis was present in 48% of the patients: CSF white blood cell counts ranged from 0 to 110/mm3 (mean [+/- SD] count, 16.3 +/- 27.0/mm3), and the mean (+/- SD) lymphocyte proportion was 51.9% +/- 23.9%. The CSF protein level was increased (>50 mg/dL) in seven patients. Nested PCR amplified six products from the 25 CSF specimens: four of the products were Boryong genotypes, and two were Karp genotypes. The results of this study suggest that O. tsutsugamushi does invade the CSF and that scrub typhus should be considered one of the causes of mononuclear meningitis in areas of endemicity.
Central Nervous System Diseases↗
Genetic differentiation of Chinese isolates of Rickettsia sibirica by partial ompA gene sequencing and multispacer typing.
Current data on rickettsiae and rickettsial diseases in China remain limited. Using partial ompA gene sequencing and multispacer typing, we identified 15 rickettsial isolates from China. All isolates were found to belong to Rickettsia sibirica subsp. sibirica. Four isolates from Dermacentor sinicus collected in Beijing, China, were fully identical to strain BJ-90, previously demonstrated to belong to R. sibirica subsp. sibirica despite antigenic and genotypic specificities. All 11 remaining isolates were similar to the R. sibirica subsp. sibirica type strain, 246. These were widely distributed in China in humans and different tick species. We emphasize the importance of surveying the distribution of R. sibirica in China.
Animals↗