Cases reported "Rickettsia Infections"

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1/61. Imported African tick bite fever: a case report.

    We describe a patient with African tick-bite fever who acquired his infection while visiting rural areas of south africa and then became sick after returning to the united states. The dominant clinical feature of his illness was the presence of multiple, ulcerated lesions (tache noires). physicians in the United States and other non-African countries who see travelers returning from southern parts of Africa who give a history of recent tick bite and/or present with multiple, crusted or vesicular skin lesions should be alert to this diagnosis and institute treatment with doxycycline. ( info)

2/61. African tick-bite fever imported into norway: presentation of 8 cases.

    We report on 8 Norwegian travellers to Southern Africa with African tick-bite fever (ATBF), a recently described spotted fever group rickettsiosis. All patients had acute flu-like symptoms and developed I or multiple inoculation eschars. The patients were treated with either doxycycline or ciprofloxacin, and all recovered. The diagnosis of ATBF was confirmed by the detection of specific IgM antibodies to Rickettsia africae by microimmunofluoroscence in convalescent-phase serum samples. ( info)

3/61. association of Rickettsia helvetica with chronic perimyocarditis in sudden cardiac death.

    BACKGROUND: Rickettsia helvetica is the only non-imported rickettsia found in scandinavia. It was first detected in ixodes ricinus ticks, but has never been linked to human disease. We studied two young Swedish men who died of sudden cardiac failure during exercise, and who showed signs of perimyocarditis similar to those described in rickettsial disease. methods: Samples from the heart and other organs were analysed by PCR and dna sequencing. May-Grunwald-Giemsa, Grocott, and acridine-orange stains were used for histopathological examinations. Staining of R. helvetica grown on shell-vials in vero cells, and the early descriptions of R. rickettsii by H T Ricketts and S B Wohlbach served as controls. immunohistochemistry was done with proteus OX-19 rabbit antisera as the primary antibody. The structure of rickettsia-like organisms was investigated by transmission electron microscopy. Serological analyses were carried out by indirect immunofluorescence with R. helvetica as the antigen. FINDINGS: By use of a semi-nested PCR, with primers specific for the 16S rRNA and 17-kDa outer-membrane-protein genes, and sequence analysis of the amplified products, genetic material from R. helvetica was detected in the pericardium and in a lymph node from the pulmonary hilum in case 1, and in a coronary artery and the heart muscle in case 2. A serological response in case 1 revealed an endpoint titre for R. helvetica of 1/320 (1/256 with R. rickettsii as the antigen). Examination of PCR-positive tissue showed chronic interstitial inflammation and the presence of rickettsia-like organisms predominantly located in the endothelium. These organisms reacted with proteus OX-19 antisera, and their size and form were consistent with rickettsia. Electron microscopy confirmed that the appearance of the organisms was similar to that described for spotted-fever rickettsia. INTERPRETATION: R. helvetica, transmitted by I. ricinus ticks, may be an important pathogen in the aetiology of perimyocarditis, which can result in sudden unexpected cardiac death in young people. ( info)

4/61. Need to increase awareness among family doctors and medical specialists of rickettsioses as an import disease in non-endemic areas.

    Europeans travelling to (sub)-tropical countries have an increased risk for infections with Rickettsia. As serious consequences are associated with delay in specific antibiotic therapy, unequivocal diagnosis of this condition is needed. We focus here on the benefits of early, and consequences of late laboratory diagnosis, and emphasise the need of an increased awareness of rickettsioses among family doctors, as well as medical specialists, in non-endemic areas when evaluating patients with travel associated fever. ( info)

5/61. Rickettsia mongolotimonae: a rare pathogen in france.

    We report a second case of laboratory-confirmed infection caused by Rickettsia mongolotimonae in Marseille, france. This rickettsiosis may represent a new clinical entity; moreover, its geographic distribution may be broader than previously documented. This pathogen should be systematically considered in the differential diagnosis of atypical rickettsioses, especially rashless fevers with lymphangitis and lymphadenopathy, in southern france and perhaps elsewhere. ( info)

6/61. Evidence of Rickettsia helvetica infection in humans, eastern france.

    A 37-year-old man living in eastern france seroconverted to Rickettsia helvetica in August 1997, 4 weeks after the onset of an unexplained febrile illness. Results of a serosurvey of forest workers from the area where the patient lived showed a 9.2% seroprevalence against R. helvetica. This organism may pose a threat for populations exposed to ixodes ricinus ticks. ( info)

7/61. rickettsia felis rickettsiosis in Yucatan.

    Three patients with fever, exanthem, headache, and central-nervous-system involvement were diagnosed with Rickettsia fells infection by specific PCR of blood or skin and seroconversion to surrogate Rickettsia antigens. Although R. felis's relationship to other Rickettsia species is known and the pathogenic potential of this clade is well documented, R. felis's role as a pathogen has not been fully understood. ( info)

8/61. Fulminant Japanese spotted fever associated with hypercytokinemia.

    We report a patient with Japanese spotted fever caused by Rickettsia japonica who developed shock associated with hypercytokinemia. Elevated levels of cytokines (macrophage colony-stimulating factor, interleukin 1 beta, interleukin 10, and gamma interferon) decreased rapidly after a combination treatment using an antibiotic (minocycline hydrochloride [MINO]) and methylprednisolone; however, tumor necrosis factor alpha levels were increased. The patient's fever relapsed and was resolved only after the addition of ciprofloxacin hydrochloride. The administration of new quinolones alone may be another useful form of treatment to eradicate R. japonica even if the symptoms of hypercytokinemia appear to improve with the administration of MINO and methylprednisolone. ( info)

9/61. Japanese spotted fever associated with multiorgan failure.

    A 49-year-old man was admitted to our hospital, with a diagnosis of multiple organ failure, on June 10, 2000. physical examination revealed high fever, generalized maculopapular erythema, and an eschar on his lower leg. Laboratory findings revealed severe renal and liver dysfunction, disseminated intravascular coagulation (DIC), and markedly elevated soluble interleukin 2-receptor (sIL2-R) level (>10 000 U/ml). Administration of minocycline was started immediately, with a diagnosis of rickettsial infection. Simultaneously, anti-thrombin III and heparin were started to treat the DIC, and hemodialysis was also initiated. However, the day after admission, his consciousness level lapsed, to the level of coma, and blood pressure was less than 60 mmHg, indicating shock. Therefore, 500 mg of methylprednisolone was administered once; as a result, rapid pyretolysis and improvement of consciousness disturbance were achieved. Laboratory data indicative of inflammation gradually improved after a few days. Hemodialysis was required ten times. During the recovery period, the level of specific IgM antibody against Rickettsia japonica increased to x2560, and he was diagnosed as having Japanese spotted fever. On July 11, he was discharged without sequelae. The course in our patient was very severe, and treatment with minocycline alone may have resulted in a fatal outcome. The level of sIL2-R, which is produced by activated lymphocytes, was markedly increased. Therefore, markedly elevated lymphocyte activation and hypercytokinemia may have been present on admission. The short-term steroid therapy may have been effective in inhibiting the excessive activation of lymphocytes in the critical stage. In the severe form of Japanese spotted fever with organ failure, combination therapy with minocycline and short-term steroids may be very useful. ( info)

10/61. rickettsia felis infection acquired in europe and documented by polymerase chain reaction.

    We report the first case of rickettsia felis infection in europe to be documented by polymerase chain reaction (PCR) and serologic testing. ( info)
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