1/31. 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.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
2/31. 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.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
3/31. 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.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
4/31. 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.- - - - - - - - - - ranking = 4keywords = infection (Clic here for more details about this article) |
5/31. 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.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
6/31. 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.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
7/31. 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.- - - - - - - - - - ranking = 5keywords = infection (Clic here for more details about this article) |
8/31. Atypical fulminant rickettsia rickettsii infection (Brazilian spotted fever) presenting as septic shock and adult respiratory distress syndrome.Brazilian spotted fever, caused by rickettsia rickettsii, has been increasingly reported in brazil especially in the southeastern states. The severe and fulminant forms of the disease are not unusual but most of the reported fatal cases have shown some typical clinical clue, which leads the attending physician to a correct diagnosis. We report a probable case of atypical fulminant Brazilian spotted fever that presented full-blown septic shock associated with adult Respiratory Distress syndrome (ARDS) and delayed uncharacteristic rash with an over four-fold increase in reciprocal IgM, but not IgG titer against rickettsia rickettsii. Brazilian practitioners should be aware of the possibility of Brazilian spotted fever as a cause of fulminant primary sepsis with ARDS; improved laboratory methods are necessary for the rapid diagnosis of such cases.- - - - - - - - - - ranking = 4keywords = infection (Clic here for more details about this article) |
9/31. Spotted fever in hong kong.A previously healthy 7-year-old hong kong-born Caucasian child developed sudden onset fever, followed by a generalized rash and systemic symptoms of rigor and prostration, mucous membrane involvement (conjunctivitis) and arthralgia. He lives in a rural area of hong kong and has been in contact with various domestic animals--rodents, dogs and cows. chloramphenicol 50 mg/kg/day was given on day 4 with rapid response. Subsequent Weil-Felix test and specific serology suggested the diagnosis of rickettsial infection of the spotted fever group. To our knowledge, this is the first confirmed case of spotted fever reported in hong kong.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
10/31. Rickettsia parkeri: a newly recognized cause of spotted fever rickettsiosis in the united states.ticks, including many that bite humans, are hosts to several obligate intracellular bacteria in the spotted fever group (SFG) of the genus Rickettsia. Only rickettsia rickettsii, the agent of rocky mountain spotted fever, has been definitively associated with disease in humans in the united states. Herein we describe disease in a human caused by Rickettsia parkeri, an SFG rickettsia first identified >60 years ago in Gulf Coast ticks (Amblyomma maculatum) collected from the southern united states. Confirmation of the infection was accomplished using serological testing, immunohistochemical staining, cell culture isolation, and molecular methods. Application of specific laboratory assays to clinical specimens obtained from patients with febrile, eschar-associated illnesses following a tick bite may identify additional cases of R. parkeri rickettsiosis and possibly other novel SFG rickettsioses in the united states.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
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