1/5. The pathologic findings in rickettsial pneumonia.A fatal case of q fever pneumonia with demonstration of the organisms in the lungs is presented. The disease clinically simulates bacterial lobar pneumonia. neutrophils were conspicuously absent in the inflammatory process. histiocytes predominated in the alveolar septal spaces and produced both radiologically and pathologically an alevolar infiltrate. Histiocytic hyperplasia and focal necrosis were present. histiocytes similar to those seen in the alveolar spaces of the lungs distorted the normal architecture of the lymph nodes. In scattered areas necrosis with histiocytes palisading in the periphery simulating the lesions of cat-scratch disease and tularemia were seen. ( info) |
2/5. Rapidly fatal Q-fever pneumonia in a patient with chronic granulomatous disease.Acute Q-fever is a systemic illness which rarely has a fatal outcome. Fatal cases do occur with the chronic form of the disease and associated with endocarditis. This report presents the case of a fatal, acute Q-fever pneumonia in an 11-year-old patient with chronic granulomatous disease. Complement fixation antibody titer rose to 1:1,024 with positive IgM in immunofluorescence. Giemsa stained lung sections and indirect immunofluorescence demonstrated the microorganisms in the tissues. The coxiella burnetii infection was probably contracted during a holiday trip to rural france. Despite the fact that the patient received a variety of antimicrobial agents with broad spectrum activity against bacteria and fungi, coverage for Q-fever, i.e. chloramphenicol or tetracyclines, was not included. ( info) |
3/5. q fever encephalitis.encephalitis is a rare but documented complication of acute q fever. We report here the case of a 48-year-old lady who presented with an acute illness characterised by influenza-like symptoms, pneumonia and neurological disturbance but in whom the serology was suggestive of chronic rather than acute q fever. ( info) |
4/5. q fever pneumonia associated with exposure to wild rabbits.4 patients with atypical pneumonia and a history of exposure to wild rabbits were found to have antibodies to coxiella burnetii but not to the other organisms also commonly associated with atypical pneumonia. 10 (45%) of 22 snowshoe hares caught in the area where 1 of the patients snared his rabbits had antibodies to coxiella burnetii. q fever ought to be included in the differential diagnosis of pneumonia acquired following exposure to wild rabbits. ( info) |
5/5. scrub typhus pneumonitis: an entity which is frequently missed.Four cases of scrub typhus pneumonitis are reported. diagnosis was confirmed by positive Weil-Felix OX-K reaction and immunofluorescent antibody test for rickettsia tsutsugamushi. Two patients presented with atypical pneumonia and two had overwhelming pneumonia resembling adult respiratory distress syndrome. All patients made a full recovery after appropriate treatment. ( info) |