1/7. Imported plague--new york city, 2002.On November 1, 2002, a married couple traveled from Santa Fe County, new mexico, to new york city (NYC), where they both became ill with fever and unilateral inguinal adenopathy; bubonic plague (yersinia pestis) was diagnosed subsequently. This report summarizes the clinical and public health investigation of these cases and underscores the importance of rapid diagnosis and communication among health-care providers, public health agencies, and the public when patients seek medical attention for an illness that might be caused by an agent of terrorism.- - - - - - - - - - ranking = 1keywords = fever (Clic here for more details about this article) |
2/7. Persistent yersinia pestis antigens in ischemic tissues of a patient with septicemic plague.In November 2002, a couple from new mexico traveled to New York where both had fever and unilateral inguinal adenopathy. The husband was in septic shock when he sought medical care and was admitted to an intensive care unit, where he developed ischemic necrosis of his feet which later required bilateral amputation. yersinia pestis was grown from his blood. Immunohistochemical assays using anti-Y pestis antibodies demonstrated multiple bacteria and granular antigens in and around vessels of the ischemic amputation tissues obtained 20 days after initiation of antibiotics; however, no evidence of Y pestis was present in viable tissues. Immunohistochemical evidence of Y pestis inside vessels of gangrenous feet in this patient underscores the importance of adequate excision of necrotic or partially necrotic tissues because antibiotics cannot be effectively delivered to necrotic and poorly perfused tissues.- - - - - - - - - - ranking = 1keywords = fever (Clic here for more details about this article) |
3/7. Clinical and pathologic differential diagnosis of selected potential bioterrorism agents of interest to pediatric health care providers.The early recognition of potential bioterrorism agents has been of increasing concern in recent years. The Centers for Disease Control and Prevention has categorized and listed biological terrorism agents. Although any or all of the highest risk biological agents (including inhalation anthrax, pneumonic plague, smallpox, tularemia, botulism, and viral hemorrhagic fevers) can be seen in the pediatric patient, several agents might closely resemble--at least in their initial stages-some of the more common childhood illnesses. The awareness of these similarities and, more importantly,their differences, are critical for all health care professionals. Selected examples of some typical childhood illnesses are presented and then compared with three of the most virulent biological agents (smallpox, anthrax and plague) that might be used in a bioterrorism attack.- - - - - - - - - - ranking = 1keywords = fever (Clic here for more details about this article) |
4/7. Bubonic plague in a child presenting with fever and altered mental status.An 8-year-old Navajo boy presented to the emergency department with fever and altered mental status. Because the child lived in a plague-endemic area of the southwestern united states, antibiotics effective against yersinia pestis were administered rapidly. Buboes were appreciated on physical examination, and the diagnosis of bubonic plague was confirmed by positive blood cultures. Characteristics and treatment of yersinia pestis infection are discussed. The need for a high index of suspicion for the presence of plague in patients who present to the ED and who reside or have recently traveled in a plague-endemic area is emphasized.- - - - - - - - - - ranking = 5keywords = fever (Clic here for more details about this article) |
5/7. Septicemic plague in new mexico.Eighteen of the 71 cases of plague reported in new mexico from 1980 to 1984 were septicemic. We reviewed these cases to better describe the clinical presentation of this disorder and to identify risk factors for developing septicemic plague. The symptoms (fever, chills, malaise, headache, and gastrointestinal symptoms) and signs (tachycardia, tachypnea, and hypotension) of septicemic plague are similar to those of other forms of gram-negative septicemia. abdominal pain was reported in nearly half of the cases, and differential white blood cell counts revealed a marked shift to the left. The risk of developing septicemic plague was higher for persons greater than 40 years of age. Because of empirical antibiotic treatment of older persons, deaths from septicemic plague occurred primarily among persons less than 30 years old. Deaths from septicemic plague could be reduced by aggressive antibiotic therapy for patients with a clinical presentation suggesting gram-negative septicemia, especially patients less than 30 years old.- - - - - - - - - - ranking = 1keywords = fever (Clic here for more details about this article) |
6/7. The hemorrhagic fevers of Southern africa with special reference to studies in the South African Institute for Medical research.In this review of studies on the hemorrhagic fevers of Southern africa carried out in the South African Institute for Medical research, attention has been called to occurrence of meningococcal septicemia in recruits to the mining industry and South African Army, to cases of staphylococcal and streptococcal septicemia with hemorrhagic manifestations, and to the occurrence of plague which, in its septicemic form, may cause a hemorrhagic state. "Onyalai," a bleeding disease in tropical africa, often fatal, was related to profound thrombocytopenia possibly following administration of toxic witch doctor medicine. Spirochetal diseases, and rickettsial diseases in their severe forms, are often manifested with hemorrhagic complications. Of enterovirus infections, Coxsackie B viruses occasionally caused severe hepatitis associated with bleeding, especially in newborn babies. Cases of hemorrhagic fever presenting in February-March, 1975 are described. The first outbreak was due to marburg virus disease and the second, which included seven fatal cases, was caused by rift valley fever virus. In recent cases of hemorrhagic fever a variety of infective organisms have been incriminated including bacterial infections, rickettsial diseases, and virus diseases, including Herpesvirus hominis; in one patient, the hemorrhagic state was related to rubella. A boy who died in a hemorrhagic state was found to have congo fever; another patient who died of severe bleeding from the lungs was infected with leptospira canicola, and two patients who developed a hemorrhagic state after a safari trip in Northern botswana were infected with trypanosoma rhodesiense. An illness manifested by high fever and melena developed in a young man after a visit to zimbabwe; the patient was found to have both malaria and marburg virus disease.- - - - - - - - - - ranking = 10keywords = fever (Clic here for more details about this article) |
7/7. Feline plague in new mexico: report of five cases.Naturally acquired plague was diagnosed in 5 domestic cats. The cats apparently contracted the disease through contact with sylvatic rodents or their fleas in plague-enzootic areas. The diagnosis was confirmed by direct immunofluorescence and isolation of yersinia pestis on culture of abscess material. abscess formation, lymphadenitis, lethargy, and fever were consistent clinical findings.- - - - - - - - - - ranking = 1keywords = fever (Clic here for more details about this article) |