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1/5. scrub typhus during pregnancy: a case report and review of the literature.

    scrub typhus is a rickettsial disease that is uncommon during pregnancy. We report a case of a 33-year-old woman, G1P0, 29 weeks pregnancy who presented to hospital with high fever, chill and headache for two weeks. Her diagnosis of scrub typhus was confirmed by serum immunofluorescent assay. She was successfully treated with chloramphenicol, but preterm delivery occurred. Her infant died from respiratory distress syndrome. No vertical transmission was demonstrated in this case. scrub typhus should be listed in the differential diagnosis of acute febrile illness in pregnant women, who either live in, or return from, endemic areas. chloramphenicol can be used safely during pregnancy if it is not circulating at the time of delivery.
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keywords = rickettsia
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2/5. Spotted fever in East Gippsland, victoria: a previously unrecognised focus of rickettsial infection.

    A new focus of spotted fever group rickettsial infection has been recognised in East Gippsland, victoria. Seven cases have been identified among Melbourne residents after they holidayed in the area. The infections were confirmed serologically. The precise identity of the rickettsia has not been determined.
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keywords = rickettsia
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3/5. Human ehrlichiosis.

    ehrlichiosis is one of the latest tick-borne illnesses to be reported in humans. The authors describe two cases of this rickettsial disease that were apparently acquired in missouri. They discuss diagnosis and treatment.
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keywords = rickettsia
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4/5. Unexplained febrile illnesses after exposure to ticks. infection with an Ehrlichia?

    The Ehrlichia are tick-borne rickettsial organisms that cause disease in animals throughout the world but that have been previously recognized as human pathogens only in asia. We have identified six patients with serological evidence of recent infection with an Ehrlichia: a fourfold or greater rise or fall in titer to ehrlichia canis. All of the patients reported recent tick bites. Rigors, myalgia, headache, nausea, and anorexia were each reported by five patients. fever was present in all patients and was accompanied by relative bradycardia and leukopenia in five patients, thrombocytopenia and abnormal liver function test results in four, and anemia in three. Five of the six patients were treated with tetracycline hydrochloride, and all recovered. infection with Ehrlichia should be considered in patients with unexplained febrile illnesses after tick exposure.
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keywords = rickettsia
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5/5. Peripheral neuropathies after arthropod stings not due to lyme disease: a report of five cases and review of the literature.

    Five patients developed neurologic symptoms a few hours to 2 months after being stung by a non-hooking arthropod with immediate cutaneous reaction. The patients had no clinical or serologic evidence for Lyme borreliosis and rickettsial disease. Clinical and electrophysiologic findings were consistent with a mixed axonal and demyelinating mononeuropathy, a monomelic multiple mononeuropathy, a mononeuropathy multiplex, a radiculoneuritis, and a distal symmetric polyneuropathy. Muscle and nerve biopsies showed lymphoplasmacytic small-vessel vasculitis in all patients, and wallerian degeneration in three. These patients, and 17 others from the literature, indicate a spectrum of peripheral neuropathies occurring after insect and spider stings.
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keywords = rickettsia
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