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Sample records for fever group rickettsial

  1. Epidemiology of Spotted Fever Group and Typhus Group Rickettsial Infection in the Amazon Basin of Peru

    Science.gov (United States)

    2010-01-01

    AC, Dfaz DE, L6pez TJ, 2007. Rickettsiosis, emerging dis- ease in Loreto. Rev Peru Med Exp Salud Publica 24: 99-100. 24. Morrison AC, Forshey BM...evidence of spotted fever group-related Rickettsia transmission in the Peruvian Amazon jungle. Rev Peru Med Exp Sa/ud Publica 23: 284-287. 23. Ramal...from an endemic area for Brazilian spotted fever in the State of Sao Paulo, Brazil. Cad Saude Publica 24: 247-252. 37. Horta MC, Labruna MB

  2. State of the art of diagnosis of rickettsial diseases: the use of blood specimens for diagnosis of scrub typhus, spotted fever group rickettsiosis, and murine typhus

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    Paris, Daniel H.; Dumler, J. Stephen

    2016-01-01

    Purpose of review With improved malaria control, acute undifferentiated febrile illness studies in tropical regions reveal a startling proportion of rickettsial illnesses, especially scrub typhus, murine typhus, and spotted fever group rickettsioses. Laboratory diagnosis of these infections evolved little over the past 40 years, but combinations of technologies like PCR and loop-mediated isothermal amplification, with refined rapid diagnostic tests and/or ELISA, are promising for guidance for early antirickettsial treatment. Recent findings The long-term reliance on serological tests – useful only late in rickettsial infections – has led to underdiagnosis, inappropriate therapies, and undocumented morbidity and mortality. Recent approaches integrate nucleic acid amplification and recombinant protein-based serological tests for diagnosing scrub typhus. Optimized using Bayesian latent class analyses, this strategy increases diagnostic confidence and enables early accurate diagnosis and treatment – a model to follow for lagging progress in murine typhus and spotted fever. Summary A laboratory diagnostic paradigm shift in rickettsial infections is evolving, with replacement of indirect immunofluorescence assay by the more objective ELISA coupled with nucleic acid amplification assays to expand the diagnostic window toward early infection intervals. This approach supports targeted antirickettsial therapy, reduces morbidity and mortality, and provides a robust evidence base for further development of diagnostics and vaccines. PMID:27429138

  3. Molecular and serological evidence of flea-associated typhus group and spotted fever group rickettsial infections in Madagascar.

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    Rakotonanahary, Rado J L; Harrison, Alan; Maina, Alice N; Jiang, Ju; Richards, Allen L; Rajerison, Minoarisoa; Telfer, Sandra

    2017-03-04

    Rickettsiae are obligate intracellular bacteria responsible for many febrile syndromes around the world, including in sub-Saharan Africa. Vectors of these pathogens include ticks, lice, mites and fleas. In order to assess exposure to flea-associated Rickettsia species in Madagascar, human and small mammal samples from an urban and a rural area, and their associated fleas were tested. Anti-typhus group (TGR)- and anti-spotted fever group rickettsiae (SFGR)-specific IgG were detected in 24 (39%) and 21 (34%) of 62 human serum samples, respectively, using indirect ELISAs, with six individuals seropositive for both. Only two (2%) Rattus rattus out of 86 small mammals presented antibodies against TGR. Out of 117 fleas collected from small mammals, Rickettsia typhi, a TGR, was detected in 26 Xenopsylla cheopis (24%) collected from rodents of an urban area (n = 107), while two of these urban X. cheopis (2%) were positive for Rickettsia felis, a SFGR. R. felis DNA was also detected in eight (31%) out of 26 Pulex irritans fleas. The general population in Madagascar are exposed to rickettsiae, and two flea-associated Rickettsia pathogens, R. typhi and R. felis, are present near or in homes. Although our results are from a single district, they demonstrate that rickettsiae should be considered as potential agents of undifferentiated fever in Madagascar.

  4. Rickettsial infection in animals and Brazilian spotted fever endemicity.

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    Sangioni, Luis A; Horta, Maurício C; Vianna, Manoella C B; Gennari, Solange M; Soares, Rodrigo M; Galvão, Márcio A M; Schumaker, Teresinha T S; Ferreira, Fernando; Vidotto, Odilon; Labruna, Marcelo B

    2005-02-01

    We compared the rickettsial infection status of Amblyomma cajennense ticks, humans, dogs, and horses in both Brazilian spotted fever (BSF)-endemic and -nonendemic areas in the state of Sao Paulo, Brazil. Most of the horses and few dogs from BSF-endemic areas had serologic titers against Rickettsia rickettsii antigens. In contrast, no dogs or horses from BSF-nonendemic areas had serologic titers against R. rickettsii antigens, although they were continually exposed to A. cajennense ticks. All human serum samples and ticks from both areas were negative by serologic assay and polymerase chain reaction, respectively. Our results indicate that surveys of horse serum are a useful method of BSF surveillance in areas where humans are exposed to A. cajennense ticks. In addition, we successfully performed experimental infection of A. cajennense ticks with R. parkeri.

  5. Rickettsia parkeri: a Rickettsial pathogen transmitted by ticks in endemic areas for spotted fever rickettsiosis in southern Uruguay

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    José M. Venzal

    2012-06-01

    Full Text Available At first Rickettsia conorii was implicated as the causative agent of spotted fever in Uruguay diagnosed by serological assays. Later Rickettsia parkeri was detected in human-biting Amblyomma triste ticks using molecular tests. The natural vector of R. conorii, Rhipicephalus sanguineus, has not been studied for the presence of rickettsial organisms in Uruguay. To address this question, 180 R. sanguineus from dogs and 245 A. triste from vegetation (flagging collected in three endemic localities were screened for spotted fever group (SFG rickettsiosis in southern Uruguay. Tick extracted DNA pools were subjected to PCR using primers which amplify a fragment of the rickettsial gltA gene. Positive tick DNA pools with these primers were subjected to a second PCR round with primers targeting a fragment of the ompA gene, which is only present in SFG rickettsiae. No rickettsial DNA was detected in R. sanguineus. However, DNA pools of A. triste were found to be positive for a rickettsial organism in two of the three localities, with prevalences of 11.8% to 37.5% positive pools. DNA sequences generated from these PCR-positive ticks corresponded to R. parkeri. These findings, joint with the aggressiveness shown by A. triste towards humans, support previous data on the involvement of A. triste as vector of human infections caused by R. parkeri in Uruguay.

  6. Rickettsia parkeri: a Rickettsial pathogen transmitted by ticks in endemic areas for spotted fever rickettsiosis in southern Uruguay.

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    Venzal, José M; Estrada-Peña, Agustín; Portillo, Aránzazu; Mangold, Atilio J; Castro, Oscar; De Souza, Carlos G; Félix, María L; Pérez-Martínez, Laura; Santibánez, Sonia; Oteo, José A

    2012-01-01

    At first Rickettsia conorii was implicated as the causative agent of spotted fever in Uruguay diagnosed by serological assays. Later Rickettsia parkeri was detected in human-biting Amblyomma triste ticks using molecular tests. The natural vector of R. conorii, Rhipicephalus sanguineus, has not been studied for the presence of rickettsial organisms in Uruguay. To address this question, 180 R. sanguineus from dogs and 245 A. triste from vegetation (flagging) collected in three endemic localities were screened for spotted fever group (SFG) rickettsiosis in southern Uruguay. Tick extracted DNA pools were subjected to PCR using primers which amplify a fragment of the rickettsial gltA gene. Positive tick DNA pools with these primers were subjected to a second PCR round with primers targeting a fragment of the ompA gene, which is only present in SFG rickettsiae. No rickettsial DNA was detected in R. sanguineus. However, DNA pools of A. triste were found to be positive for a rickettsial organism in two of the three localities, with prevalences of 11.8% to 37.5% positive pools. DNA sequences generated from these PCR-positive ticks corresponded to R. parkeri. These findings, joint with the aggressiveness shown by A. triste towards humans, support previous data on the involvement of A. triste as vector of human infections caused by R. parkeri in Uruguay.

  7. [A group fever: safari's fever].

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    Cantiniaux, S; Serratrice, J; De Roux-Serratrice, C; Disdier, P; Perez, L; Bricaire, F; Caumes, E; Mary, C; Weiller, P J

    2004-12-01

    Acute schistosomiasis, called safari's fever in Africa and Katayama fever in Japan, is an immunoallergic reaction due to transcutaneous penetration of infective cercaria. We report the collective case of seven young adults spending holidays in Mali. An eighteen years-old girl presents fever, headache, diarrhoea and abdominal pains at return from Dogon country (south of Mali). After turned down malaria and with the notion of bathing in fresh water followed by pruritus, we think to safari's fever. So we alarm all other members of the group. All can be treated to avoid chronic schistosomiasis. These observations recall that acute schistosomiasis is a real danger for tourists when bathing in fresh water in endemic areas of Africa. Education of travellers is necessary. Occurrence of safari's fever should alert physicians to prevent chronic schistosomiasis.

  8. Q Fever, Scrub Typhus, and Rickettsial Diseases in Children, Kenya, 2011-2012.

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    Maina, Alice N; Farris, Christina M; Odhiambo, Antony; Jiang, Ju; Laktabai, Jeremiah; Armstrong, Janice; Holland, Thomas; Richards, Allen L; O'Meara, Wendy P

    2016-05-01

    To increase knowledge of undifferentiated fevers in Kenya, we tested paired serum samples from febrile children in western Kenya for antibodies against pathogens increasingly recognized to cause febrile illness in Africa. Of patients assessed, 8.9%, 22.4%, 1.1%, and 3.6% had enhanced seroreactivity to Coxiella burnetii, spotted fever group rickettsiae, typhus group rickettsiae, and scrub typhus group orientiae, respectively.

  9. Fiebre manchada por rickettsias en el Delta del Paraná: Una enfermedad emergente Rickettsial spotted fever in the Paraná Delta: An emerging disease

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    Alfredo Seijo

    2007-12-01

    Full Text Available Se comunica un caso de fiebre manchada por rickettsia autóctono del delta del Paraná correspondiente a la provincia de Buenos Aires. Luego de cinco días de haber permanecido en una región cercana a la localidad de ingeniero Otamendi, partido de Campana, el paciente presentó un síndrome febril agudo caracterizado por hipertermia con escalofríos y sudoración, mialgias, cefalea, astenia y discreta odinofagia, seguido a las 72 horas por un exantema maculopapuloso congestivo con elementos purpúricos, de distribución universal. En la región preauricular izquierda se observaba una lesión papuloerosiva, producida cinco días antes de iniciada la fiebre por una garrapata adquirida en el lugar. El cuadro clínico remitió rápidamente con la administración de doxiciclina. Por inmunofluorescencia indirecta se identificaron anticuerpos reactivos contra el grupo de rickettsias causantes de fiebres manchadas (CDC, Atlanta, EE.UU.. Se realizan consideraciones sobre la especie de rickettsia, el vector involucrado y la posibilidad que la enfermedad fuera debida a Rickettsia parkeri.We describe a case of rickettsial spotted fever in the Paraná Delta region of Buenos Aires province in Argentina. The patient developed an acute febrile syndrome characterized by myalgias, headache, asthenia and moderate odynophagia, followed by a diffuse macular, papular, and purpuric exanthema. The patient had been bitten recently by a tick on the left preauricular region and an erosive papular lesion was evident at the bite site. An indirect immunofluorescence antibody assay identified antibodies reactive with spotted fever group rickettsiae in the patient's serum. The patient improved rapidly with doxycycline. Several considerations relating to the identity of the rickettsial species and tick vector are discussed, including the possibility that this patient's illness may have been caused by Rickettsia parkeri.

  10. Differences in Intracellular Fate of Two Spotted Fever Group Rickettsia in Macrophage-Like Cells

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    Curto, Pedro; Simões, Isaura; Riley, Sean P.; Martinez, Juan J.

    2016-01-01

    Spotted fever group (SFG) rickettsiae are recognized as important agents of human tick-borne diseases worldwide, such as Mediterranean spotted fever (Rickettsia conorii) and Rocky Mountain spotted fever (Rickettsia rickettsii). Recent studies in several animal models have provided evidence of non-endothelial parasitism by pathogenic SFG Rickettsia species, suggesting that the interaction of rickettsiae with cells other than the endothelium may play an important role in pathogenesis of rickettsial diseases. These studies raise the hypothesis that the role of macrophages in rickettsial pathogenesis may have been underappreciated. Herein, we evaluated the ability of two SFG rickettsial species, R. conorii (a recognized human pathogen) and Rickettsia montanensis (a non-virulent member of SFG) to proliferate in THP-1 macrophage-like cells, or within non-phagocytic cell lines. Our results demonstrate that R. conorii was able to survive and proliferate in both phagocytic and epithelial cells in vitro. In contrast, R. montanensis was able to grow in non-phagocytic cells, but was drastically compromised in the ability to proliferate within both undifferentiated and PMA-differentiated THP-1 cells. Interestingly, association assays revealed that R. montanensis was defective in binding to THP-1-derived macrophages; however, the invasion of the bacteria that are able to adhere did not appear to be affected. We have also demonstrated that R. montanensis which entered into THP-1-derived macrophages were rapidly destroyed and partially co-localized with LAMP-2 and cathepsin D, two markers of lysosomal compartments. In contrast, R. conorii was present as intact bacteria and free in the cytoplasm in both cell types. These findings suggest that a phenotypic difference between a non-pathogenic and a pathogenic SFG member lies in their respective ability to proliferate in macrophage-like cells, and may provide an explanation as to why certain SFG rickettsial species are not associated

  11. Differences in intracellular fate of two spotted fever group Rickettsia in macrophage-like cells

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    Pedro Curto

    2016-07-01

    Full Text Available Spotted fever group (SFG rickettsiae are recognized as important agents of human tick-borne diseases worldwide, such as Mediterranean spotted fever (R. conorii and Rocky Mountain spotted fever (R. rickettsii. Recent studies in several animal models have provided evidence of non-endothelial parasitism by pathogenic SFG Rickettsia species, suggesting that the interaction of rickettsiae with cells other than the endothelium may play an important role in pathogenesis of rickettsial diseases. These studies raise the hypothesis that the role of macrophages in rickettsial pathogenesis may have been underappreciated. Herein, we evaluated the ability of two SFG rickettsial species, R. conorii (a recognized human pathogen and R. montanensis (a non-virulent member of SFG to proliferate in THP-1 macrophage-like cells, or within non-phagocytic cell lines. Our results demonstrate that R. conorii was able to survive and proliferate in both phagocytic and epithelial cells in vitro. In contrast, R. montanensis was able to grow in non-phagocytic cells, but was drastically compromised in the ability to proliferate within both undifferentiated and PMA-differentiated THP-1 cells. Interestingly, association assays revealed that R. montanensis was defective in binding to THP-1-derived macrophages; however, the invasion of the bacteria that are able to adhere did not appear to be affected. We have also demonstrated that R. montanensis which entered into THP-1-derived macrophages were rapidly destroyed and partially co-localized with LAMP-2 and cathepsin D, two markers of lysosomal compartments. In contrast, R. conorii was present as intact bacteria and free in the cytoplasm in both cell types. These findings suggest that a phenotypic difference between a non-pathogenic and a pathogenic SFG member lies in their respective ability to proliferate in macrophage-like cells, and may provide an explanation as to why certain SFG rickettsial species are not associated with

  12. Spotted fever group rickettsiae in ticks from the Masai Mara region of Kenya.

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    Macaluso, Kevin R; Davis, Jon; Alam, Uzma; Korman, Amy; Rutherford, Jeremiah S; Rosenberg, Ronald; Azad, Abdu F

    2003-05-01

    We have identified for the first time Rickettsia africae, and the ticks that harbored them, in Kenya. A total of 5,325 ticks were collected from vegetation, livestock, and wild animals during two field trips to southwestern Kenya. Most were immature forms (85.2%) belonging to the genera Amblyomma or Rhipicephalus. The adults also included representatives from the genus Boophilus. Ticks were assessed for rickettsial DNA by a polymerase chain reaction (PCR) using primers for the spotted fever group (SFG)-specific rickettsial outer membrane protein A (rompA) gene, and positive amplicons were sequenced. While none of the immature ticks tested positive by PCR, 15.8% of the adult Amblyomma variegatum and less than 1% of the Rhipicephalus spp. were SFG positive. Sequences of amplified products were identified as R. africae. These findings extend the known range of R. africae.

  13. Scarlet Fever: A Group A Streptococcal Infection

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    ... this? Submit Button Past Emails CDC Features Scarlet Fever: A Group A Streptococcal Infection Language: English Español ( ... red rash that feels rough, like sandpaper. Scarlet Fever Podcast A pediatrician explains the cause, treatment, and ...

  14. Serological prevalence study of exposure of cats and dogs in Launceston, Tasmania, Australia to spotted fever group rickettsiae.

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    Izzard, L; Cox, E; Stenos, J; Waterston, M; Fenwick, S; Graves, S

    2010-01-01

    A sero-epidemiological study of cats and dogs in the Launceston area of Tasmania, Australia was undertaken to determine the prevalence of antibodies to spotted fever group (SFG) rickettsiae. Results showed that 59% of cats and 57% of dogs were positive for antibodies, but there was no correlation between the animal's health and seropositivity at the time of testing, suggesting that rickettsial exposure is unrelated to ill-health in these two species of domestic animals.

  15. Plasmids and rickettsial evolution: insight from Rickettsia felis.

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    Joseph J Gillespie

    Full Text Available BACKGROUND: The genome sequence of Rickettsia felis revealed a number of rickettsial genetic anomalies that likely contribute not only to a large genome size relative to other rickettsiae, but also to phenotypic oddities that have confounded the categorization of R. felis as either typhus group (TG or spotted fever group (SFG rickettsiae. Most intriguing was the first report from rickettsiae of a conjugative plasmid (pRF that contains 68 putative open reading frames, several of which are predicted to encode proteins with high similarity to conjugative machinery in other plasmid-containing bacteria. METHODOLOGY/PRINCIPAL FINDINGS: Using phylogeny estimation, we determined the mode of inheritance of pRF genes relative to conserved rickettsial chromosomal genes. Phylogenies of chromosomal genes were in agreement with other published rickettsial trees. However, phylogenies including pRF genes yielded different topologies and suggest a close relationship between pRF and ancestral group (AG rickettsiae, including the recently completed genome of R. bellii str. RML369-C. This relatedness is further supported by the distribution of pRF genes across other rickettsiae, as 10 pRF genes (or inactive derivatives also occur in AG (but not SFG rickettsiae, with five of these genes characteristic of typical plasmids. Detailed characterization of pRF genes resulted in two novel findings: the identification of oriV and replication termination regions, and the likelihood that a second proposed plasmid, pRFdelta, is an artifact of the original genome assembly. CONCLUSION/SIGNIFICANCE: Altogether, we propose a new rickettsial classification scheme with the addition of a fourth lineage, transitional group (TRG rickettsiae, that is unique from TG and SFG rickettsiae and harbors genes from possible exchanges with AG rickettsiae via conjugation. We offer insight into the evolution of a plastic plasmid system in rickettsiae, including the role plasmids may have played in

  16. Rickettsial Disease in the Peruvian Amazon Basin.

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    Kocher, Claudine; Morrison, Amy C; Leguia, Mariana; Loyola, Steev; Castillo, Roger M; Galvez, Hugo A; Astete, Helvio; Flores-Mendoza, Carmen; Ampuero, Julia S; Bausch, Daniel G; Halsey, Eric S; Cespedes, Manuel; Zevallos, Karine; Jiang, Ju; Richards, Allen L

    2016-07-01

    Using a large, passive, clinic-based surveillance program in Iquitos, Peru, we characterized the prevalence of rickettsial infections among undifferentiated febrile cases and obtained evidence of pathogen transmission in potential domestic reservoir contacts and their ectoparasites. Blood specimens from humans and animals were assayed for spotted fever group rickettsiae (SFGR) and typhus group rickettsiae (TGR) by ELISA and/or PCR; ectoparasites were screened by PCR. Logistic regression was used to determine associations between patient history, demographic characteristics of participants and symptoms, clinical findings and outcome of rickettsial infection. Of the 2,054 enrolled participants, almost 2% showed evidence of seroconversion or a 4-fold rise in antibody titers specific for rickettsiae between acute and convalescent blood samples. Of 190 fleas (Ctenocephalides felis) and 60 ticks (Rhipicephalus sanguineus) tested, 185 (97.4%) and 3 (5%), respectively, were positive for Rickettsia spp. Candidatus Rickettsia asemboensis was identified in 100% and 33% of the fleas and ticks tested, respectively. Collectively, our serologic data indicates that human pathogenic SFGR are present in the Peruvian Amazon and pose a significant risk of infection to individuals exposed to wild, domestic and peri-domestic animals and their ectoparasites.

  17. Molecular evidence for novel tick-associated spotted fever group rickettsiae from Thailand.

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    Hirunkanokpun, Supanee; Kittayapong, Pattamaporn; Cornet, Jean-Paul; Gonzalez, Jean-Paul

    2003-03-01

    Ticks are of considerable medical and veterinary importance because they directly harm the host through their feeding action and indirectly through vectoring many bacterial pathogens. Despite many ticks being known from Thailand, very little is known about the bacteria they may harbor. We report here the results of a survey of tick-associated bacteria in Thailand. A total of 334 individuals representing 14 species of ticks in five genera were collected from 10 locations in Thailand and were examined for the human pathogens, Borrelia, Francisella, Rickettsia, and the common arthropod endosymbionts, Wolbachia, by polymerase chain reaction (PCR) assay using specific primers. Rickettsial DNA was detected in 30% (9/30) of Amblyomma testudinarium (Koch, 1844) collected from Khao Yai National Park, Nakhon Nayok Province and 16.84% (16/95) of Hemaphysalis ornithophila (Hoogstraal and Kohls, 1959) collected from Khao Yai National Park, Nakhon Nayok Province and Khao Ang Rue Nai Wildlife Sanctuary, Chachoengsao Province. Rickettsial DNA was not detected in any of the other tick species and no DNA of Borrelia, Francisella, or Wolbachia was detected in any of 14 tick species. Phylogenetic relationships among the rickettsiae detected in this study and those of other rickettsiae were inferred from comparison of sequences of the 17-kDa antigen gene, the citrate synthase gene (gltA), and the 190-kDa outer membrane protein gene (ompA). Results indicated that the three Thai rickettsiae detected in this study represent new rickettsial genotypes and form a separate cluster among the spotted fever group rickettsiae.

  18. Molecular detection of spotted fever group rickettsia in feral raccoons (Procyon lotor) in the western part of Japan.

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    Baba, Kenji; Kaneda, Toshiya; Nishimura, Hitoshi; Sato, Hiroshi

    2013-02-01

    Rickettsial infection in feral raccoons (Procyon lotor) in the western part of Japan (Shimane, Fukuoka, Saga and Nagasaki Prefectures) was surveyed by a nested polymerase chain reaction (PCR) assay detecting the rickettsial citrate synthase (gltA) gene. Four of one hundred and ninety-four feral raccoon spleens (2.1%) were positive for Rickettsia spp. One gltA gene sequence was identical to R. helvetica, whereas the other 3 sequences were identical and had the highest similarity (98.4%) to R. amblyommii. Simultaneously, we determined a partial sequence of the rickettsial 17-kilodalton (17K) genus-common antigen gene in the later 3 raccoon samples. Their sequences were identical and had the highest similarity (98.5%) to Rickettsia sp. Hj126. Based on the sequences of gltA and 17K antigen genes, these raccoons might be infected with spotted fever group (SFG) rickettsia most closely related to R. amblyommii and/or Rickettsia sp. Hj126. Feral raccoons may be a susceptible reservoir for SFG rickettsiae in Japan.

  19. A novel spotted fever group Rickettsia infecting Amblyomma parvitarsum (Acari: Ixodidae) in highlands of Argentina and Chile.

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    Ogrzewalska, Maria; Nieri-Bastos, Fernanda A; Marcili, Arlei; Nava, Santiago; González-Acuña, Daniel; Muñoz-Leal, Sebastián; Ruiz-Arrondo, Ignacio; Venzal, José M; Mangold, Atilio; Labruna, Marcelo B

    2016-04-01

    The tick Amblyomma parvitarsum (Acari: Ixodidae) has established populations in Andean and Patagonic environments of South America. For the present study, adults of A. parvitarsum were collected in highland areas (elevation >3500 m) of Argentina and Chile during 2009-2013, and tested by PCR for rickettsial infection in the laboratory, and isolation of rickettsiae in Vero cell culture by the shell vial technique. Overall, 51 (62.2%) out of 82 A. parvitarsum adult ticks were infected by spotted fever group (SFG) rickettsiae, which generated DNA sequences 100% identical to each other, and when submitted to BLAST analysis, they were 99.3% identical to corresponding sequence of the ompA gene of Rickettsia sp. strain Atlantic rainforest. Rickettsiae were successfully isolated in Vero cell culture from two ticks, one from Argentina and one from Chile. DNA extracted from the third passage of the isolates of Argentina and Chile were processed by PCR, resulting in partial sequences for three rickettsial genes (gltA, ompB, ompA). These sequences were concatenated and aligned with rickettsial corresponding sequences available in GenBank. Phylogenetic analysis revealed that the A. pavitarsum rickettsial agent grouped under high bootstrap support in a clade composed by the SFG pathogens R. sibirica, R. africae, R. parkeri, Rickettsia sp. strain Atlantic rainforest, and two unnamed SFG agents of unknown pathogenicty, Rickettsia sp. strain NOD, and Rickettsia sp. strain ApPR. The pathogenic role of this A. parvitarsum rickettsia cannot be discarded, since several species of tick-borne rickettsiae that were considered nonpathogenic for decades are now associated with human infections.

  20. Importation of exotic ticks and tick-borne spotted fever group rickettsiae into the United States by migrating songbirds.

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    Mukherjee, Nabanita; Beati, Lorenza; Sellers, Michael; Burton, Laquita; Adamson, Steven; Robbins, Richard G; Moore, Frank; Karim, Shahid

    2014-03-01

    Birds are capable of carrying ticks and, consequently, tick-transmitted microorganisms over long distances and across geographical barriers such as oceans and deserts. Ticks are hosts for several species of spotted fever group rickettsiae (SFGR), which can be transmitted to vertebrates during blood meals. In this study, the prevalence of this group of rickettsiae was examined in ticks infesting migratory songbirds by using polymerase chain reaction (PCR). During the 2009 and 2010 spring migration season, 2064 northward-migrating passerine songbirds were examined for ticks at Johnson Bayou, Louisiana. A total of 91 ticks was removed from 35 individual songbirds for tick species identification and spotted fever group rickettsia detection. Ticks were identified as Haemaphysalis juxtakochi (n=38, 42%), Amblyomma longirostre (n=22, 24%), Amblyomma nodosum (n=17, 19%), Amblyomma calcaratum (n=11, 12%), Amblyomma maculatum (n=2, 2%), and Haemaphysalis leporispalustris (n=1, 1%) by comparing their 12S rDNA gene sequence to homologous sequences in GenBank. Most of the identified ticks were exotic species originating outside of the United States. The phylogenetic analysis of the 71 ompA gene sequences of the rickettsial strains detected in the ticks revealed the occurrence of 6 distinct rickettsial genotypes. Two genotypes (corresponding to a total of 28 samples) were included in the Candidatus Rickettsia amblyommii clade (less than 1% divergence), 2 of them (corresponding to a total of 14 samples) clustered with Rickettsia sp. "Argentina" with less than 0.2% sequence divergence, and 2 of them (corresponding to a total of 27 samples), although closely related to the R. parkeri-R. africae lineage (2.50-3.41% divergence), exhibited sufficient genetic divergence from its members to possibly constitute a new rickettsial genotype. Overall, there does not seem to be a specific relationship between exotic tick species, the rickettsiae they harbor, or the reservoir competence of the

  1. IAP Guidelines on Rickettsial Diseases in Children.

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    Rathi, Narendra; Kulkarni, Atul; Yewale, Vijay

    2017-03-15

    To formulate practice guidelines on rickettsial diseases in children for pediatricians across India. Rickettsial diseases are increasingly being reported from various parts of India. Due to low index of suspicion, nonspecific clinical features in early course of disease, and absence of easily available, sensitive and specific diagnostic tests, these infections are difficult to diagnose. With timely diagnosis, therapy is easy, affordable and often successful. On the other hand, in endemic areas, where healthcare workers have high index of suspicion for these infections, there is rampant and irrational use of doxycycline as a therapeutic trial in patients of undifferentiated fevers. Thus, there is a need to formulate practice guidelines regarding rickettsial diseases in children in Indian context. A committee was formed for preparing guidelines on rickettsial diseases in children in June 2016. A meeting of consultative committee was held in IAP office, Mumbai and scientific content was discussed. Methodology and results were scrutinized by all members and consensus was reached. Textbook references and published guidelines were also used in few instances to make recommendations. Various Indian and international publications pertinent to present study were collated and guidelines were approved by all committee members. Future updates in these guidelines will be dictated by new scientific data in the field of rickettsial diseases in children. Indian tick typhus and scrub typhus are commonly seen rickettsial diseases in India. It is recommended that practicing pediatricians should be well conversant with compatible clinical scenario, suggestive epidemiological features, differential diagnoses and suggestive laboratory features to make diagnosis and avoid over diagnosis of these infections, as suggested in these guidelines. Doxycycline is the drug of choice and treatment should begin promptly without waiting for confirmatory laboratory results.

  2. Spotted fever group rickettsiae in Amblyomma ticks likely to infest humans in rural areas from northwestern Argentina.

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    Saracho Bottero, María N; Tarragona, Evelina L; Nava, Santiago

    2015-01-01

    This work was performed to detect Rickettsia species of the spotted fever group in Amblyomma ticks likely to infest humans in rural areas from northwestern Argentina. Free-living ticks were collected and determined as Amblyomma tigrinum, Amblyomma neumanni and Amblyomma tonelliae. Rickettsia infection was determined by polymerase chain reactions which amplify fragments of the rickettsial genes gltA and ompA. A high frequency (35/44, 79.5%) of Candidatus "Rickettsia andeanae" was observed in A. tigrinum ticks, and Candidatus "Rickettsia amblyommii" was found in three out of 14 nymphs of A. neumanni. All 14 Amblyomma tonelliae ticks were negative for rikettsiae. The infection with spotted fever group rickettsiae in ticks aggressive for humans reveals the potential risk of exposure to tick-borne pathogens of people inhabiting rural areas of northwestern Argentina.

  3. African tick-bite fever in a returning traveler.

    Science.gov (United States)

    Binder, William D; Gupta, Rajat

    2015-05-01

    African tick bite fever (ATBF) is an emerging infection endemic to sub-Saharan Africa and increasingly noted in travelers to the region. We present a case of ATBF in a 63-year-old man who presented with complaints of a rash and fever to the emergency department. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Rickettsial diseases are increasingly common and are seen on every continent except Antarctica. Many factors are contributing to their prevalence, and they have become the second most common cause of fever behind malaria in the traveler returning from Africa. Due to the global distribution of rickettsial diseases, as well as increasing international travel, emergency physicians might encounter ill and febrile travelers. A careful travel history and examination will enable the emergency physician to consider spotted fever group rickettsial diseases in their differential diagnosis for single and multiple eschars. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. Characterization of rickettsial adhesin Adr2 belonging to a new group of adhesins in α-proteobacteria.

    Science.gov (United States)

    Vellaiswamy, Manohari; Kowalczewska, Malgorzata; Merhej, Vicky; Nappez, Claude; Vincentelli, Renaud; Renesto, Patricia; Raoult, Didier

    2011-05-01

    Rickettsia prowazekii is the etiological agent of epidemic typhus and is an obligate intracellular bacterium that grows as a parasite freely within the cytoplasm of a eukaryotic host cell. Previous studies have shown that rOmpA and rOmpB which belong to the family of rickettsial cell surface antigens are involved in vitro in the adhesion of Rickettsiae to epithelial cells. Recently, two putative rickettsial adhesins have been identified using high resolution 2D-PAGE coupled with mass spectrometry. In this study, we further characterize and describe the adhesin Adr2 from R. prowazekii. Using an overlay assay coupled with mass spectrometry two adhesins, Adr1 (RP827) and Adr2 (RP828), were identified from the R. prowazekii proteome Recombinant R. prowazekii Adr2 was expressed through fusion with Dsbc in Escherichia coli, purified and concentrated, thus allowing production of specific monoclonal antibodies, as confirmed by western blot assays. Finally, inhibition of rickettsiae-induced cytotoxicity with monoclonal anti-Adr2 antibody has showed a greatest impact on bacterial cell entry at 8 h post-infection (ca50%) and then decreased progressively to attempt 18% of inhibition at day 7. These, correlated to the inhibition of rickettsiae-induced cytotoxicity with monoclonal anti-rOmpB antibody. Thus, Adr2 is sufficient to mediate R. prowazekii entry into the cell at early stage of mammalian cell infection. Our results suggest that R. prowazekii Adr2 could be the main actor promoting the entry of rickettsiae into the host cells. The present study opens the framework for future investigations for better understanding of the Adr2 -mediated mechanisms involved in adhesion/invasion or intracellular survival of R. prowazekii. Copyright © 2011 Elsevier Ltd. All rights reserved.

  5. Rickettsial Diseases of Military Importance: An Australian Perspective

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    Stephen Frances

    2011-10-01

    Full Text Available The threat of rickettsial diseases to Australian Defence Force (ADF personnel is reviewed, focusing on the historical impact and epidemiology of these diseases. Scrub typhus, a mite borne disease caused by Orientia tsutsugamushi is historically the most important rickettsial disease, and continues to cause morbidity in ADF personnel today. The historical occurrence of tick typhus, murine typhus, epidemic typhus and Q fever has been limited, and modern diagnostic tools and antibiotic therapy mean that their impact is minimal. Deployment of troops to endemic areas, bioterrorism and exposure during humanitarian missions mean that rickettsial diseases will remain a threat to ADF personnel. Several rickettsial diseases have the potential to impact on military deployments. This article is a review of the information concerning the ecology, epidemiology and historical impact of rickettsial diseases on the Australian Defence Force (ADF personnel in peace and in wartime. Probably the most widespread and important rickettsial disease is scrub typhus, while diseases such as tick typhus, murine typhus, epidemic typhus and Q fever have been of lesser importance.

  6. No serological evidence for rickettsial diseases among Danish elite orienteerers

    DEFF Research Database (Denmark)

    Schiellerup, Peter; Dyhr, Thomas; Rolain, Jean Marc;

    2006-01-01

    orienteerers. We conducted a case-control study aimed to elucidate the serologic prevalence of rickettsial diseases among Danish elite orienteerers. Ticks are known as vectors for some rickettsial diseases. None of the orienteerers had a positive antibody titer against any of the tested Rickettsia despite...... a very high frequency of tick bites in this group....

  7. Rickettsial infection caused by accidental conjunctival inoculation

    Science.gov (United States)

    Brissos, Joao; de Sousa, Rita; Santos, Ana Sofia; Gouveia, Catarina

    2015-01-01

    The most common transmission route of tick-borne Rickettsia is through tick bite; nevertheless, other transmission routes should also be considered. We report a case of rickettsial infection in a 15-year-old boy caused by accidental contamination of the conjunctiva through the infected fluid of a crushed engorged tick removed from a dog. Right eye pain, conjunctival hyperaemia with mucopurulent exudate, chemosis and eyelid oedema were the first signs and symptoms. Two days later, the boy developed fever, myalgia, headache, abdominal pain and was vomiting; physical examination showed multiple cervical adenopathies but no rash. He was treated with doxycycline (200 mg/day) for 7 days with progressive resolution of clinical signs. Rickettsial infection was confirmed by immunofluorescence assay with serological seroconversion in two consecutive samples. Rickettsia conorii or Rickettsia massiliae were the possible causal agents since they are the Rickettsia spp found in the Rhipicephalus sanguineus dog tick in Portugal. PMID:25568272

  8. Rickettsial infections of fleas collected from small mammals on four islands in Indonesia.

    Science.gov (United States)

    Barbara, Kathryn A; Farzeli, Arik; Ibrahim, Ima N; Antonjaya, Ungke; Yunianto, Andre; Winoto, Imelda; Ester; Perwitasari, Dian; Widjaya, Susana; Richards, Allen L; Williams, Maya; Blair, Patrick J

    2010-11-01

    Ectoparasites were sampled from small mammals collected in West Java, West Sumatra, North Sulawesi, and East Kalimantan, Indonesia, in 2007-2008 and were screened for evidence of infection from bacteria in the Rickettsaceae family. During eight trap nights at eight sites, 208 fleas were collected from 96 of 507 small mammals trapped from four orders (379 Rodentia; 123 Soricomorpha; two Carnivora; three Scandentia). Two species of fleas were collected: Xenopsylla cheopis (n = 204) and Nosopsyllus spp. (n = 4). Among the 208 fleas collected, 171 X. cheopis were removed from rats (Rattus spp.) and 33 X. cheopis from shrews (Suncus murinus). X. cheopis were pooled and tested for DNA from rickettsial agents Rickettsia typhi, Rickettsia felis, and spotted fever group rickettsiae. R. typhi, the agent of murine typhus, was detected in X. cheopis collected from small mammals in West Java and East Kalimantan. R. felis was detected in X. cheopis collected from small mammals in Manado, North Sulawesi. R. felis and spotted fever group rickettsiae were detected in a pool of X. cheopis collected from an animal in East Kalimantan. Sixteen percent of the X. cheopis pools were found positive for Rickettsia spp.; four (10.8%) R. typhi, one (2.7%) R. felis, and one (2.7%) codetection of R. felis and a spotted fever group rickettsia. These data suggest that rickettsial infections remain a threat to human health across Indonesia.

  9. Detection of a novel spotted fever group Rickettsia in the gophertortoise tick.

    Science.gov (United States)

    Zemtsova, Galina E; Gleim, Elizabeth; Yabsley, Michael J; Conner, L Mike; Mann, Tom; Brown, Mary D; Wendland, Lori; Levin, Michael L

    2012-05-01

    The gophertortoise tick, Amblyomma tuberculatum (Marx), is distributed throughout the southeastern United States, and its immature life stages have been reported to occasionally bite humans. Here we report detection of a novel spotted fever group (SFG) Rickettsia in A. tuberculatum ticks collected in the southern United States. Among questing ticks collected in Georgia, 10 pools of larvae were identified as gophertortoise ticks, A. tuberculatum. Each of these samples was positive for SFG Rickettsiae. The restriction fragment-length polymorphism profiles were identical to each other, but distinct from those of other rickettsiae previously found in Amblyomma spp. ticks. Partial genetic characterization of the novel agent was achieved by sequencing the 17 kDa, gltA, ompB, ompA, rpoB, and sca4 genes. Analysis of a concatenated tree of four genes (gltA, ompB, ompA, and sca4) demonstrates close relatedness of the detected Rickettsia to several SFG Rickettsia spp. The identical rickettsial DNA was detected in 50 and 70% of adult A. tuberculatum ticks from Mississippi and Florida, respectively. The results indicate wide distribution of a novel Rickettsia, capability for transovarial transmission, and high prevalence in tested tick populations.

  10. Rickettsial spotted fever in capoeirão Village, Itabira, Minas Gerais, Brazil Rickettsiose do grupo da febre maculosa na Vila de Capoeirão, Itabira, Minas Gerais, Brasil

    Directory of Open Access Journals (Sweden)

    Manoella Campostrini Barreto Vianna

    2008-10-01

    Full Text Available The present study investigated the infection by spotted fever rickettsia in an endemic area for Brazilian spotted fever (BSF; caused by Rickettsia rickettsii in Minas Gerais State, Brazil. Human, canine and equine sera samples, and Amblyomma cajennense adult ticks collected in a rural area of Itabira City, Minas Gerais State were tested for rickettsial infection. Through Immunofluorescence Assay (IFA we demonstrated the presence of antibodies anti-R. rickettsii in 8.2%, 81.3% and 100% of the human, canine and equine sera, respectively. None of the 356 tick specimens analyzed were positive for Rickettsia by the hemolymph test or Polymerase Chain Reaction technique (PCR for the htrA and the gltA genes. Our serological results on horses and dogs (sentinels for BSF appoint for the circulation of a SFG Rickettsia in the study area, however in a very low infection rate among the A. cajennense tick population.O presente estudo investigou a infecção por rickéttsias do grupo da febre maculosa (GFM em área endêmica para febre maculosa brasileira (FMB; causada por Rickettsia rickettsii no Estado de Minas Gerais, Brasil. Amostras de soros de humanos, cães e eqüídeos, e carrapatos Amblyomma cajennense adultos colhidos em um povoado rural em Itabira, Minas Gerais foram testados para infecção por Rickettsia. Pela Reação de Imunofluorescência Indireta (RIFI foram detectados anticorpos anti-R. rickettsii em 8,2% dos soros humanos, 81,3% dos cães e em 100% dos eqüídeos. Nenhum dos 356 carrapatos se mostrou positivo para Rickettsia no teste de hemolinfa e na reação em cadeia pela polimerase (PCR objetivando amplificar fragmentos de DNA dos genes htrA and the gltA. Os resultados sorológicos em eqüinos e cães (sentinelas para FMB apontam para a circulação de uma rickéttsia do GFM na área do estudo, porém, numa freqüência de infecção muito baixa na população do carrapato A. cajennense.

  11. Identification of factors for physicians to facilitate early differential diagnosis of scrub typhus, murine typhus, and Q fever from dengue fever in Taiwan.

    Science.gov (United States)

    Chang, Ko; Lee, Nan-Yao; Ko, Wen-Chien; Tsai, Jih-Jin; Lin, Wei-Ru; Chen, Tun-Chieh; Lu, Po-Liang; Chen, Yen-Hsu

    2017-02-01

    Dengue fever, rickettsial diseases, and Q fever are acute febrile illnesses with similar manifestations in tropical areas. Early differential diagnosis of scrub typhus, murine typhus, and Q fever from dengue fever may be made by understanding the distinguishing clinical characteristics and the significance of demographic and weather factors. We conducted a retrospective study to identify clinical, demographic, and meteorological characteristics of 454 dengue fever, 178 scrub typhus, 143 Q fever, and 81 murine typhus cases in three Taiwan hospitals. Case numbers of murine typhus and Q fever correlated significantly with temperature and rainfall; the scrub typhus case number was only significantly related with temperature. Neither temperature nor rainfall correlated with the case number of dengue fever. The rarity of dengue fever cases from January to June in Taiwan may be a helpful clue for diagnosis in the area. A male predominance was observed, as the male-to-female rate was 2.1 for murine typhus and 7.4 for Q fever. Multivariate analysis revealed the following six important factors for differentiating the rickettsial diseases and Q fever group from the dengue fever group: fever ≥8 days, alanine aminotransferase > aspartate aminotransferase, platelets >63,000/mL, C-reactive protein >31.9 mg/L, absence of bone pain, and absence of a bleeding syndrome. Understanding the rarity of dengue in the first half of a year in Taiwan and the six differentiating factors may help facilitate the early differential diagnosis of rickettsial diseases and Q fever from dengue fever, permitting early antibiotic treatment. Copyright © 2015. Published by Elsevier B.V.

  12. Spotted fever group rickettsiae detected in immature stages of ticks parasitizing on Iberian endemic lizard Lacerta schreiberi Bedriaga, 1878.

    Science.gov (United States)

    Kubelová, Michaela; Papoušek, Ivo; Bělohlávek, Tomáš; de Bellocq, Joëlle Goüy; Baird, Stuart J E; Široký, Pavel

    2015-09-01

    Spotted fever rickettsioses are tick-borne diseases of growing public health concern. The prevalence of rickettsia-infected ticks and their ability to parasitize humans significantly influence the risk of human infection. Altogether 466 Ixodes ricinus ticks (428 nymphs and 38 larvae) collected from 73 Lacerta schreiberi lizards were examined by PCR targeting the citrate synthetase gene gltA for the presence of Rickettsia spp. Rickettsial DNA was detected in 47% of nymphs and 31.6% of larvae. They were subsequently subjected to a second PCR reaction using primers derived from the outer membrane protein rOmpA encoding gene (ompA) to detect spotted fever group rickettsiae (SFG). This analysis shows that 41.4% of nymphs and 7.9% of larvae collected from the lizards contain DNA of SFG rickettsiae. Sequencing of 43 randomly selected samples revealed two different haplotypes, both closely related to R. monacensis (39 and 4 samples, respectively). The remaining ompA negative Rickettsia spp. samples were determined to be R. helvetica based on sequencing of ompB and gltA fragments. Our results indicate that the role of Iberian endemic lizard L. schreiberi and its ectoparasites in the ecology and epidemiology of zoonotic SFG rickettsioses may be appreciable.

  13. Rickettsial Diseases: Scrub Typhus and Trench Fever.

    Science.gov (United States)

    1979-05-01

    the laboratory and helped us by advising us on many aspects of rickett - sial cultivation and related serological studies. During the cOMing year, he...Micro- biology Department at University of Massachusetts in Amherst, MA and Ms. T. Rota transferred to a position at the Mass General Hospital . During...prior to inoculation with R. tsutsugamushi. This radiation inhibits cell division and proliferation of the BHK 2 1 cells but does not kill them. Fur

  14. Molecular surveillance of spotted fever group rickettsioses in wildlife and detection of Rickettsia sibirica in a Topi (Damaliscus lunatus ssp. jimela) in Kenya.

    Science.gov (United States)

    Ndeereh, David; Thaiyah, Andrew; Muchemi, Gerald; Miyunga, Antoinette A

    2017-01-30

    Spotted fever group rickettsioses are a group of tick-borne zoonotic diseases caused by intracellular bacteria of the genus Rickettsia. The diseases are widely reported amongst international travellers returning from most sub-Saharan Africa with fever, yet their importance in local populations largely remains unknown. Although this has started to change and recently there have been increasing reports of the diseases in livestock, ticks and humans in Kenya, they have not been investigated in wildlife. We examined the presence, prevalence and species of Rickettsia present in wildlife in two regions of Kenya with a unique human-wildlife-livestock interface. For this purpose, 79 wild animals in Laikipia County and 73 in Maasai Mara National Reserve were sampled. DNA extracted from blood was tested using the polymerase chain reaction (PCR) to amplify the intergenic spacer rpmE-tRNAfMet and the citrate synthase-encoding gene gltA. Rickettsial DNA was detected in 2 of the 79 (2.5%) animals in Laikipia and 4 of the 73 (5.5%) in Maasai Mara. The PCR-positive amplicons of the gltA gene were sequenced to determine the detected Rickettsia species. This revealed Rickettsia sibirica in a Topi (Damaliscus lunatus ssp. jimela). This is the first report of spotted fever group rickettsioses in wildlife and the first to report R. sibirica in Kenya. The finding demonstrates the potential role of wild animals in the circulation of the diseases.

  15. Molecular surveillance of spotted fever group rickettsioses in wildlife and detection of Rickettsia sibirica in a Topi (Damaliscus lunatus ssp. jimela in Kenya

    Directory of Open Access Journals (Sweden)

    David Ndeereh

    2017-01-01

    Full Text Available Spotted fever group rickettsioses are a group of tick-borne zoonotic diseases caused by intracellular bacteria of the genus Rickettsia. The diseases are widely reported amongst international travellers returning from most sub-Saharan Africa with fever, yet their importance in local populations largely remains unknown. Although this has started to change and recently there have been increasing reports of the diseases in livestock, ticks and humans in Kenya, they have not been investigated in wildlife. We examined the presence, prevalence and species of Rickettsia present in wildlife in two regions of Kenya with a unique human–wildlife–livestock interface. For this purpose, 79 wild animals in Laikipia County and 73 in Maasai Mara National Reserve were sampled. DNA extracted from blood was tested using the polymerase chain reaction (PCR to amplify the intergenic spacer rpmE-tRNAfMet and the citrate synthase-encoding gene gltA. Rickettsial DNA was detected in 2 of the 79 (2.5% animals in Laikipia and 4 of the 73 (5.5% in Maasai Mara. The PCR-positive amplicons of the gltA gene were sequenced to determine the detected Rickettsia species. This revealed Rickettsia sibirica in a Topi (Damaliscus lunatus ssp. jimela. This is the first report of spotted fever group rickettsioses in wildlife and the first to report R. sibirica in Kenya. The finding demonstrates the potential role of wild animals in the circulation of the diseases.

  16. Spotted fever rickettsiosis in Coronel Fabriciano, Minas Gerais State

    Directory of Open Access Journals (Sweden)

    Galvão Márcio Antônio Moreira

    2003-01-01

    Full Text Available We report cases of spotted fever rickettsiosis in Coronel Fabriciano Municipality of Minas Gerais State, Brazil. The cases occurred in May and June of 2000. During this period there were two deaths among children from an area named Pedreira in a periurban area of this municipality. In a boy who died with clinical manifestations of Brazilian spotted fever, a necropsy revealed the presence of a spotted fever group Rickettsia. The serological results confirm the difficulty in the differential diagnosis of patients with symptoms of rickettsial diseases.

  17. Rickettsial pathogens and arthropod vectors of medical and veterinary significance on Kwajalein Atoll and Wake Island

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    Durden, L.

    2012-05-01

    Full Text Available Modern surveys of ectoparasites and potential vector-borne pathogens in the Republic of the Marshall Islands and Wake Island are poorly documented. We report on field surveys of ectoparasites from 2010 with collections from dogs, cats, and rats. Five ectoparasites were identified: the cat flea Ctenocephalides felis, a sucking louse Hoplopleura pacifica, the mites Laelaps nuttalli and Radfordia ensifera, and the brown dog tickRhipicephalus sanguineus. Ectoparasites were screened for rickettsial pathogens. DNA from Anaplasma platys, a Coxiella symbiont of Rhipicephalus sanguineus, anda Rickettsia sp. were identified by PCR and DNA sequencing from ticks and fleas on Kwajalein Atoll. An unidentified spotted fever group Rickettsia was detected in a pool of Laelaps nuttalli and Hoplopleura pacifica from Wake Island. The records of Hoplopleura pacifica, Laelaps nuttalli, and Radfordia ensifera and the pathogens are new for Kwajalein Atoll and Wake Island.

  18. The detection of spotted fever group Rickettsia DNA from fever patients in Dali, Yunnan%云南省大理州发热患者血液中检测斑点热群立克次体

    Institute of Scientific and Technical Information of China (English)

    亚红祥; 王静林

    2012-01-01

    目的 调查云南省大理州不明原因发热患者是否存在斑点热.方法 用巢式-聚合酶链反应法扩增患者血液中的立克次体属groEL基因,并进行核酸序列鉴定和分析.结果 20例患者血液中检出1例立克次体核酸阳性(检出率5%),其序列分析与GenBank中Rickcttsia rickcttsii Iowa、Rickcttsia peacockii Rustic、Rickcttsia sibirica等斑点热群立克次体株的同源性最高(为99%).结论 首次证实云南大理地区存在斑点热患者,医疗部门应加强对斑点热的诊断与鉴别.%Objective To identify the pathogen of patients with fever with unknown origin and determine whether they were infected with spotted fever group Rickettsia. Methods Nested polymerase chain reaction (nPCR) was conducted to amplify groEL gene of rickettsia from the blood samples of the patients, the nucleotide sequencing and identification were carried out. Results Rickettsial DNA was detected in 1 of the 20 patients (5% ). The groEL gene of the strain shared high homology (99%) with Rickcttsia rickcttsii Iowa, Rickcttsia peacockii Rustic and Rickettsia sibirica. Conclusion It was the first time to diagnose the patient with spotted fever in Dali, Yunnan province. It is necessary to enhance the differential diagnosis of spotted fever in local medical institutions.

  19. Clinical and Epidemiological Studies on Rickettsial Infections.

    Science.gov (United States)

    1980-06-01

    EPIDEMOLOGICAL STUDIES ON RICKETTSIAL INFECTI011-"- APPLICATION FOR RENEWAL FOR TEAR-7 (1979-1980) Pase 2 Repor Page 11 effective control of the infection were...34CLINICAL AND EPIDEMOLOGICAL STUDIES ON RICKETTSIAL INFECTIONS" ANINUAL REPORT. YFAR-7(1979-1980) Page 62 Report Page 31 OFFICE OF NAVAL RESEARCH

  20. Detection of rickettsial DNA in ticks and wild boars in Kyoto City, Japan.

    Science.gov (United States)

    Someya, Azusa; Ito, Ryuki; Maeda, Akihiko; Ikenaga, Mitsuhiro

    2015-01-01

    The tick is a well-known vector for arthropod-borne pathogens, such as tick-borne encephalitis, Lyme disease, Japanese spotted fever and severe fever with thrombocytopenia syndrome. It is therefore important to know the tick population and distribution in our environment and wild animals in order to prevent tick-borne diseases. Here, we report the results of tick surveillance from May to September 2011 at 14 geographical points and in 5 wild boars in Kyoto City, Kyoto prefecture, Japan. We collected 3,198 ticks comprising 5 tick species, Haemaphysalis (H.) longicornis, H. flava, H. kitaokai, Amblyomma testudinarium and Dermacentor taiwanensis. Interestingly, the proportion of tick species varied according to geographical region within the city. The ticks collected in the city were reported as potential vectors of pathogens, such as rickettsiosis. We detected rickettsial DNA by PCR in 71.1% of 201 ticks investigated. The ticks that carried rickettsiae were distributed across the whole the city. The sequences of PCR-amplified DNA fragments were determined and showed similarities to spotted fever group rickettsiae. Although their pathogenicity for animals including humans is still unclear, it is important to stay alert and pay attention to tick-borne diseases in order to ensure the safety of the citizens of the city as well as that of visitors.

  1. Two different rickettsial bacteria invading Volvox carteri.

    Directory of Open Access Journals (Sweden)

    Kaoru Kawafune

    Full Text Available Bacteria of the family Rickettsiaceae are principally associated with arthropods. Recently, endosymbionts of the Rickettsiaceae have been found in non-phagotrophic cells of the volvocalean green algae Carteria cerasiformis, Pleodorina japonica, and Volvox carteri. Such endosymbionts were present in only C. cerasiformis strain NIES-425 and V. carteri strain UTEX 2180, of various strains of Carteria and V. carteri examined, suggesting that rickettsial endosymbionts may have been transmitted to only a few algal strains very recently. However, in preliminary work, we detected a sequence similar to that of a rickettsial gene in the nuclear genome of V. carteri strain EVE.Here we explored the origin of the rickettsial gene-like sequences in the endosymbiont-lacking V. carteri strain EVE, by performing comparative analyses on 13 strains of V. carteri. By reference to our ongoing genomic sequence of rickettsial endosymbionts in C. cerasiformis strain NIES-425 cells, we confirmed that an approximately 9-kbp DNA sequence encompassing a region similar to that of four rickettsial genes was present in the nuclear genome of V. carteri strain EVE. Phylogenetic analyses, and comparisons of the synteny of rickettsial gene-like sequences from various strains of V. carteri, indicated that the rickettsial gene-like sequences in the nuclear genome of V. carteri strain EVE were closely related to rickettsial gene sequences of P. japonica, rather than those of V. carteri strain UTEX 2180.At least two different rickettsial organisms may have invaded the V. carteri lineage, one of which may be the direct ancestor of the endosymbiont of V. carteri strain UTEX 2180, whereas the other may be closely related to the endosymbiont of P. japonica. Endosymbiotic gene transfer from the latter rickettsial organism may have occurred in an ancestor of V. carteri. Thus, the rickettsiae may be widely associated with V. carteri, and likely have often been lost during host evolution.

  2. Rickettsial Infections among Ctenocephalides felis and Host Animals during a Flea-Borne Rickettsioses Outbreak in Orange County, California

    Science.gov (United States)

    Fogarty, Carrie; Krueger, Laura; Macaluso, Kevin R.; Odhiambo, Antony; Nguyen, Kiet; Farris, Christina M.; Luce-Fedrow, Alison; Bennett, Stephen; Jiang, Ju; Sun, Sokanary; Cummings, Robert F.; Richards, Allen L.

    2016-01-01

    Due to a resurgence of flea-borne rickettsioses in Orange County, California, we investigated the etiologies of rickettsial infections of Ctenocephalides felis, the predominant fleas species obtained from opossums (Didelphis virginiana) and domestic cats (Felis catus), collected from case exposure sites and other areas in Orange County. In addition, we assessed the prevalence of IgG antibodies against spotted fever group (SFGR) and typhus group (TGR) rickettsiae in opossum sera. Of the 597 flea specimens collected from opossums and cats, 37.2% tested positive for Rickettsia. PCR and sequencing of rickettsial genes obtained from C. felis flea DNA preparations revealed the presence of R. typhi (1.3%), R. felis (28.0%) and R. felis-like organisms (7.5%). Sera from opossums contained TGR-specific (40.84%), but not SFGR-specific antibodies. The detection of R. felis and R. typhi in the C. felis fleas in Orange County highlights the potential risk for human infection with either of these pathogens, and underscores the need for further investigations incorporating specimens from humans, animal hosts, and invertebrate vectors in endemic areas. Such studies will be essential for establishing a link in the ongoing flea-borne rickettsioses outbreaks. PMID:27537367

  3. Novel identification of Dermacentor variabilis Arp2/3 complex and its role in rickettsial infection of the arthropod vector.

    Directory of Open Access Journals (Sweden)

    Natthida Petchampai

    Full Text Available Tick-borne spotted fever group (SFG Rickettsia species must be able to infect both vertebrate and arthropod host cells. The host actin-related protein 2/3 (Arp2/3 complex is important in the invasion process and actin-based motility for several intracellular bacteria, including SFG Rickettsia in Drosophila and mammalian cells. To investigate the role of the tick Arp2/3 complex in tick-Rickettsia interactions, open reading frames of all subunits of the protein including Arp2, Arp3, ARPC1, ARPC2, ARPC3, ARPC4, and ARPC5 were identified from Dermacentor variabilis. Amino acid sequence analysis showed variation (ranging from 25-88% in percent identity compared to the corresponding subunits of the complex from Drosophila melanogaster, Mus musculus, Homo sapiens, and Saccharomyces cerevisiae. Potential ATP binding sites were identified in D. variabilis (Dv Arp2 and Arp3 subunits as well as five putative WD (Trp-Asp motifs which were observed in DvARPC1. Transcriptional profiles of all subunits of the DvArp2/3 complex revealed greater mRNA expression in both Rickettsia-infected and -uninfected ovary compared to midgut and salivary glands. In response to R. montanensis infection of the tick ovary, the mRNA level of only DvARPC4 was significantly upregulated compared to uninfected tissues. Arp2/3 complex inhibition bioassays resulted in a decrease in the ability of R. montanensis to invade tick tissues with a significant difference in the tick ovary, indicating a role for the Arp2/3 complex in rickettsial invasion of tick cells. Characterization of tick-derived molecules associated with rickettsial infection is imperative in order to better comprehend the ecology of tick-borne rickettsial diseases.

  4. Ticks and spotted fever group rickettsiae of southeastern Virginia.

    Science.gov (United States)

    Nadolny, Robyn M; Wright, Chelsea L; Sonenshine, Daniel E; Hynes, Wayne L; Gaff, Holly D

    2014-02-01

    The incidence of tick-borne rickettsial disease in the southeastern United States has been rising steadily through the past decade, and the range expansions of tick species and tick-borne infectious agents, new and old, has resulted in an unprecedented mix of vectors and pathogens. The results of an ongoing 4-year surveillance project describe the relative abundance of questing tick populations in southeastern Virginia. Since 2009, more than 66,000 questing ticks of 7 species have been collected from vegetation in a variety of habitats, with Amblyomma americanum constituting over 95% of ticks collected. Other species represented included Ixodes scapularis, Dermacentor variabilis, Amblyomma maculatum, Ixodes affinis, Haemaphysalis leporispalustris, and Ixodes brunneus. We found that 26.9-54.9% of A. americanum ticks tested were positive for Rickettsia amblyommii, a non-pathogenic symbiont of this tick species. We also found no evidence of R. rickettsii in D. variabilis ticks, although they did show low infection rates of R. montanensis (1.5-2.0%). Rickettsia parkeri and Candidatus R. andeanae were found in 41.8-55.7% and 0-1.5% A. maculatum ticks, respectively. The rate of R. parkeri in A. maculatum ticks is among the highest in the literature and has increased in the 2 years since R. parkeri and A. maculatum were first reported in southeastern Virginia. We conclude that tick populations in southeastern Virginia have recently undergone dramatic changes in species and abundance and that these populations support a variety of rickettsial agents with the potential for increased risk to human health.

  5. Evidence of Rickettsial and Leptospira Infections in Andean Northern Peru

    Science.gov (United States)

    2004-01-01

    about health in six Latin American countries, 1973- 1992. Rev Panam Salud Publica 1: 23–34. 3. Cowan G, 2000. Rickettsial diseases: the typhus group of...Leonardo Mendoza Instituto Nacional de Salud , Capac Yupanqui No. 1400, Jesús Maria, Lima 11, Peru, Telephone: 51-1-471-9920. Allen L. Richards, Viral and...Colli C, 1997. Leptospira interrogans in a canine population of greater Bue- nos Aires: variables associated with seropositivity. Rev Panam Salud

  6. Origin and Evolution of Rickettsial Plasmids.

    Science.gov (United States)

    El Karkouri, Khalid; Pontarotti, Pierre; Raoult, Didier; Fournier, Pierre-Edouard

    2016-01-01

    Rickettsia species are strictly intracellular bacteria that have undergone a reductive genomic evolution. Despite their allopatric lifestyle, almost half of the 26 currently validated Rickettsia species have plasmids. In order to study the origin, evolutionary history and putative roles of rickettsial plasmids, we investigated the evolutionary processes that have shaped 20 plasmids belonging to 11 species, using comparative genomics and phylogenetic analysis between rickettsial, microbial and non-microbial genomes. Plasmids were differentially present among Rickettsia species. The 11 species had 1 to 4 plasmid (s) with a size ranging from 12 kb to 83 kb. We reconstructed pRICO, the last common ancestor of the current rickettsial plasmids. pRICO was vertically inherited mainly from Rickettsia/Orientia chromosomes and diverged vertically into a single or multiple plasmid(s) in each species. These plasmids also underwent a reductive evolution by progressive gene loss, similar to that observed in rickettsial chromosomes, possibly leading to cryptic plasmids or complete plasmid loss. Moreover, rickettsial plasmids exhibited ORFans, recent gene duplications and evidence of horizontal gene transfer events with rickettsial and non-rickettsial genomes mainly from the α/γ-proteobacteria lineages. Genes related to maintenance and plasticity of plasmids, and to adaptation and resistance to stress mostly evolved under vertical and/or horizontal processes. Those involved in nucleotide/carbohydrate transport and metabolism were under the influence of vertical evolution only, whereas genes involved in cell wall/membrane/envelope biogenesis, cycle control, amino acid/lipid/coenzyme and secondary metabolites biosynthesis, transport and metabolism underwent mainly horizontal transfer events. Rickettsial plasmids had a complex evolution, starting with a vertical inheritance followed by a reductive evolution associated with increased complexity via horizontal gene transfer as well as

  7. Differences in Intracellular Fate of Two Spotted Fever Group Rickettsia in Macrophage-Like Cells

    OpenAIRE

    Pedro Curto; Isaura Simoes; Riley, Sean P; Juan Jose Martinez

    2016-01-01

    Spotted fever group (SFG) rickettsiae are recognized as important agents of human tick-borne diseases worldwide, such as Mediterranean spotted fever (Rickettsia conorii) and Rocky Mountain spotted fever (Rickettsia rickettsii). Recent studies in several animal models have provided evidence of non-endothelial parasitism by pathogenic SFG Rickettsia species, suggesting that the interaction of rickettsiae with cells other than the endothelium may play an important role in pathogenesis of rickett...

  8. Fever in Children and Fever of Unknown Origin.

    Science.gov (United States)

    Dayal, Rajeshwar; Agarwal, Dipti

    2016-01-01

    Fever is the most common symptom in children and can be classified as fever with or without focus. Fever without focus can be less than 7 d and is subclassified as fever without localizing signs and fever of unknown origin (FUO). FUO is defined as a temperature greater than 38.3 °C, for more than 3 wk or failure to reach a diagnosis after 1 wk of inpatient investigations. The most common causes of FUO in children are infections, connective tissue disorders and neoplasms. Infectious diseases most commonly implicated in children with FUO are salmonellosis, tuberculosis, malaria and rickettsial diseases. Juvenile rheumatic arthritis is the connective tissue disease frequently associated with FUO. Malignancy is the third largest group responsible for FUO in children. Diagnostic approach of FUO includes detailed history and examination supported with investigations. Age, history of contact, exposure to wild animals and medications should be noted. Examination should include, apart from general appearance, presence of sweating, rashes, tonsillitis, sinusitis and lymph node enlargement. Other signs such as abdominal tenderness and hepatosplenomegly should be looked for. The muscles and bones should be carefully examined for connective tissue disorders. Complete blood count, blood smear examination and level of acute phase reactants should be part of initial investigations. Radiological imaging is useful aid in diagnosing FUO. Trials of antimicrobial agents should not be given as they can obscure the diagnosis of the disease in FUO.

  9. Knowledge, attitudes and practices towards spotted fever group rickettsioses and Q fever in Laikipia and Maasai Mara, Kenya

    Directory of Open Access Journals (Sweden)

    David Ndeereh

    2016-08-01

    Full Text Available Many factors contribute to misdiagnosis and underreporting of infectious zoonotic diseases in most sub-Saharan Africa including limited diagnostic capacity and poor knowledge. We assessed the knowledge, practices and attitudes towards spotted fever group rickettsioses (SFGR and Q fever amongst local residents in Laikipia and Maasai Mara in Kenya. A semistructured questionnaire was administered to a total of 101 respondents including 51 pastoralists, 17 human health providers, 28 wildlife sector personnel and 5 veterinarians. The pastoralists expressed no knowledge about SFGR and Q fever. About 26.7% of the wildlife sector personnel in Laikipia expressed some knowledge about SFGR and none in Maasai Mara. None of these respondents had knowledge about Q fever. About 45.5 and 33.3% of the health providers in Laikipia and Maasai Mara respectively expressed knowledge about SFGR and 9.1% in Laikipia expressed good knowledge on Q fever and none in Maasai Mara. The diseases are not considered amongst potential causes of febrile illnesses in most medical facilities except in one facility in Laikipia. Majority of pastoralists practiced at least one predisposing activity for transmission of the diseases including consumption of raw milk, attending to parturition and sharing living accommodations with livestock. Education efforts to update knowledge on medical personnel and One-Health collaborations should be undertaken for more effective mitigation of zoonotic disease threats. The local communities should be sensitized through a multidisciplinary approach to avoid practices that can predispose them to the diseases.

  10. Group C beta-hemolytic streptococci causing pharyngitis and scarlet fever.

    Science.gov (United States)

    Corson, A P; Garagusi, V F; Chretien, J H

    1989-09-01

    After a young woman had scarlet fever associated with group C beta-hemolytic streptococcal pharyngitis, we reviewed all cases of pharyngitis treated at a student health clinic during that semester. From 541 cases of pharyngitis, 34 cultures yielded group C Streptococcus. The patients who harbored group C organisms were similar to the patients with group A streptococcal pharyngitis in the presence of fever, exudate, and cervical adenopathy. The severity of symptoms and the demonstration of scarlet fever developing from infection with this organism supports antibiotic treatment of patients with group C streptococcal pharyngitis.

  11. Music Fever Sufferers—the New Cultural Consumer group

    Institute of Scientific and Technical Information of China (English)

    1994-01-01

    IN 1993 Beijing Music Radio formally began to air classical music programs, giving people suffering from music fever the chance to express their feelings. More than a decade ago, only musicians could enjoy music on oldfashioned gramophones. But in the 1980s advanced audio equipment, cassette tapes and compact discs gradually became available, which has

  12. Childhood fever in well-child clinics: a focus group study among doctors and nurses.

    Science.gov (United States)

    Peetoom, Kirsten K B; Ploum, Luc J L; Smits, Jacqueline J M; Halbach, Nicky S J; Dinant, Geert-Jan; Cals, Jochen W L

    2016-07-08

    Fever is common in children aged 0-4 years old and often leads to parental worries and in turn, high use of healthcare services. Educating parents may have beneficial effects on their sense of coping and fever management. Most parents receive information when their child is ill but it might be more desirable to educate parents in the setting of well-child clinics prior to their child becoming ill, in order to prepare parents for future illness management. This study aims to explore experiences of well-child clinic professionals when dealing with childhood fever and current practices of fever information provision to identify starting points for future interventions. We held four focus group discussions based on naturalistic enquiry among 22 well-child clinic professionals. Data was analysed using the constant comparative technique. Well-child clinic professionals regularly received questions from parents about childhood fever and felt that parental worries were the major driving factor behind these contacts. These worries were assumed to be driven by: (1) lack of knowledge (2) experiences with fever (3) educational level and size social network (4) inconsistencies in paracetamol administration advice among healthcare professionals. Well-child clinic professionals perceive current information provision as limited and stated a need for improvement. For example, information should be consistent, easy to find and understand. Fever-related questions are common in well-child care and professionals perceive that most of the workload is driven by parental worries. The focus group discussions revealed a desire to optimise the current limited information provision for childhood fever. Future interventions aimed at improving information provision for fever in well-child clinics should consider parental level of knowledge, experience, educational level and social network and inconsistencies among healthcare providers. Future fever information provision should focus on

  13. Tickborne Rickettsial Diseases: Epidemiological studies in China

    NARCIS (Netherlands)

    W.C. Cao (Wu Chun)

    2010-01-01

    textabstractRickettsial diseases are vector-borne zoonoses caused by obligate intracellular bacteria within the order Rickettsiales, which was previously described as short, Gram-negative rod bacteria that retained basic fuchsin when stained by the method of Gimenez. As development in molecular tech

  14. High detection rate of Rickettsia africae in Amblyomma variegatum but low prevalence of anti-rickettsial antibodies in healthy pregnant women in Madagascar.

    Science.gov (United States)

    Keller, Christian; Krüger, Andreas; Schwarz, Norbert Georg; Rakotozandrindrainy, Raphael; Rakotondrainiarivelo, Jean Philibert; Razafindrabe, Tsiry; Derschum, Henri; Silaghi, Cornelia; Pothmann, Daniela; Veit, Alexandra; Hogan, Benedikt; May, Jürgen; Girmann, Mirko; Kramme, Stefanie; Fleischer, Bernhard; Poppert, Sven

    2016-02-01

    Tick-borne spotted fever group (SFG) rickettsioses are emerging infectious diseases in Sub-Saharan Africa. In Madagascar, the endemicity of tick-borne rickettsiae and their vectors has been incompletely studied. The first part of the present study was conducted in 2011 and 2012 to identify potential anthropophilic tick vectors for SFG rickettsiae on cattle from seven Malagasy regions, and to detect and characterize rickettsiae in these ticks. Amblyomma variegatum was the only anthropophilic tick species found on 262 cattle. Using a novel ompB-specific qPCR, screening for rickettsial DNA was performed on 111 A. variegatum ticks. Rickettsial DNA was detected in 96 of 111 ticks studied (86.5%). Rickettsia africae was identified as the only infecting rickettsia using phylogenetic analysis of ompA and ompB gene sequences and three variable intergenic spacers from 11 ticks. The second part of the study was a cross-sectional survey for antibodies against SFG rickettsiae in plasma samples taken from healthy, pregnant women at six locations in Madagascar, two at sea level and four between 450 and 1300m altitude. An indirect fluorescent antibody test with Rickettsia conorii as surrogate SFG rickettsial antigen was used. We found R. conorii-seropositives at all altitudes with prevalences between 0.5% and 3.1%. Our results suggest that A. variegatum ticks highly infected with R. africae are the most prevalent cattle-associated tick vectors for SFG rickettsiosis in Madagascar. Transmission of SFG rickettsiosis to humans occurs at different altitudes in Madagascar and should be considered as a relevant cause of febrile diseases.

  15. The seropositivity and risk factors for rickettsial infections in selected areas from Black Sea Region of Turkey

    Directory of Open Access Journals (Sweden)

    Alicem Tekin

    2010-09-01

    Full Text Available Objectives: The aim of this study was to evaluate the seropositivity of rickettsial infections (rickettsioses and to as-sess risky behaviors for rickettsioses in North Anatolia, which have dense tick population. Materials and methods: Blood samples of 409 voluntary participants were collected in a cross-sectional seropreva-lence research in Samsun-Tekkeköy and 171 from Samsun Regional Laboratory, KTÜ Medical Faculty/Clinic of Infec-tion Diseases and Tokat State Hospital to determine regional characteristics and risk factors of rickettsial infections. The total sample size was 580 persons. A standard questionnaire was performed by a face to face interview with par-ticipants. The 0-4 age group children were not included. The presence of anti-Rickettsia IgG antibodies was tested in blood samples with Indirect Immunoflourescein Antibody (IFA method.Results: Spotted fever group anti-Rickettsia IgG antibody seropositivity was detected in 68 (11.7% blood samples. Contrarily, typhus group anti-Rickettsia IgG antibody seropositivity was not found in any participant. With bivariate analyses following variables were found to be significantly correlated with rickettsia seropositivity: education status (p=0.015, age (p=0.001, working in farm (p=0.008, working in garden (p=0.022, agricultural activities (p=0.001, being interested in relaxation activity (p=0.009, animal breeding (p=0.007, milking (p=0.001 and exposure to wild animals (p=0.004. With logistic regression analysis; age [Risk Odds Ratio ‘ROR’=1.03 (95% GA=1.02-1.05] and ex-posure to wild animals [ROR=1.97 (95% GA=1.12-3.46] were found to be associated with increased seropositivity.Conclusions: Our results supported the existence of rickettsial diseases in Turkey. Further seroepidemiological in-vestigations are needed to detect incidence/prevalences of rickettsioses and related risky behaviors in our country.

  16. Isolation of the rickettsial agent genetically similar to Candidatus Rickettsia kotlanii, from Haemaphysalis megaspinosa in Japan.

    Science.gov (United States)

    Andoh, Masako; Ogasawara, Yumiko; Sakata, Akiko; Ito, Takuya; Fujita, Hiromi; Kawabata, Hiroki; Ando, Shuji

    2014-09-01

    Two rickettsial isolates, HM-1 and HM-2, were isolated from Haemaphysalis megaspinosa collected in Japan in 2006 and 2011, respectively. The isolates were analyzed by DNA sequences of the outer membrane protein A gene, the outer membrane protein B gene, the citrate synthase gene, the genus Rickettsia-specific outer membrane protein 17-kDa gene, the 16S ribosome RNA gene, and the PS120 protein gene ("geneD"). HM-1 was identified as Rickettsia tamurae. HM-2 matched most closely with 'Candidatus Rickettsia kotlanii' DNA, which has only been reported from H. concinna in Hungary. This is the first report of isolation in Japan of the agent genetically similar to 'Candidatus R. kotlanii,' which belongs phylogenetically to the spotted fever group Rickettsia. Our study shows the possibility that 'Candidatus R. kotlanii' can be carried by at least two tick species. Furthermore, because the Rickettsia sp. has been found two distant countries, Hungary and Japan, it has potential for wider distribution.

  17. Tick- and flea-borne rickettsial emerging zoonoses.

    Science.gov (United States)

    Parola, Philippe; Davoust, Bernard; Raoult, Didier

    2005-01-01

    Between 1984 and 2004, nine more species or subspecies of spotted fever rickettsiae were identified as emerging agents of tick-borne rickettsioses throughout the world. Six of these species had first been isolated from ticks and later found to be pathogenic to humans. The most recent example is Rickettsia parkeri, recognized as a human pathogen more than 60 years after its initial isolation from ticks. A new spotted fever rickettsia, R. felis was also found to be associated with fleas and to be a human pathogen. Similarly, bacteria within the family Anaplasmataceae have been considered to be of veterinary importance only, yet three species have been implicated in human diseases in recent years, including Ehrlichia chaffeensis, the agent of human monocytic ehrlichiosis, Anaplasma phagocytophilum, the agent of human anaplasmosis (formerly known as "human granulocytic ehrlichiosis agent", E. equi and E. phagocytophila), and finally Ehrlichia ewingii, which causes granulocytic ehrlichiosis in humans. We present here an overview of the various tick- and flea-borne rickettsial zoonoses described in the last 20 years, focusing on the ecological, epidemiological and clinical aspects.

  18. Primary isolation of spotted fever group rickettsiae from Amblyomma cooperi collected from Hydrochaeris hydrochaeris in Brazil

    Directory of Open Access Journals (Sweden)

    Elba Regina Sampaio de Lemos

    1996-06-01

    Full Text Available This paper reports the first isolation of a spotted fever group rickettsia from an Amblyomma cooperi ixodid collected from a capybara (Hydrochaeris hydrochaeris in an endemic area of spotted fever in the County of Pedreira, State of São Paulo, Brazil. Isolation was performed in Vero cell culture and submitted to immunofluorescence, using antibody from Rickettsia rickettsii-positive human serum.

  19. Haemophilus aegyptius bacteraemia in Brazilian purpuric fever. Brazilian Purpuric Fever Study Group.

    Science.gov (United States)

    1987-10-03

    Brazilian purpuric fever (BPF) is a fulminant, often fatal childhood illness that was first recognised in 1984. An outbreak in Serrana, São Paulo State in March to May, 1986, resulted in 11 cases. Haemophilus aegyptius was isolated from normally sterile body fluids in 10 children (9 from blood and 1 from cerebrospinal fluid contaminated with blood), consistent with a direct role for H aegyptius in the pathogenesis of BPF. The ability to define cases by positive blood cultures permitted an evaluation of the spectrum of illness of this disease. 5 culture-positive cases were clinically similar to those previously described; the other 5 had milder illness without petechial or purpuric skin manifestations at the time the bacterium was isolated. Blood cultures were a sensitive means of diagnosing BPF; cultures were positive in 5 of 6 patients that met the full clinical case definition. Treatment of conjunctivitis did not appear to prevent BPF. However, children treated with intravenous antimicrobials early in the systemic illness had a trend toward better survival, suggesting that early therapy may prevent progression of the illness.

  20. Typhoid Fever, Below the Belt

    OpenAIRE

    Raveendran, Kamakshi Mahadevan; Viswanathan, Stalin

    2016-01-01

    Genital ulcers occur due to infective, inflammatory, malignant and drug-related causes. In tropical countries such as India, such ulcers are due to parasitic, tubercular, rickettsial and bacterial (sexually transmitted infections) aetiologies. Typhoid fever is endemic in the tropics. Except “rose spots”, skin manifestations in typhoid fever are unusual, and they are missed due to pigmented skin. Patients do not often complain of genital ulcers due to shame or fear. Genital examination is not ...

  1. Typhoid Fever, Below the Belt.

    Science.gov (United States)

    Raveendran, Kamakshi Mahadevan; Viswanathan, Stalin

    2016-01-01

    Genital ulcers occur due to infective, inflammatory, malignant and drug-related causes. In tropical countries such as India, such ulcers are due to parasitic, tubercular, rickettsial and bacterial (sexually transmitted infections) aetiologies. Typhoid fever is endemic in the tropics. Except "rose spots", skin manifestations in typhoid fever are unusual, and they are missed due to pigmented skin. Patients do not often complain of genital ulcers due to shame or fear. Genital examination is not routinely performed in typhoid fever. We describe scrotal ulcers as the presenting symptom of typhoid fever, which subsided with appropriate therapy.

  2. Candidatus Rickettsia andeanae, a spotted fever group agent infecting Amblyomma parvum ticks in two Brazilian biomes.

    Science.gov (United States)

    Nieri-Bastos, Fernanda Aparecida; Lopes, Marcos Gomes; Cançado, Paulo Henrique Duarte; Rossa, Giselle Ayres Razera; Faccini, João Luiz Horácio; Gennari, Solange Maria; Labruna, Marcelo Bahia

    2014-04-01

    Adult ticks of the species Amblyomma parvum were collected from the vegetation in the Pantanal biome (state of Mato Grosso do Sul) and from horses in the Cerrado biome (state of Piauí) in Brazil. The ticks were individually tested for rickettsial infection via polymerase chain reaction (PCR) targeting three rickettsial genes, gltA, ompA and ompB. Overall, 63.5% (40/63) and 66.7% (2/3) of A. parvum ticks from Pantanal and Cerrado, respectively, contained rickettsial DNA, which were all confirmed by DNA sequencing to be 100% identical to the corresponding fragments of the gltA, ompA and ompB genes of Candidatus Rickettsia andeanae. This report is the first to describe Ca. R. andeanae in Brazil.

  3. Candidatus Rickettsia andeanae, a spotted fever group agent infecting Amblyomma parvum ticks in two Brazilian biomes

    Directory of Open Access Journals (Sweden)

    Fernanda Aparecida Nieri-Bastos

    2014-04-01

    Full Text Available Adult ticks of the species Amblyomma parvum were collected from the vegetation in the Pantanal biome (state of Mato Grosso do Sul and from horses in the Cerrado biome (state of Piauí in Brazil. The ticks were individually tested for rickettsial infection via polymerase chain reaction (PCR targeting three rickettsial genes, gltA, ompA and ompB. Overall, 63.5% (40/63 and 66.7% (2/3 of A. parvum ticks from Pantanal and Cerrado, respectively, contained rickettsial DNA, which were all confirmed by DNA sequencing to be 100% identical to the corresponding fragments of the gltA, ompA and ompB genes of Candidatus Rickettsia andeanae. This report is the first to describe Ca. R. andeanae in Brazil.

  4. Comparative growth of spotted fever group Rickettsia spp. strains in Vero cells

    Science.gov (United States)

    Silva, Arannadia Barbosa; Duarte, Myrian Morato; Vizzoni, Vinicius Figueiredo; Duré, Ana Íris de Lima; Lopéz, Diego Montenegro; Nogueira, Rita de Maria Seabra; Soares, Carlos Augusto Gomes; Machado-Ferreira, Erik; Gazêta, Gilberto Salles

    2016-01-01

    In Brazil, the spotted fever group (SFG) Rickettsia rickettsii and Rickettsia parkeri related species are the etiological agents of spotted fever rickettsiosis. However, the SFG, Rickettsia rhipicephali, that infects humans, has never been reported. The study of growth dynamics can be useful for understanding the infective and invasive capacity of these pathogens. Here, the growth rates of the Brazilian isolates R. rickettsii str. Taiaçu, R. parkeri str. At#24, and R. rhipicephali HJ#5, were evaluated in Vero cells by quantitative polymerase chain reaction. R. rhipicephali showed different kinetic growth compared to R. rickettsii and R. parkeri. PMID:27508322

  5. Ultrasensitive microanalytical diagnostic methods for rickettsial pathogens

    Energy Technology Data Exchange (ETDEWEB)

    Hatch, A. V.

    2012-03-01

    A strategic CRADA was established between Sandia National Laboratories (SNL) and the University of Texas Medical Branch (UTMB) at Galveston to address pressing needs for US protection against biological weapons of mass destruction (WMD) and emerging infectious diseases. The combination of unique expertise and facilities at UTMB and SNL enabled interdisciplinary research efforts in the development of rapid and accurate diagnostic methods for early detection of trace priority pathogen levels. Outstanding postdoctoral students were also trained at both institutions to help enable the next generation of scientists to tackle the challenging interdisciplinary problems in the area of biodefense and emerging infectious diseases. Novel approaches to diagnostics were developed and the both the speed of assays as well as the detection sensitivity were improved by over an order of magnitude compared to traditional methods. This is a significant step toward more timely and specific detection of dangerous infections. We developed in situ polymerized porous polymer monoliths that can be used as (1) size exclusion elements for capture and processing of rickettsial infected cells from a sample, (2) photopatternable framework for grafting high densities of functionalized antibodies/fluorescent particles using novel monolith chemistry. Grafting affinity reagents specific to rickettsial particles enables rapid, ultra-sensitive assays by overcoming transport limitations of traditional planar assay approaches. We have selectively trapped particles and bacteria at the cell trap and have also detected picomolar mouse IL-6 captured with only 20 minutes total incubation times using the densely patterned monolith framework. As predicted, the monolith exhibits >10x improvements in both capture speed and capture density compared to traditional planar approaches. The most significant advancements as part of this CRADA is the optimization of techniques allowing the detection of <10 rickettsial

  6. Clinical and immunological characteristics of hemorrhagic fever with renal syndrome in women of different age groups

    Directory of Open Access Journals (Sweden)

    Kutdusova A.M.

    2012-09-01

    Full Text Available Objective: To evaluate the clinical and immunological features of the hemorrhagic fever with renal syndrome in women of different age groups. Materials and methods: Clinical and laboratory characteristics of hemorrhagic fever with renal syndrome in 148 women aged 17 to 65 years old have been investigated. Patients have been divided into two groups: group I included 101 patients with normal menstrual rhythm, group II included 47 female patients with menopause. In 57 women (36 from group I, 21 — from group II the content of CD3+, CD4+, CD8+, CD16+, CD19+ — sub-populations of peripheral blood lymphocytes has been determined. Results: In compared groups significant differences in structure and frequency of complications of the disease have been revealed. Unidirectional tendency to increase significantly reduced absolute rates of investigated lymphocyte subpopulations in dynamics of the disease has been identified. It also has been stated that by the time of early convalescence in case of severe form of HFRS the indices did not reach the standard level. In an older group of women deeper damage and long-term recovery of immune system have been marked. Conclusion: According to the results of clinical and immunological studies the research work has revealed that in young women the response of the immune system to HFRS has developed faster and stronger than that in patients during the menopause period.

  7. Risk groups for yellow fever vaccine-associated viscerotropic disease (YEL-AVD).

    Science.gov (United States)

    Seligman, Stephen J

    2014-10-07

    Although previously considered as the safest of the live virus vaccines, reports published since 2001 indicate that live yellow fever virus vaccine can cause a severe, often fatal, multisystemic illness, yellow fever vaccine-associated viscerotropic disease (YEL-AVD), that resembles the disease it was designed to prevent. This review was prompted by the availability of a listing of the cumulative cases of YEL-AVD, insights from a statistical method for analyzing risk factors and re-evaluation of previously published data. The purpose of this review is to identify and analyze risk groups based on gender, age, outcome and predisposing illnesses. Using a passive surveillance system in the US, the incidence was reported as 0.3 to 0.4 cases per 100,000. However, other estimates range from 0 to 12 per 100,000. Identified and potential risk groups for YEL-AVD include elderly males, women between the ages of 19 and 34, people with a variety of autoimmune diseases, individuals who have been thymectomized because of thymoma, and infants and children ≤11 years old. All but the last group are supported by statistical analysis. The confirmed risk groups account for 77% (49/64) of known cases and 76% (32/42) of the deaths. The overall case fatality rate is 66% (42/64) with a rate of 80% (12/15) in young women, in contrast to 50% (13/26) in men ≥56 years old. Recognition of YEL-AVD raises the possibility that similar reactions to live chimeric flavivirus vaccines that contain a yellow fever virus vaccine backbone could occur in susceptible individuals. Delineation of risk groups focuses the search for genetic mutations resulting in immune defects associated with a given risk group. Lastly, identification of risk groups encourages concentration on measures to decrease both the incidence and the severity of YEL-AVD.

  8. Molecular analyses reveal an abundant diversity of ticks and rickettsial agents associated with wild birds in two regions of primary Brazilian Atlantic Rainforest.

    Science.gov (United States)

    Luz, Hermes Ribeiro; Faccini, João Luiz Horacio; McIntosh, Douglas

    2017-06-01

    Brazilian wild birds are recognized as frequent and important hosts for immature stages of more than half of the 32 recognized species of Amblyomma ticks recorded in that country. Several species of Amblyomma harbor rickettsial agents, including members of the spotted fever group (SFG). Most studies on this topic relied primarily on morphological characterization and reported large portions of the collected ticks at the genus rather than species level. Clearly, this factor may have contributed to an underestimation of tick diversity and distribution and makes comparisons between studies difficult. The current investigation combined morphological and molecular analyses to assess the diversity of ticks and rickettsial agents associated with wild birds, captured in two regions of native Atlantic rainforest, in the state of Rio de Janeiro, Brazil. A total of 910 birds were captured, representing two orders, 34 families and 106 species, among which 93 specimens (10.2%), were parasitized by 138 immature ticks (60 larvae and 78 nymphs), representing 10 recognized species of the genus Amblyomma; together with two reasonably well classified haplotypes (Amblyomma sp. haplotype Nazaré and Amblyomma sp. strain USNTC 6792). Amplification by PCR and sequencing of rickettsial genes (htrA, gltA, ompA and ompB), demonstrated the presence of Rickettsia DNA in 48 (34%) of the ticks. Specifically, Rickettsia bellii was detected in a single larva and a single nymph of A. aureolatum; R. amblyomatis was found in 16 of 37 A. longirostre and was recorded for the first time in three nymphs of A. calcaratum; R. rhipicephali was detected in 9 (47%) of 19 Amblyomma sp. haplotype Nazaré ticks. The remaining ticks were infected with genetic variants of R. parkeri, namely strain ApPR in 12 A. parkeri and seven Amblyomma sp. haplotype Nazaré ticks, with the strain NOD found in two specimens of A. nodosum. Interestingly, a single larvae of A. ovale was shown to be infected with the emerging

  9. Expert groups in Denmark with special reference to Classical and African swine fever

    DEFF Research Database (Denmark)

    Uttenthal, Åse

    2012-01-01

    surveillance, in Contingency planning exercises and many efforts is done to keep the group updated on the current international situation for swine fevers. The group has been very stabile and especially our participation in a Taiex workshop in 2005 in Romania was a very good basis for our fruitful...... Authorities. Questions like “Could we be allowed to vaccinate the pigs in Zoo if there is an outbreak”, or other things that may have a high interest in the press but which do not matter that much in the gross picture of the eradication could be handed over to the expert group. My presentation will give...... examples of what we have done and how we have kept the group alive. It is my impression that the “good chemistry” of the group is very important for the success in peacetime. Should there ever be a war-time, I feel confident that “my” Expert group will be of use....

  10. Rickettsial ompB promoter regulated expression of GFPuv in transformed Rickettsia montanensis.

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    Gerald D Baldridge

    Full Text Available Rickettsia spp. (Rickettsiales: Rickettsiaceae are Gram-negative, obligate intracellular, alpha-proteobacteria that have historically been associated with blood-feeding arthropods. Certain species cause typhus and spotted fevers in humans, but others are of uncertain pathogenicity or may be strict arthropod endosymbionts. Genetic manipulation of rickettsiae should facilitate a better understanding of their interactions with hosts.We transformed a species never associated with human disease, Rickettsia montanensis, by electroporation with a TN5 transposon (pMOD700 containing green fluorescent protein (GFPuv and chloramphenicol acetyltransferase (CAT genes under regulation of promoters cloned from the Rickettsia rickettsii ompB gene, and isolated a Chloramphenicol-resistant GFP-fluorescent rickettsiae population (Rmontanensis700. The Rmontanensis700 rickettsiae contained a single transposon integrated near an acetyl-CoA acetyltransferase gene in the rickettsial chromosome. Northern blots showed that GFPuv and CAT mRNAs were both expressed as two transcripts of larger and smaller than predicted length. Western immunoblots showed that Rmontanensis700 and E. coli transformed with a plasmid containing the pMOD700 transposon both expressed GFPuv proteins of the predicted molecular weight.Long-standing barriers to transformation of rickettsiae have been overcome by development of transposon-based rickettsial transformation vectors. The ompB promoter may be the most problematic of the four promoters so far employed in those vectors.

  11. Antibodies against spotted fever group Rickettsia sp., in horses of the colombian Orinoquia

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    Diego A. Riveros-Pinilla

    2015-11-01

    Full Text Available Objective. It was determined the presence of antibodies against Rickettsia sp. of the spotted fever group, in horses of 8 municipalities of the Colombian Orinoquia. Matherials and methods. A cross-sectional study was conducted on 246 sera from apparently healthy horses and processed by the indirect immunofluorescence test (IFI. Results. General seropositivity was (2.85%; 7/246, while by municipalities the results were, Arauca (9.1%; 2/22, Saravena (5.6%; 1/18, San José del Guaviare (4.9%; 2/41, San Martín (3.8%; 1/26, Yopal (1.9%; 1/52. It was not identified the presence of antibodies in Puerto López (0/52, Puerto Gaitán (0/15 and Villavicencio (0/20. Four of the positive samples presented titles of 1:64, while the remaining 3 1:128. Conclusions. It shows the circulation of Rickettsia sp. of the Spotted Fever Group in horses in the region of the Colombian Orinoquia, suggesting the need for further studies to understand the ecoepidemiology of municipalities with presence of seropositive.

  12. Health beliefs and practices related to dengue fever: a focus group study.

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    Li Ping Wong

    Full Text Available BACKGROUND: This qualitative study aimed to provide an in-depth understanding of the meaning of dengue fever (DF amongst people living in a dengue endemic region, dengue prevention and treatment-seeking behaviours. The Health Belief Model was used as a framework to explore and understand dengue prevention behaviours. METHODS: A total of 14 focus group discussions were conducted with 84 Malaysian citizens of different socio-demographic backgrounds between 16(th December, 2011 and 12(th May, 2012. RESULTS: The study revealed that awareness about DF and prevention measures were high. The pathophysiology of dengue especially dengue haemorrhagic fever (DHF and dengue shock syndrome (DSS were rarely known; as a result, it was seen as deadly by some but was also perceived as easily curable by others without a basis of understanding. Young adults and elderly participants had a low perception of susceptibility to DF. In general, the low perceived susceptibility emerged as two themes, namely a perceived natural ability to withstand infection and a low risk of being in contact with the dengue virus vector, Aedes spp. mosquitoes. The barriers to sustained self-prevention against dengue prevention that emerged in focus groups were: i lack of self-efficacy, ii lack of perceived benefit, iii low perceived susceptibility, and iv unsure perceived susceptibility. Low perceived benefit of continued dengue prevention practices was a result of lack of concerted action against dengue in their neighborhood. Traditional medical practices and home remedies were widely perceived and experienced as efficacious in treating DF. CONCLUSION: Behavioural change towards attaining sustainability in dengue preventive practices may be enhanced by fostering comprehensive knowledge of dengue and a change in health beliefs. Wide use of unconventional therapy for DF warrants the need to enlighten the public to limit their reliance on unproven alternative treatments.

  13. Molecular detection and characterization of spotted fever group rickettsiae in ticks from Central Italy.

    Science.gov (United States)

    Scarpulla, M; Barlozzari, G; Marcario, A; Salvato, L; Blanda, V; De Liberato, C; D'Agostini, C; Torina, A; Macrì, G

    2016-07-01

    The aim of this study was to investigate the presence of rickettsial pathogens in ticks from Central Italy. A total of 113 ticks hailed from Latium and Tuscany regions were identified and tested by PCR to detect gltA, ompA, ompB genes of Rickettsia. Positive amplicons were sequenced and identified at species level. Ticks were analyzed individually or in pools. The percentage of positivity for SFG rickettsiae was 12.4%, expressed as minimum infection rate (MIR) assuming that one tick was positive in each positive pool. Rickettsia aeschlimannii was detected in Hyalomma marginatum, Rickettsia monacensis in Ixodes ricinus and Rickettsia massiliae and Rickettsia conorii in Rhipicephalus sanguineus sensu lato. These findings confirm the circulation of pathogenic rickettsiae in Latium and Tuscany regions. To our knowledge this is the first report of R. massiliae in Latium region.

  14. Dynamics of hormonal status in women of different age groups in hemorrhagic fever with renal syndrome

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    Murzabaeva R.Т.

    2012-06-01

    Full Text Available Objective: To study the hormonal parameters in women of different age groups in hemorrhagic fever with renal syndrome. Materials and methods: We have studied the content of cortisol, thyrotropic hormone (TTH, triiodothyro-nine (T3, free thyroxin (FT4, luteinizing hormone (LH, follicle-stimulating hormone (FSH, testosterone, estradiol, progesterone, prolactin in blood serum of 62 women with moderate (33 and severe (29 HFRS forms age (17-62. They were divided into 2 groups: the first group (33 patients women with the normal menstrual cycle, the second group (29 women consisted of patients in climacteric period. Results: TTH secretion increase, T3 and FT4 — decrease with their normalization to the recovery period were registered in the thyroid system of the compared groups. Blood cortisol level was high during the illness. Gonadotropic hypophysis function study demonstrated that LH and blood prolactin concentrations were increased since oliguria period; FSH was authentic reduced. The indices of these hormones were restored to the normal level by the reconvalescence period. LH and FSH contents were authentic higher in women of the second group in comparison with the first group. The hyperprolactinemia was observed in both women groups during the whole period of disease. The increased progesterone and testosterone concentrations have been manifested in blood serum. The estradiol concentration had different direction tendencies. Conclusion: Thus, the complex study of hypophysic- thyreoid and gonadotropic hormone state of adrenal system and the sexual hormone levels in women of different age groups in HFRS revealed the hormone status indces changes due to the period and severity of the disease, connected with the virus action, intoxication, the general inflammation reactions and their age.

  15. Subcellular localization of rickettsial invasion protein, InvA.

    Science.gov (United States)

    Gaywee, Jariyanart; Sacci, John B; Radulovic, Suzana; Beier, Magda S; Azad, Abdu F

    2003-01-01

    To understand further the molecular basis of rickettsial host cell invasion, Rickettsia prowazekii invasion gene homolog (invA) has been characterized. Our previous experiments have shown that InvA is an Ap5A pyrophosphatase, a member of the Nudix hydrolase family, which is up-regulated during the internalization, early growth phase, and exit steps during rickettsial mammalian cell infection. In addition to the molecular characterization, subcellular localization of InvA was investigated. InvA-specific antibodies were raised in mice and used for immunoelectron microscopy. The generated antibodies were shown to recognize InvA and by immunogold labeling showed InvA in the cytoplasm of rickettsiae. A cytoplasmic location for InvA would allow for a rapid response to any internal substance and efficient functioning in hydrolysis of toxic metabolic by-products that are accumulated in the rickettsial cytoplasm during host cell invasion. Protecting bacteria from a hazardous environment could enhance their viability and allow them to remain metabolically active, which is a necessary step for the rickettsial obligate intracellular lifestyle.

  16. Association of ABO Blood Group Phenotype and Allele Frequency with Chikungunya Fever

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    Pairaya Rujirojindakul

    2015-01-01

    Full Text Available Background. The objective of this study was to investigate the association of the ABO blood group phenotype and allele frequency with CHIK fever. Methods. A rural community survey in Southern Thailand was conducted in August and September 2010. A total of 506 villagers were enrolled. Cases were defined as individuals having anti-CHIK IgG by hemagglutination ≥1 : 10. Results. There were 314 cases (62.1% with CHIK seropositivity. Females were less likely to have positive anti-CHIK IgG with odds ratio (OR (95% CI of 0.63 (0.43, 0.93. All samples tested were Rh positive. Distribution of CHIK seropositivity versus seronegativity (P value in A, B, AB, and O blood groups was 80 versus 46 (0.003, 80 versus 48 (0.005, 24 versus 20 (0.55, and 130 versus 78 (<0.001, respectively. However, chi-square test between ABO and CHIK infection showed no statistical significance P=0.76. Comparison of the ABO blood group allele frequency between CHIK seropositivity and seronegativity was not statistically significant. Conclusion. This finding demonstrated no association of the ABO blood group phenotypes and allele frequencies with CHIK infection.

  17. Detection of spotted fever group Rickettsiae in ticks from Zhejiang Province, China.

    Science.gov (United States)

    Sun, Jimin; Lin, Junfen; Gong, Zhenyu; Chang, Yue; Ye, Xiaodong; Gu, Shiping; Pang, Weilong; Wang, Chengwei; Zheng, Xiaohua; Hou, Juan; Ling, Feng; Shi, Xuguang; Jiang, Jianmin; Chen, Zhiping; Lv, Huakun; Chai, Chengliang

    2015-03-01

    Tick species distribution and prevalence of spotted fever group Rickettsiae (SFGR) in ticks were investigated in Zhejiang Province, China in 2010 and 2011. PCR was used to detect SFGR and positive amplicons were sequenced, compared to published sequences and phylogenic analysis was performed using MEGA 4.0. A total of 292 adult ticks of ten species were captured and 7.5 % (22/292) of the ticks were PCR-positive for SFG Rickettsia. The PCR-positive rates were 5.5 % (6/110) for Haemaphysalis longicornis, 3.6 % (1/28) for Amblyomma testudinarium and 16 % (15/94) for Ixodes sinensis, respectively. Phylogenetic analyses of gltA genes detected in ticks indicated that there are two dominating groups of SFGR. Sequences of group one were closely related to Rickettsia monacensis, whereas sequences of group two were closest related to Rickettsia heilongjiangensis and Rickettsia japonica, which are human pathogens. Our findings underline the importance of these ticks in public health surveillance in Zhejiang Province, China.

  18. Rickettsial infection in ticks from wild birds from Cerrado and the Pantanal region of Mato Grosso, midwestern Brazil.

    Science.gov (United States)

    Ramos, Dirceu G de S; Melo, Andréia L T; Martins, Thiago F; Alves, Alvair da S; Pacheco, Thábata dos A; Pinto, Letícia B; Pinho, João B; Labruna, Marcelo B; Dutra, Valéria; Aguiar, Daniel M; Pacheco, Richard C

    2015-09-01

    The involvement of different species of ticks and wild animals, such as birds, play an important role in the epidemiology of tick-borne diseases. Birds may serve as reservoirs for some tick-borne diseases, and may carry and spread hematophagous ectoparasites mechanically. This study aimed to show the diversity of ticks on birds and molecular detection of rickettsial infection in ticks from Pantanal and Cerrado, two similar Brazilian biomes characterized by hydrological seasons. During two years, August 2012 to May 2014, ticks were collected from birds and from the environment in total of 14 visits for collecting samples, distributed in all hydrological seasons. A total of 674 birds were captured representing 113 species from 26 families. In total, 71 birds were parasitized (10.5%), and 155 ticks of the following 7 tick species (in decreasing order of prevalence) were identified: Amblyomma longirostre Koch, Amblyomma nodosum Neumann, Amblyomma cajennense Fabricius sensu lato (s.l.), Amblyomma calcaratum Neumann, Ornithodoros mimon Kohls, Clifford & Jones, Amblyomma ovale Koch, and Amblyomma triste Koch. Among free-living ticks collected in the environment, A. cajennense s.l. was the most common. This is the first occurrence of O. mimon on birds, and of A. triste on Passeriformes in Brazil. Molecular analyses revealed that 6 A. longirostre ticks were infected by 'Candidatus Rickettsia amblyommii', whereas 1 A. nodosum was infected by a Rickettsia parkeri-like agent, previously reported as Rickettsia sp. strain NOD. Spotted fever group (SFG) agents were, for the first time, reported in ticks from birds captured in Pantanal biome, and the potential involvement of these agents as human pathogens should be considered in further studies.

  19. Ibex-associated malignant catarrhal fever-like disease in a group of bongo antelope (Tragelaphus euryceros)

    Science.gov (United States)

    A private zoological facility experienced an outbreak of fatal malignant catarrhal fever (MCF) in a group of bongo antelope (Tragelaphus euryceros). Three periparturient female bongos exhibited an acute onset of anorexia beginning ~6 weeks after being housed with a Nubian ibex (Capra nubiana). Disea...

  20. Prevalence of antibodies to spotted fever group rickettsiae in human beings and dogs from and endemic area of mediterranean spotted fever in Catalonia, Spain.

    Science.gov (United States)

    Segura-Porta, F; Diestre-Ortin, G; Ortuño-Romero, A; Sanfeliu-Sala, I; Font-Creus, B; Muñoz-Espin, T; de Antonio, E M; Casal-Fábrega, J

    1998-06-01

    We assessed the prevalence of antibodies to spotted fever group rickettsiae in human beings and dogs by indirect immunofluorescence in the region of 'Vallés Occidental', Barcelona (Spain). In the group of 150 serum samples from patients without former history of Mediterranean spotted fever, 12 had antibodies to Rickettsia conori. The overall seroprevalence was 8% (95% confidence interval, 4.6% to 13.5%). There were no statistically significant differences between the mean ages of patients with positive and negative antibodies to R. conorii. However, seropositivity was significantly more common among patients living in semi-rural areas. In the group of 138 dog serum samples, 36 (26.1%) sera had antibodies to R. conorii. When the present results were compared with those obtained in a previous seroepidemiological survey carried out in the same geographical region in 1987, no significant differences were found. Therefore, although the epidemiological markers have dropped, this does not absolutely confirm the decrease of the presence of R. conorii in this area.

  1. A newly discovered flavivirus in the yellow fever virus group displays restricted replication in vertebrates.

    Science.gov (United States)

    Colmant, Agathe M G; Bielefeldt-Ohmann, Helle; Hobson-Peters, Jody; Suen, Willy W; O'Brien, Caitlin A; van den Hurk, Andrew F; Hall, Roy A

    2016-05-01

    A novel flavivirus, provisionally named Bamaga virus (BgV), was isolated from Culex annulirostris mosquitoes collected from northern Australia. Phylogenetic analysis of the complete nucleotide sequence of the BgV genome revealed it clustered with the yellow fever virus (YFV) group, and was most closely related to Edge Hill virus (EHV), another Australian flavivirus, with 61.9% nucleotide and 63.7% amino acid sequence identity. Antigenic analysis of the envelope and pre-membrane proteins of BgV further revealed epitopes common to EHV, dengue and other mosquito-borne flaviviruses. However, in contrast to these viruses, BgV displayed restricted growth in a range of vertebrate cell lines with no or relatively slow replication in inoculated cultures. There was also restricted BgV replication in virus-challenged mice. Our results indicate that BgV is an evolutionary divergent member of the YFV group of flaviviruses, and represents a novel system to study mechanisms of virus host-restriction and transmission.

  2. Serological Evidence of Immune Priming by Group A Streptococci in Patients with Acute Rheumatic Fever

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    Jeremy M Raynes

    2016-07-01

    Full Text Available Acute rheumatic fever (ARF is an autoimmune response to Group A Streptococcus (GAS infection. Repeated GAS exposures are proposed to ‘prime’ the immune system for autoimmunity. This notion of immune-priming by multiple GAS infections was first postulated in the 1960s, but direct experimental evidence to support the hypothesis has been lacking. Here we present novel methodology, based on antibody responses to GAS T‑antigens, that enables previous GAS exposures to be mapped in patient sera. T-antigens are surface expressed, type specific antigens and GAS strains fall into 18 major clades or T-types. A panel of recombinant T-antigens was generated and immunoassays were performed in parallel with serum depletion experiments allowing type-specific T‑antigen antibodies to be distinguished from cross-reactive antibodies. At least two distinct GAS exposures were detected in each of the ARF sera tested. Furthermore, no two sera had the same T-antigen reactivity profile suggesting that each patient was exposed to a unique series of GAS T‑types prior to developing ARF. The methods have provided much-needed experimental evidence to substantiate the immune-priming hypothesis, and will facilitate further serological profiling studies that explore the multifaceted interactions between GAS and the host.

  3. Molecular evidence of spotted fever group rickettsiae and Anaplasmataceae from ticks and stray dogs in Bangladesh.

    Science.gov (United States)

    Qiu, Yongjin; Nakao, Ryo; Thu, May June; Akter, Shirin; Alam, Mohammad Zahangir; Kato, Satomi; Katakura, Ken; Sugimoto, Chihiro

    2016-03-01

    Emerging tick-borne diseases (TBDs) are important foci for human and animal health worldwide. However, these diseases are sometimes over looked, especially in countries with limited resources to perform molecular-based surveys. The aim of this study was to detect and characterize spotted fever group (SFG) rickettsiae and Anaplasmataceae in Bangladesh, which are important tick-borne pathogens for humans and animals worldwide. A total of 50 canine blood samples, 15 ticks collected from dogs, and 154 ticks collected from cattle were screened for the presence of SFG rickettsiae and Anaplasmataceae using molecular-based methods such as PCR and real-time PCR. The sequence analysis of the amplified products detected two different genotypes of SFG rickettsiae in ticks from cattle. The genotype detected in Rhipicephalus microplus was closely related to Rickettsia monacensis, while the genotype detected in Haemaphysalis bispinosa was closely related to Rickettsia sp. found in Korea and Japan. Anaplasma bovis was detected in canine blood and ticks (Rhipicephalus sanguineus and H. bispinosa). Unexpectedly, the partial genome sequence of Wolbachia sp., presumably associated with the nematode Dirofilaria immitis, was identified in canine blood. The present study provides the first molecular evidence of SFG rickettsiae and A. bovis in Bangladesh, indicating the possible emergence of previously unrecognized TBDs in this country.

  4. Molecular epidemiology of group A streptococcus causing scarlet fever in northern Taiwan, 2001-2002.

    Science.gov (United States)

    Chen, Ying-Yan; Huang, Chung-Ter; Yao, Shu-Man; Chang, Yi-Ching; Shen, Pei-Wun; Chou, Chen-Ying; Li, Shu-Ying

    2007-07-01

    In this study, 830 Streptococcus pyogenes isolates collected between 2001 and 2002 from patients with scarlet fever in northern Taiwan were analyzed by M protein gene (emm) sequence typing, pulsed-field gel electrophoresis (PFGE), and antimicrobial susceptibility testing. A total of 21 emm types and 56 PFGE patterns were identified. The most frequent emm types were emm1 (29.2%), emm4 (24.1%), emm12 (19.0%), emm6 (15.8%), stIL103 (5.7%), and emm22 (1.9%). Antimicrobial resistance profiles were determined, and resistance to erythromycin (24.6%), clindamycin (2.0%), and chloramphenicol (1.3%) was detected. Five major emm types (emm4, emm12, emm1, emm22, and emm6) accounted for 95.6% of the erythromycin-resistant isolates. The decreased prevalence of erythromycin-resistant emm12 strains coincided with the overall decrease in erythromycin resistance from 32.1% in 2001 to 21.1% in 2002 in Taiwan. Five major clones (emm4/2000, emm12/0000, emm4/2010, emm1/1000, and emm22/8100) represented 72.1% of the erythromycin-resistant isolates. The survey of group A Streptococcus emm types, genetic diversity, and antibiotic resistance has direct relevance to current antimicrobial use policies and potential vaccine development strategies.

  5. New Spotted Fever Group Rickettsia in a Rhipicephalus turanicus Tick Removed from a Child in Eastern Sicily, Italy

    OpenAIRE

    Eremeeva, Marina E; Stromdahl, Ellen Y.

    2011-01-01

    A new genotype of spotted fever group Rickettsia (SFGR) was identified in Rhipicephalus turanicus from eastern Sicily. On the basis of current molecular criteria, the genetic characteristics obtained from multiple locus sequence typing satisfy the requirements for Candidatus status of this SFGR. Further detection and identification of this SFGR during entomological and clinical surveys will be required to establish the prevalence of this Rickettsia and its potential pathogenicity for humans.

  6. The 2007-2010 Q fever epidemic in the Netherlands: risk factors and risk groups

    NARCIS (Netherlands)

    van der Hoek, W.

    2012-01-01

    An analysis of 3,264 notifications for acute Q fever show that the patients were mostly men, smokers and persons aged 40–60 years. Pneumonia was the most common clinical presentation in >60% of patients. Fewer than 5% of the notified patients were working in the agriculture sector or meat-processing

  7. The 2007-2010 Q fever epidemic in the Netherlands: risk factors and risk groups

    NARCIS (Netherlands)

    van der Hoek, W.

    2012-01-01

    An analysis of 3,264 notifications for acute Q fever show that the patients were mostly men, smokers and persons aged 40–60 years. Pneumonia was the most common clinical presentation in >60% of patients. Fewer than 5% of the notified patients were working in the agriculture sector or meat-processing

  8. A survey for spotted fever group rickettsiae and ehrlichiae in Amblyomma variegatum from St. Kitts and Nevis.

    Science.gov (United States)

    Kelly, Patrick J; Fournier, Pierre-Edouard; Parola, Philippe; Raoult, Didier

    2003-07-01

    Eighty-nine Amblyomma variegatum ticks were collected from the islands of St. Kitts and Nevis in the Caribbean and preserved in 70% ethanol or local rum. After being washed in sterile water, their DNA was extracted and analyzed by a polymerase chain reaction (PCR) for DNA of spotted fever group rickettsiae and ehrlichiae. None of the tested ticks was positive in a PCR assay using the primers 16S EHRD and 16S EHRR for the 16S rRNA gene of Ehrlichia spp.. Forty-one percent of the A. variegatum (36 of 89 of which 34 [47%] of 72 were adult males, 2 (13%) of 16 were adult females, and 0 (0%) of 1 were nymphs) were positive in a PCR assay using the primer pair 190-70 and 190-701 for the outer membrane protein A (ompA) gene of spotted fever group rickettsiae. All PCR amplification products obtained had 100% sequence homology with Rickettsia africae, the agent of African tick-bite fever.

  9. Exposure and risk factors to coxiella burnetii, spotted fever group and typhus group Rickettsiae, and Bartonella henselae among volunteer blood donors in Namibia.

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    Bruce H Noden

    Full Text Available The role of pathogen-mediated febrile illness in sub-Saharan Africa is receiving more attention, especially in Southern Africa where four countries (including Namibia are actively working to eliminate malaria. With a high concentration of livestock and high rates of companion animal ownership, the influence of zoonotic bacterial diseases as causes of febrile illness in Namibia remains unknown.The aim of the study was to evaluate exposure to Coxiella burnetii, spotted fever and typhus group rickettsiae, and Bartonella henselae using IFA and ELISA (IgG in serum collected from 319 volunteer blood donors identified by the Blood Transfusion Service of Namibia (NAMBTS. Serum samples were linked to a basic questionnaire to identify possible risk factors. The majority of the participants (64.8% had extensive exposure to rural areas or farms. Results indicated a C. burnetii prevalence of 26.1% (screening titre 1∶16, and prevalence rates of 11.9% and 14.9% (screening titre 1∶100 for spotted fever group and typhus group rickettsiae, respectively. There was a significant spatial association between C. burnetii exposure and place of residence in southern Namibia (P0.012, especially cattle (P>0.006, were also significantly associated with C. burnetii exposure. Males were significantly more likely than females to have been exposed to spotted fever (P<0.013 and typhus (P<0.011 group rickettsiae. Three (2.9% samples were positive for B. henselae possibly indicating low levels of exposure to a pathogen never reported in Namibia.These results indicate that Namibians are exposed to pathogenic fever-causing bacteria, most of which have flea or tick vectors/reservoirs. The epidemiology of febrile illnesses in Namibia needs further evaluation in order to develop comprehensive local diagnostic and treatment algorithms.

  10. Spotted fever group Rickettsia in Amblyomma dubitatum tick from the urban area of Campo Grande, Mato Grosso do Sul, Brazil.

    Science.gov (United States)

    Matias, Jaqueline; Garcia, Marcos Valério; Cunha, Rodrigo Casquero; Aguirre, André de Abreu Rangel; Barros, Jacqueline Cavalvante; Csordas, Bárbara Guimarães; Andreotti, Renato

    2015-03-01

    Rickettsia infection of each tick was evaluated by the hemolymph test and polymerase chain reaction (PCR) targeting gltA and ompA genes. All hemolymph tests were negative and PCR of one A. dubitatum detected both Rickettsia genes. Sequence of ompA exhibited a 99% identity with Rickettsia parkeri and R. africae and a 98% identity with R. sibirica. Rickettsia of the spotted fever group in A. dubitatum is described for the first time in an urban area within the municipality of Campo Grande in the state of Mato Grosso do Sul (MS), Brazil. This finding reinforces the importance of more detailed studies to determine the role of A. dubitatum in the transmission of spotted fever agents.

  11. Field Collection and Genetic Classification of Rickettsial Tick-Born Pathogens in South Texas

    Science.gov (United States)

    2008-01-01

    accepted mode for the major ity of human infections is inhalat ion. The Centers for Disease Control Viral and Rickeusial Zoonoses Or-mch asserts the Q...human infections is inhalation. The Centers for Disease Control and Prevention, Division of Viral and Rickettsial Diseases, Rickettsial Zoonoses

  12. Leptospirosis presenting as honeymoon fever.

    Science.gov (United States)

    de Sainte Marie, B; Delord, M; Dubourg, G; Gautret, P; Parola, P; Brouqui, P; Lagier, J C

    2015-05-01

    An increasing number of travelers from western countries visit tropical regions, questioning western physicians on the prophylaxis, the diagnosis and the therapeutic management of patients with travel-associated infection. In July 2014, a French couple stayed for an adventure-travel in Columbia without malaria prophylaxis. A week after their return the woman presented with fever, myalgia, and retro-orbital pain. Three days later, her husband presented similar symptoms. In both patients, testing for malaria, arboviruses and blood cultures remained negative. An empirical treatment with doxycycline and ceftriaxone was initiated for both patients. Serum collected from the female patient yielded positive IgM for leptospirosis but was negative for her husband. Positive Real-Time PCR were observed in blood and urine from both patients, confirming leptospirosis. Three lessons are noteworthy from this case report. First, after exclusion of malaria, as enteric fever, leptospirosis and rickettsial infection are the most prevalent travel-associated infections, empirical treatment with doxycycline and third generation cephalosporin should be considered. In addition, the diagnosis of leptospirosis requires both serology and PCR performed in both urine and blood samples. Finally, prophylaxis using doxycycline, also effective against leptospirosis, rickettsial infections or travellers' diarrhea should be recommended for adventure travelers in malaria endemic areas.

  13. Rocky Mountain spotted fever

    Science.gov (United States)

    ... Mountain spotted fever is caused by the bacteria Rickettsia rickettsii (R. Rickettsii) , which is carried by ticks. ... Saunders; 2014:chap 212. Walker DH, Blaton LS. Rickettsia rickettsii and other spotted fever group rickettsiae (Rocky ...

  14. Ecology of tick vectors of American spotted fever.

    Science.gov (United States)

    Burgdorfer, W

    1969-01-01

    The author reviews the natural history of the tick vectors of American spotted fever. The discussion concerns the ecology of the Rocky Mountain wood tick, Dermacentor andersoni, the American dog tick, Dermacentor variabilis, and the lone-star tick, Amblyomma americanum, all of which are proven vectors of Rocky Mountain spotted fever to man. Also included are the rabbit tick, Haemaphysalis leporispalustris and Dermacentor parumapertus, which very rarely bite man but which are considered of importance in maintaining and distributing Rickettsia rickettsi, the etiological agent of Rocky Mountain spotted fever, in nature. Brief reference is also made to recently developed techniques for studying the ecology of tick vectors.

  15. Rickettsial infections in ticks from wild birds in Paraguay.

    Science.gov (United States)

    Ogrzewalska, Maria; Literak, Ivan; Martins, Thiago F; Labruna, Marcelo B

    2014-03-01

    Ticks were collected from wild birds at 3 locations in Paraguay during the South American winter in August and September 2012. In total, 480 birds belonging to 106 species were examined. Overall, 31 (6.5%) birds representing 21 species were found parasitized by ticks which were identified as Amblyomma calcaratum Neumann (2 larvae, 20 nymphs), Amblyomma longirostre (Koch) (17 larvae, 3 nymphs), Amblyomma parvum Aragão (7 nymphs), Amblyomma aureolatum (Pallas) (1 nymph), Amblyomma ovale Koch (1 nymph), Amblyomma tigrinum Koch (1 larva), and Amblyomma spp. (4 larvae). Ticks collected accidentally on humans at the study locations during field work included 1 nymph of Amblyomma coelebs Neumann and 54 nymphs of Amblyomma cajennense (Fabricius). Most ticks were individually tested for the presence of Rickettsia species by polymerase chain reaction targeting rickettsial genes gltA and ompA and by amplicon sequencing. Two (12%) out of 17 A. longirostre larvae were found infected with Candidatus 'Rickettsia amblyommii', and 2 (33%) out of 6 A. parvum nymphs were infected with Candidatus 'Rickettsia andeanae'. This study provides the first report of rickettsial infections in Paraguayan ticks.

  16. Isolation of a Spotted Fever Group Rickettsia, Rickettsia peacockii, in a Rocky Mountain Wood Tick, Dermacentor andersoni, Cell Line

    OpenAIRE

    Simser, Jason A.; Palmer, Ann T.; Munderloh, Ulrike G.; Kurtti, Timothy J.

    2001-01-01

    An embryonic cell line (DAE100) of the Rocky Mountain wood tick, Dermacentor andersoni, was observed by microscopy to be chronically infected with a rickettsialike organism. The organism was identified as a spotted fever group (SFG) rickettsia by PCR amplification and sequencing of portions of the 16S rRNA, citrate synthase, Rickettsia genus-specific 17-kDa antigen, and SFG-specific 190-kDa outer membrane protein A (rOmpA) genes. Sequence analysis of a partial rompA gene PCR fragment and indi...

  17. Scarlet Fever (For Parents)

    Science.gov (United States)

    ... Feeding Your 1- to 2-Year-Old Scarlet Fever KidsHealth > For Parents > Scarlet Fever Print A A A What's in this article? ... to Call the Doctor en español Escarlatina Scarlet fever is caused by an infection with group A ...

  18. Detection of a spotted fever group Rickettsia in the tick Ixodes tasmani collected from koalas in Port Macquarie, Australia.

    Science.gov (United States)

    Vilcins, Inger-Marie E; Old, Julie M; Deane, Elizabeth M

    2008-07-01

    Four species of Rickettsia are recognized as endemic to Australia. This study reports the detection of a new spotted fever group Rickettsia in the common marsupial tick Ixodes tasmani Neumann collected from koalas (Phascolarctos cinereus) in Port Macquarie, NSW, Australia. Based on the results of polymerase chain reaction (PCR) amplification of extracted tick DNA with primers targeting the citrate synthase gene (gltA) and the outer membrane proteins A and B (ompA. ompB), Rickettsiae were detected in 22 of 78 I. tasmani tick samples (28.2%). Sequence data obtained for the three genes displayed the closest degree of similarity to Rickettsia heilongjiangiensiss for gltA (99.4%; 331/333 bp), Rickettsia amblyommii for the ompA gene (94.8%; 417/440 bp), and both Rickettsia massiliae and Rickettsia rhipicephali for the ompB gene (97%; 770/803 bp). BLAST and phylogenetic analysis of partial sequences obtained for the three genes were found to have sufficient nucleotide variation from the current recognized Australian species to be considered a distinct spotted fever group Rickettsia.

  19. Childhood fever.

    Science.gov (United States)

    Chong, C Y; Allen, D M

    1996-02-01

    Childhood fever is a common symptom, reflective of multiple causes. As the child is often unable to express himself, the physician must rely on parents' observations and the physical examination. The majority of febrile children have non-bacterial upper respiratory tract infection and indiscriminate use of antibiotics is inappropriate, ineffective and leads to drug-resistance such as the emergence of Penicillin-resistant Streptococcus pneumoniae. In this article, we attempt to identify the possible causes of fever by a simple approach using the presence or absence of associated or localising symptoms. Infants less than 3 months constitute a unique group as the fever may be related to perinatal events and as serious bacterial infections can still occur despite unremarkable physical findings. Management of fever needs to take into account the toxicity, immune status and age of the patients as well as the source of the infection. Zealous overprescription of antipyretics needs to be avoided with attention directed to the cause of the fever, the child's capacity to cope with the illness and parental education.

  20. Identification of rickettsial pathogens in ixodid ticks in northern Senegal.

    Science.gov (United States)

    Sambou, Masse; Faye, Ngor; Bassène, Hubert; Diatta, Georges; Raoult, Didier; Mediannikov, Oleg

    2014-09-01

    The spotted fevers, caused by the Rickettsia bacteria, are a group of emerging diseases that are responsible for significant human morbidity. In Africa, the distribution of different species of Rickettsia in their tick vectors is poorly studied. We have collected 1169 hard ticks from 5 different species in the northern Senegal, close to the Saharan border. In a far northern collection site, corresponding to the Rickettsia africae distribution area, we collected three Amblyomma variegatum ticks infected by R. africae. Rickettsia africae was also identified in a Hyalomma marginatum rufipes tick, which may represent the secondary host for the pathogen. Rickettsia aeschlimannii was identified in H. m. rufipes, Rhipicephalus evertsi evertsi, and Hyalomma impeltatum ticks.

  1. ACUTE UNDIFFERENTIATED FEVER IN INTENSIVE CARE UNITS

    Directory of Open Access Journals (Sweden)

    Srikanth Ram Mohan

    2014-03-01

    Full Text Available Acute undifferentiated fever (AUF is common in tropical regions of the developing world, its specific etiology is often unknown. It’s common causes include malaria, dengue fever, enteric fever, leptospirosis, rickettsial infection. AUF is defined as fever without any localised source of infection, of 14 days or less in duration. The objective of the study was to focus on identifying the causes of AUF in patients admitted to Intensive care units & to determine importance of clinical examination in identifying the cause. It was a prospective study done in our Medical college Hospital at Kolar, Karnataka between 1-11-2010 to 30-11-2011. Cases presenting to hospital aged >18 years with complaints of Fever & admitted in Intensive care units were included in study. A total of 558 cases were enrolled. The clinical findings were noted and subsequent Investigations required were asked for. The study compromised of approximately equal number of Male & Female patients & age varied from 18 – 100 years. There was a clear seasonal variation – More no of cases were admitted between April & November. Majority presented with Fever of Short duration (1-3 days. Certain well defined syndromes were identified like:  Fever with Thrombocytopenia – the most common of all the syndromes.  Fever with Myalgia & Arthralgia,  Fever with Hepatorenal dysfunction,  Fever with Encephalopathy,  Fever with Pulmonary - Renal dysfunction and  Fever with Multiorgan dysfunction (MODS. Out of 558 cases AUF was noted in 339 cases (60.86%. An etiological diagnosis could be made for 218 cases (39.06%. Leptospirosis was the commonest cause with 72 cases (12.9%. The no of cases with Dengue were 48(8.6%, Malaria –25 (4.4%, Viral fever –35 (6.2%, Mixed infections – 12 (2.1%, Pulmonary Tuberculosis -25 ( 4.4% and one case of Rickettsial Infection. MODS was the most common presentation in AUF patients, seen in 108 cases (31.8% and 40 cases expired. A study of AUF

  2. Comparison of lipopolysaccharides from Brazilian purpuric fever isolates and conjunctivitis isolates of Haemophilus influenzae biogroup aegyptius. Brazilian Purpuric Fever Study Group.

    OpenAIRE

    Erwin, A L; Munford, R S

    1989-01-01

    Haemophilus influenzae biogroup aegyptius (H. aegyptius) has been identified as the etiologic agent of the recently described disease Brazilian purpuric fever (BPF). Although there is heterogeneity among the strains associated with conjunctivitis, isolates from patients with BPF appear to be derived from a single clone. The clinical presentation of BPF suggests that bacterial lipopolysaccharides (LPS) are involved in its pathogenesis. We prepared LPS from H. influenzae biogroup aegyptius and ...

  3. Intraerythrocytic rickettsial inclusions in Ocoee salamanders (Desmognathus ocoee): prevalence, morphology, and comparisons with inclusions of Plethodon cinereus.

    Science.gov (United States)

    Davis, Andrew K; Cecala, Kristen

    2010-07-01

    Reports of an unusual intraerythrocytic pathogen in amphibian blood have been made for decades; these pathogens appear as membrane-bound vacuoles within erythrocytes. It is now understood that the pathogen is a Rickettsia bacteria, which are obligate intracellular parasites, and most are transmitted by arthropod vectors. In an effort to further understand the host range and characteristics of this pathogen, we examined 20 Ocoee salamanders (Desmognathus ocoee) from a site in southwest North Carolina for the presence of rickettsial inclusions and report the general characteristics of infections. Seven individuals (35%) were infected, and this level of prevalence was consistent with all other members of this genus examined to date. In contrast, infections within the genus Plethodon tend to occur in less than 10% of individuals, based on review of the literature. The difference could be related to the semi-aquatic nature of Desmognathus salamanders versus the completely terrestrial Plethodon. It is also possible that both groups are hosts to different types of rickettsial bacteria, since the inclusions found here only vaguely resembled those found recently in red-backed salamanders (Plethodon cinereus). Inclusions in Ocoee salamanders measured 4 microm in diameter on average, and most cells (88%) only had one inclusion. Of all infected individuals, inclusions occurred in approximately 3% of erythrocytes. Similar to that found in red-backed salamanders, infected hosts were significantly larger than non-infected. Future investigations into the nature of this unusual parasite of amphibians would help to further our understanding of its life cycle and transmission.

  4. Hemorrhagic Fevers

    Science.gov (United States)

    ... of viruses. These include the Ebola and Marburg, Lassa fever, and yellow fever viruses. VHFs have common features: ... the animals that carry them live. For example, Lassa fever is limited to rural areas of West Africa ...

  5. Genotypic and biological characteristics of non-identified strain of spotted fever group rickettsiae isolated in Crimea.

    Science.gov (United States)

    Balayeva, N M; Demkin, V V; Rydkina, E B; Ignatovich, V F; Artemiev, M I; Lichoded LYa; Genig, V A

    1993-12-01

    A strain of rickettsiae, designated Crimea-108, was isolated from ticks Dermacentor marginatus in the Crimea in 1977. Its immunobiological characteristics involve low pathogenicity for experimental animals, moderate infectivity for chick embryos, and antigenic relatedness to spotted fever group (SFG) rickettsiae (R. sibirica, R. conorii, R. akari), especially to R. sibirica. The genotypic characterization of the strain Crimea-108 was carried out in comparison with SFG and typhus group rickettsiae by using restriction fragment length polymorphism (RFLP) analysis and DNA-probe hybridization. The marked similarity was detected between DNA restriction patterns of the strains Crimea-108, R. sibirica and R. conorii, but each of them besides comigrating fragments had specific ones. Genotypic analysis of the strain Crimea-108, the SFG and typhus group rickettsiae by three independent DNA probes, based on R. prowazekii DNA, gave unique hybridization patterns for the Crimea-108 strain with all probes. The obtained data show that the Crimea-108 isolate does not belong to the species of R. sibirica, R. conorii, R. akari. The strain Crimea-108 is a novel strain of SFG rickettsiae for the Crimea region.

  6. Travelers' Health: Rickettsial (Spotted and Typhus Fevers) and Related Infections (Anaplasmosis and Ehrlichiosis)

    Science.gov (United States)

    ... the genera Rickettsia , Orientia , Ehrlichia , Neorickettsia , Neoehrlichia , and Anaplasma ( Table 3-18 ). Rickettsia spp. are classically divided ... are most common. Infections with various Ehrlichia and Anaplasma spp. have also been reported in Europe, Asia, ...

  7. Travelers' Health: Rickettsial (Spotted and Typhus Fevers) and Related Infections (Anaplasmosis and Ehrlichiosis)

    Science.gov (United States)

    ... traveling in endemic areas. The proper use of insect or tick repellents, self-examination after visits to ... Newsroom Training/Education Funding CDC's Organization Mission and Vision Using this Site Legal Link to Us Policies ...

  8. Seasonal communication about dengue fever in educational groups in primary healthcare.

    Science.gov (United States)

    Silva, Líliam Barbosa; Soares, Sônia Maria; Fernandes, Maria Teresinha de Oliveira; Aquino, Ana Luiza de

    2011-12-01

    To analyze how seasonal communication for dengue control and prevention is conveyed in educational peer groups of Family Health teams. An exploratory and descriptive qualitative study was performed with 25 coordinators of peer education groups, distributed among eight basic health units of Belo Horizonte, Southeastern Brazil. Data collection occurred from March to June 2009, by non-participant observation and semi-structured interviews with coordinators. Content analysis and the principal theories in health communication were utilized in data interpretation. Three thematic units were identified: seasonal communication; subjects discussed and information sources about dengue; and information versus communication for action. Dengue prevention and control actions were principally discussed in groups during outbreaks, based on actions previously programmed by the Ministry of Health. The topics addressed focused on epidemiology, life cycle, modes of transmission, symptoms, prevention, domiciliary visits by zoonosis control units and vaccination for dengue. The predominant communication action is information conveyance by the coordinator, centered on a behavioralist and prescriptive discourse. Communication practices focused on dialogue is recommended, allowing the coordinator and group members freedom in regards to emergent issues in the group, so they learn to recognize and reflexively discuss them in context.

  9. Plasma IL-8 and IL-6 levels can be used to define a group with low risk of septicaemia among cancer patients with fever and neutropenia

    NARCIS (Netherlands)

    de Bont, ESJM; Vellenga, E; Swaanenburg, JCJM; Fidler, [No Value; Visser-van Brummen, PJ; Kamps, WA

    1999-01-01

    The standard therapy for patients with fever and chemotherapy-related neutropenia is hospitalization and infusion of broad-spectrum antibiotics. Early discharge of a defined group of patients at low risk for septicaemia would be of great advantage for these patients. Ih this study plasma

  10. Plasma IL-8 and IL-6 levels can be used to define a group with low risk of septicaemia among cancer patients with fever and neutropenia

    NARCIS (Netherlands)

    de Bont, ESJM; Vellenga, E; Swaanenburg, JCJM; Fidler, [No Value; Visser-van Brummen, PJ; Kamps, WA

    1999-01-01

    The standard therapy for patients with fever and chemotherapy-related neutropenia is hospitalization and infusion of broad-spectrum antibiotics. Early discharge of a defined group of patients at low risk for septicaemia would be of great advantage for these patients. Ih this study plasma interleukin

  11. Spotted fever group rickettsia closely related to Rickettsia monacensis isolated from ticks in South Jeolla province, Korea.

    Science.gov (United States)

    Lee, Kyung-Min; Choi, Yeon-Joo; Shin, Sun-Hye; Choi, Min-Kyung; Song, Hyeon-Je; Kim, Heung-Chul; Klein, Terry A; Richards, Allen L; Park, Kyung-Hee; Jang, Won-Jong

    2013-07-01

    Rickettsia monacensis, a spotted fever group rickettsia, was isolated from Ixodes nipponensis ticks collected from live-captured small mammals in South Jeolla province, Korea in 2006. Homogenates of tick tissues were inoculated into L929 and Vero cell monolayers using shell vial assays. After several passages, Giemsa staining revealed rickettsia-like organisms in the inoculated Vero cells, but not the L929 cells. Sequencing analysis revealed that the ompA-small part (25-614 bp region), ompA-large part (2849-4455 bp region), nearly full-length ompB (58-4889 bp region) and gltA (196-1236 bp region) of the isolates had similarities of 100%, 99.8%, 99.3% and 99.5%, respectively, to those of R. monacensis. Furthermore, phylogenetic analysis showed that the isolate was grouped into the cluster in the same way as R. monacensis in the trees of all genes examined. These results strongly suggest that the isolate is closely related to R. monacensis. As far as is known, this is the first report of isolation of R. monacensis from ticks in Korea.

  12. Rheumatic fever reappraised

    Institute of Scientific and Technical Information of China (English)

    Ulrik Baandrup

    2005-01-01

    @@ Rheumatic fever is a complication following an episode of group A streptococcal pharyngitis. It is an acute immunologically mediated, multisystem inflammatory disorder. Acute rheumatic heart disease during the active phase of rheumatic fever sometimes progresses to chronic rheumatic heart disease. Despite its declining importance in industrialised countries rheumatic fever remains the leading cause of death from heart disease in children and young adults in less developed regions. Fifteen to twenty million new cases emerge every year in developing countries.1

  13. Relapsing Fever: Diagnosis Thanks to a Vigilant Hematology Laboratory.

    Science.gov (United States)

    Fuchs, Inbal; Tarabin, Salman; Kafka, Michael

    2015-07-01

    Three cases of relapsing fever from southern Israel were diagnosed promptly thanks to vigilance of the hematology laboratory technicians. In this region of Israel, patients presenting with prolonged fever and leukopenia without localizing symptoms are generally suspected of having brucellosis or a rickettsial disease. Pediatric patients with prolonged fever, cytopenias, and negative aforementioned serologies are often hospitalized for further work-up. Because of the policy of performing a manual blood smear when results of the automated blood count demonstrate severe anemia and abnormal platelet and/or white blood cell counts, a diagnosis of tick-borne relapsing fever was confirmed and promptly relayed to the physician. This routine prevented unnecessary examinations and hospitalization days and provided important information to regional epidemiology and public health authorities.

  14. High prevalence of spotted fever group rickettsiae in Amblyomma variegatum from Uganda and their identification using sizes of intergenic spacers.

    Science.gov (United States)

    Nakao, Ryo; Qiu, Yongjin; Igarashi, Manabu; Magona, Joseph W; Zhou, Lijia; Ito, Kimihito; Sugimoto, Chihiro

    2013-12-01

    The spotted fever group (SFG) rickettsiae are obligate intracellular bacteria transmitted by ticks that cause several tick-borne rickettsioses in humans worldwide. This study was intended to determine the prevalence of SFG rickettsiae in Amblyomma variegatum from 7 districts across Uganda. In addition to sequencing of gltA and ompA genes, identification of Rickettsia species based on the sizes of highly variable intergenic spacers, namely, dksA-xerC, mppA-purC, and rpmE-tRNA(fMet) was carried out. Application of multiplex PCR for simultaneous amplification of 3 spacers combined with capillary electrophoresis separation allowed simple, accurate, and high-throughput fragment sizing with considerable time and cost savings. Rickettsia genus-specific real-time PCR detected 136 positives out of 140 samples, giving an overall prevalence of 97.1%. Most samples (n=113) had a size combination of 225, 195, and 341 bp for dksA-xerC, mppA-purC, and rpmE-tRNA(fMet), respectively, which was identical to that of R. africae, a causative agent of African tick bite fever. In addition, several samples had size variants in either dksA-xerC or rpmE-tRNA(fMet). Nonetheless, the partial sequences of gltA and ompA genes of samples of all size combinations showed the greatest similarity to R. africae (99.3-100% for gltA and 98.1-100% for ompA). Given these results, it is highly possible that the tested ticks were infected with R. africae or closely related species. This is a first report on molecular genetic detection of R. africae and its high endemicity in Uganda. Clinicians in this country should be aware of this pathogen as a cause of non-malarial febrile illness. This study provided a starting point for the development of Rickettsia species identification based on the sizes of intergenic spacers. The procedure is simple, rapid, and cost-effective to perform; hence it might be particularly well suited for preliminary species identification in epidemiological investigations. The results

  15. Molecular evidence of potential novel spotted fever group rickettsiae, Anaplasma and Ehrlichia species in Amblyomma ticks parasitizing wild snakes.

    Science.gov (United States)

    Kho, Kai Ling; Koh, Fui Xian; Tay, Sun Tee

    2015-02-19

    Amblyomma ticks parasitize a wide range of animals in tropical regions. This study describes the identification of Amblyomma ticks from wild snakes in Malaysia and the detection of potential human pathogens such as Rickettsia, Anaplasma, Ehrlichia and bartonellae in the ticks. Twenty one adult ticks (twelve A. varanense and nine Amblyomma helvolum ticks) identified from seven Python molurus snakes in Sepang and a pool of six A. helvolum ticks from a Naja sumatrana snake in Johore, Malaysia were investigated in this study. Amplification of the citrate synthase (gltA), 190-kDa surface antigen gene (ompA), 135-kDa surface antigen (ompB) and surface cell antigen (sca4) genes followed by sequence analysis confirmed the presence of two potential novel spotted fever group rickettsiae in the ticks. Candidatus Rickettsia sepangensis from an engorged A. varanense tick demonstrated high sequence similarity to Rickettsia tamurae; while Candidatus Rickettsia johorensis from two samples (individual and pooled) of A. helvolum and two A. varanense ticks were closely related to Rickettsia raoultii. Anaplasma and Ehrlichia DNA were detected from seven and two ticks, respectively. No bartonellae was detected from any of the ticks. The finding in this study suggests that Amblyomma ticks parasitizing wild snakes may serve as reservoir hosts and carriers for rickettsioses, anaplasmosis and ehrlichiosis in this region.

  16. CLINICAL PROFILE OF RHEUMATIC FEVER AND RHEUMATIC HEART DISEASE IN CHILDREN UNDER 15 YEARS AGE GROUP AND ITS CORRELATION WITH ECHOCARDIOGRAPHY

    Directory of Open Access Journals (Sweden)

    Ramu

    2015-02-01

    Full Text Available Context ( Back ground Acute Rheumatic fever and Rheumatic heart disease are the most common acquired childhood heart disease in India. It is well established that 2 D Echo cardiography is more sensitive in picking up minor degrees of valvular regurgitation than clinical examination . AIMS & OBJECTIVES: To study the clinical profile of “Rheumatic Fever and Rheumatic heart disease“ & correlate it with Echocardiographic fin dings in Children under 15 years age group presenting to a tertiary care hospital. MATERIALS AND METHODS OF STUDY: Thirty six cases of Acute Rheumatic fever, which includes eight cases of first attack and twenty eight cases of reactivation of Rheumatic fev er were studied over a period of two years in paediatric medical wards, King George Hospital, Visakhapatnam. The revised (1992 modified Jones criteria with the 1988 WHO modification was taken as a criterion to diagnose Acute Rheumatic fever . RESULTS : Peak age of Acute Rheumatic fever and Chronic Rheumatic heart disease is between 5 - 10 years (55.8%. No sex variation has been observed. Fever and joint involvement are the most common clinical manifestations (87.5%each in first attack cases. Active cardi tis (75% the second most common manifestation , followed by arthralgia (25% and sore throat (25% , chorea , chest pain , abdominal pain were infrequent manifestations found to be 12.5% each. None of the cases had Erythema marginatum. CONCLUSION : In the pres ent study the clinical findings were correlated with that of previous studies and Echocardiographic findings were correlated well as far as moderate to severe lesions. Further Echocardiography was proved to be more sensitive in detecting even trivial or mi ld aortic regurgitation and mitral or aortic stenosis.

  17. Molecular survey of rickettsial agents in feral raccoons (Procyon lotor) in Hokkaido, Japan.

    Science.gov (United States)

    Sashika, Mariko; Abe, Go; Matsumoto, Kotaro; Inokuma, Hisashi

    2010-09-01

    Rickettsial infection in feral raccoons (Procyon lotor) in Hokkaido, Japan was analyzed by molecular methods. Genus-specific nested polymerase chain reaction (PCR) analysis based on the Rickettsia citrate synthase (gltA) gene showed that 13 of 699 raccoons (1.9%) examined were positive for Rickettsia. Twelve of the 13 partial gltA sequence amplicons were successfully analyzed. The nucleotide sequence of one amplicon was identical to both Rickettsia heilongjiangensis and R. japonica, one was identical to R. felis, and the rest to R. helvetica. This is the first report on the detection of rickettsial agents in peripheral blood of raccoons.

  18. Comparison of lipopolysaccharides from Brazilian purpuric fever isolates and conjunctivitis isolates of Haemophilus influenzae biogroup aegyptius. Brazilian Purpuric Fever Study Group.

    Science.gov (United States)

    Erwin, A L; Munford, R S

    1989-04-01

    Haemophilus influenzae biogroup aegyptius (H. aegyptius) has been identified as the etiologic agent of the recently described disease Brazilian purpuric fever (BPF). Although there is heterogeneity among the strains associated with conjunctivitis, isolates from patients with BPF appear to be derived from a single clone. The clinical presentation of BPF suggests that bacterial lipopolysaccharides (LPS) are involved in its pathogenesis. We prepared LPS from H. influenzae biogroup aegyptius and found them to be similar to H. influenzae type b LPS in apparent size (by sodium dodecyl sulfate-polyacrylamide gel electrophoresis), biological activities, and fatty acid composition. We compared LPS from BPF clone isolates with LPS from non-BPF clone isolates in tests of Limulus lysate activation, spleen cell mitogenesis, promotion of neutrophil adherence to LPS-treated endothelial cells, and the dermal Shwartzman reaction. In none of these activities were LPS from the BPF clone isolates more potent. Because LPS shed from growing bacteria may be involved in the pathogenesis of purpura, we also measured the rate at which LPS were released into culture medium during bacterial growth and found no significant difference between BPF clone and non-BPF clone isolates.

  19. Valley Fever

    Science.gov (United States)

    Valley Fever is a disease caused by a fungus (or mold) called Coccidioides. The fungi live in the soil ... from person to person. Anyone can get Valley Fever. But it's most common among older adults, especially ...

  20. Lassa Fever

    Science.gov (United States)

    ... The CDC Cancel Submit Search The CDC Lassa Fever Note: Javascript is disabled or is not supported ... French) Recommend on Facebook Tweet Share Compartir Lassa fever is an acute viral illness that occurs in ...

  1. Scarlet fever

    Science.gov (United States)

    ... the throat infection. This is crucial to prevent rheumatic fever, a serious complication of strep throat and scarlet ... with the right treatment, but may include: Acute rheumatic fever , which can affect the heart, joints, skin, and ...

  2. Rickettsial infection in ticks infesting wild birds from two eco-regions of Argentina.

    Science.gov (United States)

    Flores, Fernando Sebastián; Costa, Francisco Borges; Nava, Santiago; Diaz, Luiz Adrián; Labruna, Marcelo Bahia

    2016-01-01

    Several tick-borne Rickettsia species are recognized human pathogens in Argentina. Here we evaluated rickettsial infection in ticks collected on passerine birds during 2011-2012 in two eco-regions of Argentina. The ticks were processed by molecular analysis through polymerase chain reaction (PCR) detection and DNA sequencing of fragments of two rickettsial genes, gltA and ompA. A total of 594 tick specimens (532 larvae and 62 nymphs), representing at least 4 species (Amblyomma tigrinum, Ixodes pararicinus, Haemaphysalis juxtakochi, Haemaphysalis leporispalustris), were evaluated. At least one A. tigrinum larva, collected on Coryphospingus cucullatus in Chaco Seco, was infected with Rickettsia parkeri, whereas at least 12 larvae and 1 nymph of I. pararicinus, collected from Troglodytes aedon, Turdus amaurochalinus, Turdus rufiventris, C. cucullatus and Zonotrichia capensis, were infected with an undescribed Rickettsia agent, genetically related to several rickettsial endosymbionts of ticks of the Ixodes ricinus complex. R. parkeri is a recognized human pathogen in several American countries including Argentina, where a recent study incriminated A. tigrinum as the potential vector of R. parkeri to humans. Birds could play an important role in dispersing R. parkeri-infected A. tigrinum ticks. Additionally, we report for the first time a rickettsial agent infecting I. pararicinus ticks.

  3. Differential Rickettsial Transcription in Bloodfeeding and Non-Bloodfeeding Arthropod Hosts

    Science.gov (United States)

    Verhoeve, Victoria I.; Jirakanwisal, Krit; Utsuki, Tadanobu; Macaluso, Kevin R.

    2016-01-01

    Crucial factors influencing the epidemiology of Rickettsia felis rickettsiosis include pathogenesis and transmission. Detection of R. felis DNA in a number of arthropod species has been reported, with characterized isolates, R. felis strain LSU and strain LSU-Lb, generated from the cat flea, Ctenocephalides felis, and the non-hematophagous booklouse, Liposcelis bostrychophila, respectively. While it is realized that strain influence on host biology varies, the rickettsial response to these distinct host environments remained undefined. To identify a panel of potential rickettsial transmission determinants in the cat flea, the transcriptional profile for these two strains of R. felis were compared in their arthropod hosts using RNAseq. Rickettsial genes with increased transcription in the flea as compared to the booklouse were identified. Genes previously associated with bacterial virulence including LPS biosynthesis, Type IV secretion system, ABC transporters, and a toxin-antitoxin system were selected for further study. Transcription of putative virulence-associated genes was determined in a flea infection bioassay for both strains of R. felis. A host-dependent transcriptional profile during bloodfeeding, specifically, an increased expression of selected transcripts in newly infected cat fleas and flea feces was detected when compared to arthropod cell culture and incubation in vertebrate blood. Together, these studies have identified novel, host-dependent rickettsial factors that likely contribute to successful horizontal transmission by bloodfeeding arthropods. PMID:27662479

  4. Rapid, simple, and sensitive detection of the ompB gene of spotted fever group rickettsiae by loop-mediated isothermal amplification

    Directory of Open Access Journals (Sweden)

    Pan Lei

    2012-10-01

    Full Text Available Abstract Background Spotted fever caused spotted fever group rickettsiae (SFGR is prevalent throughout China. In this study, we describe a rapid, simple, and sensitive loop-mediated isothermal amplification (LAMP assay targeting the ompB gene of spotted fever group rickettsiae ideal for application in China. The LAMP assay has the potential to detect spotted fever group rickettsiae early in infection and could therefore serve as an alternative to existing methods. Methods A set of universal primers which are specific 7 common species of spotted fever group rickettsiae in China were designed using PrimerExplorer V4 software based on conserved sequences of ompB gene. The sensitivity, specificity and reproducibility of the LAMP were evaluated. The LAMP assay for detecting SFGR was compared with conventional PCR assays for sensitivity and specificity in early phase blood samples obtained from 11 infected human subjects. Results The sensitivity of the LAMP assay was five copies per reaction (25 μL total volume, and the assay did not detect false-positive amplification across 42 strains of 27 members of the order Rickettsiales and 17 common clinical pathogens. The LAMP assay was negative to typhus group rickettsiae including R. prowazekii and R. typhi for no available conserved sequences of ompB was obtained for designing primers. To evaluate the clinical applicability of the LAMP assay, a total of 11 clinical samples, 10 samples confirmed serologically (3 cases, ecologically (1 case, by real-time polymerase chain reaction (PCR; 2 cases, ecologically and by real-time PCR (1 case, and serologically and by real-time PCR (3 cases were analyzed by the ompB LAMP assay. Data were validated using a previously established nested PCR protocol and real-time PCR. A positive LAMP result was obtained for 8 of the 10 confirmed cases (sensitivity, 73%; specificity, 100%, while none of these samples were positive by nested PCR (sensitivity, 0%; specificity, 100

  5. Detection of Rickettsia rickettsii in the tick Amblyomma cajennense in a new Brazilian spotted fever-endemic area in the state of Minas Gerais

    OpenAIRE

    Elizângela Guedes; Leite,Romário C.; Márcia CA Prata; PACHECO, Richard C.; Walker, David H.; Labruna, Marcelo B.

    2005-01-01

    The present study evaluated rickettsial infection in Amblyomma spp. ticks collected in a farm in Coronel Pacheco, a Brazilian spotted fever (BSF) endemic area. A total of 78 A. cajennense and 78 A. dubitatum free-living adult ticks were collected and tested by polymerase chain reaction (PCR) targeting a fragment of the rickettsial gene gltA. Only one pool of three A. cajennense ticks showed the expected product by PCR. This pool was further tested by PCR using sets of primers targeting the ri...

  6. Haemorrhagic Fevers, Viral

    Science.gov (United States)

    ... is usually applied to disease caused by Arenaviridae (Lassa fever, Junin and Machupo), Bunyaviridae (Crimean-Congo haemorrhagic fever, ... fever Dengue and severe dengue Ebola virus disease Lassa fever Marburg haemorrhagic fever Rift Valley fever Multimedia, features ...

  7. Molecular Pathogenesis of Rickettsioses and Development of Novel Anti-Rickettsial Treatment by Combinatorial Peptide-Based Libraries

    Science.gov (United States)

    2007-02-01

    microvascular endothelium, leading to a disseminated infection whose most severe complications include a vasogenic cerebral edema and non- cardiogenic ......cerebral and non- cardiogenic pulmonary edema . With the development of powerful research tools, advances in the understanding of rickettsial pathogenesis

  8. Yellow fever.

    Science.gov (United States)

    Monath, Thomas P; Vasconcelos, Pedro F C

    2015-03-01

    Yellow fever, a mosquito-borne flavivirus disease occurs in tropical areas of South America and Africa. It is a disease of major historical importance, but remains a threat to travelers to and residents of endemic areas despite the availability of an effective vaccine for nearly 70 years. An important aspect is the receptivity of many non-endemic areas to introduction and spread of yellow fever. This paper reviews the clinical aspects, pathogenesis, and epidemiology of yellow fever, with an emphasis on recent changes in the distribution and incidence of the disease. Recent knowledge about yellow fever 17D vaccine mechanism of action and safety are discussed.

  9. Ibex-associated malignant catarrhal fever-like disease in a group of bongo antelope (Tragelaphus eurycerus).

    Science.gov (United States)

    Gasper, D; Barr, B; Li, H; Taus, N; Peterson, R; Benjamin, G; Hunt, T; Pesavento, P A

    2012-05-01

    A private zoological facility experienced an outbreak of malignant catarrhal fever (MCF) in 3 bongo antelope (Tragelaphus eurycerus). All cases were periparturient bongos that presented acutely anorectic beginning ~6 weeks after being housed with a Nubian ibex. Disease quickly progressed to respiratory distress and death within 24-72 hours of onset of clinical signs. Consistent gross findings in affected bongos were pulmonary edema and small pale tan foci in the livers. Histological lesions included a nonsuppurative vasculitis in multiple tissues, which is well recognized in MCF, but additionally included necrotizing cholangiohepatitis and neutrophilic, necrotizing myocarditis. Ibex-associated viral DNA was detected by polymerase chain reaction and was identical in sequence whether derived from bongos or ibex. The sequence closely matched an MCF viral DNA fragment that had been amplified from an ibex and bongo in a previous case report.

  10. Rheumatic Fever.

    Science.gov (United States)

    Visvanathan; Manjarez; Zabriskie

    1999-10-01

    There have been numerous reports stating that treatment of acute rheumatic fever with either aspirin or corticosteroids does not alter the long-term outcome of rheumatic heart disease. Yet, it should be emphasized that most of these studies were carried out with the first generic corticosteroids before the advent of the more active and more potent corticosteroid agents. In spite of this caveat, there is no question that all the clinical and laboratory parameters of inflammation (erythrocyte sedimentation rate, C-reactive protein) return to normal much more rapidly with corticosteroids than with aspirin alone. It is therefore our belief that steroids should be used when clinical and laboratory evidence of carditis exists, and aspirin should be reserved for cases of acute rheumatic arthritis with no evidence of carditis. The incidence of long-term valvular disease in active carditis may be decreased with steroid therapy. For example, the number of valve replacements differs markedly in centers that do use steroids and in those that do not. In Capetown, South Africa, where steroids are routinely used for carditis, valve replacement is quite rare. In contrast, in Johannesburg, where steroids are rarely used, the rate of valve replacement is quite high. The racial backgrounds of both groups of patients are similar, thus eliminating the question of racial differences. Concerning secondary prophylaxis, there is also controversy concerning the best second-line therapy. It is now well known that monthly intramuscular injections of benzathine penicillin are really effective for only 20 days. Thus, there is a window in which penicillin coverage is not adequate. To circumvent this problem, some investigators give benzathine penicillin every 3 weeks. These injections are quite painful, however, and it has been our "rule" that compliance with this treatment is inversely proportional to the ratio of the size of the child to the mother. In our own experience over 30 years with the

  11. Hereditary periodic fever and reactive amyloidosis.

    NARCIS (Netherlands)

    Hilst, J.C.H. van der; Simon, A.; Drenth, J.P.H.

    2005-01-01

    Hereditary periodic fever syndromes (HPF) are a group of diseases characterised by recurrences of fever and inflammation separated by symptom-free intervals. Familial Mediterranean fever (FMF) is the most frequent entity within this group of disorders which further consists of

  12. Isolation of Rickettsia parkeri and identification of a novel spotted fever group Rickettsia sp. from Gulf Coast ticks (Amblyomma maculatum) in the United States.

    Science.gov (United States)

    Paddock, Christopher D; Fournier, Pierre-Edouard; Sumner, John W; Goddard, Jerome; Elshenawy, Yasmin; Metcalfe, Maureen G; Loftis, Amanda D; Varela-Stokes, Andrea

    2010-05-01

    Until recently, Amblyomma maculatum (the Gulf Coast tick) had garnered little attention compared to other species of human-biting ticks in the United States. A. maculatum is now recognized as the principal vector of Rickettsia parkeri, a pathogenic spotted fever group rickettsia (SFGR) that causes an eschar-associated illness in humans that resembles Rocky Mountain spotted fever. A novel SFGR, distinct from other recognized Rickettsia spp., has also been detected recently in A. maculatum specimens collected in several regions of the southeastern United States. In this study, 198 questing adult Gulf Coast ticks were collected at 4 locations in Florida and Mississippi; 28% of these ticks were infected with R. parkeri, and 2% of these were infected with a novel SFGR. Seventeen isolates of R. parkeri from individual specimens of A. maculatum were cultivated in Vero E6 cells; however, all attempts to isolate the novel SFGR were unsuccessful. Partial genetic characterization of the novel SFGR revealed identity with several recently described, incompletely characterized, and noncultivated SFGR, including "Candidatus Rickettsia andeanae" and Rickettsia sp. Argentina detected in several species of Neotropical ticks from Argentina and Peru. These findings suggest that each of these "novel" rickettsiae represent the same species. This study considerably expanded the number of low-passage, A. maculatum-derived isolates of R. parkeri and characterized a second, sympatric Rickettsia sp. found in Gulf Coast ticks.

  13. Comparison of illumigene Group A Streptococcus Assay with Culture of Throat Swabs from Children with Sore Throats in the New Zealand School-Based Rheumatic Fever Prevention Program.

    Science.gov (United States)

    Upton, Arlo; Bissessor, Liselle; Farrell, Elizabeth; Shulman, Stanford T; Zheng, Xiaotian; Lennon, Diana

    2016-01-01

    Group A streptococcal (GAS) pharyngitis is a particularly important condition in areas of New Zealand where the incidence of acute rheumatic fever remains unacceptably high. Prompt diagnosis and treatment of GAS pharyngitis are cornerstones of the Rheumatic Fever Prevention Programme, but these are hindered by the turnaround time of culture. Tests with excellent performance and rapid turnaround times are needed. For this study, throat swabs (Copan ESwabs) were collected from schoolchildren self-identifying with a sore throat. Samples were tested by routine culture and the illumigene GAS assay using loop-mediated isothermal amplification. Discrepant results were resolved by retesting of the same specimen by an alternative molecular assay. Seven hundred fifty-seven throat swab specimens were tested by both methods. The performance characteristics of the illumigene assay using culture on blood agar as the "gold standard" and following discrepancy analysis were as follows: sensitivity, 82% and 87%, respectively; specificity, 93% and 98%, respectively; positive predictive value, 61% and 88%, respectively; and negative predictive value, 97% and 97%, respectively. In our unique setting of a school-based throat swabbing program, the illumigene assay did not perform quite as well as described in previous reports. Despite this, its improved sensitivity and rapid turnaround time compared with those of culture are appealing.

  14. Typhoid fever

    Science.gov (United States)

    ... most commonly caused due to a bacteria called Salmonella typhi ( S typhi ). Causes S typhi is spread through contaminated food, ... as food handlers. Alternative Names Enteric fever Images Salmonella typhi organism Fly Digestive system organs References Harris JB, ...

  15. Dengue fever

    Science.gov (United States)

    ... the mosquito Aedes aegypti , which is found in tropic and subtropic regions. This area includes parts of: ... encephalitis, St. Louis encephalitis, tick-borne encephalitis, Kyasanur forest disease, Alkhurma hemorrhagic fever, Zika). In: Bennett JE, ...

  16. Recurrent fevers.

    Science.gov (United States)

    Isaacs, David; Kesson, Alison; Lester-Smith, David; Chaitow, Jeffrey

    2013-03-01

    An 11-year-old girl had four episodes of fever in a year, lasting 7-10 days and associated with headache and neck stiffness. She had a long history of recurrent urticaria, usually preceding the fevers. There was also a history of vague pains in her knees and in the small joints of her hands. Her serum C-reactive protein was moderately raised at 41 g/L (normal <8). Her rheumatologist felt the association of recurrent fevers that lasted 7 or more days with headaches, arthralgia and recurrent urticaria suggested one of the periodic fever syndromes. Genetic testing confirmed she had a gene mutation consistent with one of tumour necrosis factor receptor-associated periodic syndrome.

  17. Rickettsial infections in ticks from reptiles, birds and humans in Honduras.

    Science.gov (United States)

    Novakova, Marketa; Literak, Ivan; Chevez, Luis; Martins, Thiago F; Ogrzewalska, Maria; Labruna, Marcelo B

    2015-09-01

    Ticks were collected from captive reptiles, wild birds, and incidentally from humans at two locations in Honduras and part of these were tested for the presence of Rickettsia using polymerase chain reaction. The following species of ticks were found: Amblyomma dissimile on Iguanidae reptiles, Amblyomma longirostre and Amblyomma nodosum on birds, and Amblyomma mixtum (Amblyomma cajennense complex) on humans. A. dissimile was infected with Rickettsia sp. strain Colombianensi. Both A. longirostre and A. mixtum were infected with Candidatus 'Rickettsia amblyommii'. This study provides the first report of rickettsial infections in ticks from reptiles, birds and humans in Honduras. New host - Amblyomma tick associations are documented.

  18. Rickettsial Infection in Animals, Humans and Ticks in Paulicéia, Brazil.

    Science.gov (United States)

    Silveira, I; Martins, T F; Olegário, M M; Peterka, C; Guedes, E; Ferreira, F; Labruna, M B

    2015-11-01

    A previous study in Paulicéia Municipality, south-eastern Brazil, reported 9.7% of the Amblyomma triste ticks to be infected by Rickettsia parkeri, a bacterial pathogen that causes spotted fever in humans. These A. triste ticks were shown to be associated with marsh areas, where the marsh deer Blastocerus dichotomus is a primary host for this tick species. During 2008-2009, blood serum samples were collected from 140 horses, 41 dogs, 5 opossums (Didelphis albiventris) and 26 humans in farms from Pauliceia Municipality. Ticks were collected from these animals, from vegetation and from additional wildlife in these farms. Overall, 25% (35/140) of the horses, 7.3% (3/41) of the dogs, 3.8% (1/26) of the humans and 100% (5/5) of the opossums were seroreactive (titre ≥64) to spotted fever group (SFG) Rickettsia spp. Multivariate statistical analysis indicated that horses that were allowed to forage in the marsh were 4.8 times more likely to be seroreactive to spotted fever group (SFG) Rickettsia spp than horses that did not forage in the marsh. In addition, horses that had been living in the farm for more than 8.5 years were 2.8 times more likely to be seroreactive to SFG Rickettsia spp than horses that were living for ≤8.5 years. Ticks collected from domestic animals or from vegetation included Amblyomma cajennense, Amblyomma coelebs, Amblyomma dubitatum, Dermacentor nitens and Rhipicephalus microplus. By PCR analyses, only one pool of A. coelebs ticks from the vegetation was shown to be infected by rickettsiae, for which DNA sequencing revealed to be Rickettsia amblyommii. Ticks (not tested by PCR) collected from wildlife encompassed A. cajennense and Amblyomma rotundatum on lizards (Tupinambis sp), and A. cajennense and A. triste on the bird Laterallus viridis. Our results indicate that the marsh area of Paulicéia offers risks of infection by SFG rickettsiae.

  19. Typhoid fever

    DEFF Research Database (Denmark)

    Wain, John; Hendriksen, Rene S.; Mikoleit, Matthew L.

    2015-01-01

    Control of typhoid fever relies on clinical information, diagnosis, and an understanding for the epidemiology of the disease. Despite the breadth of work done so far, much is not known about the biology of this human-adapted bacterial pathogen and the complexity of the disease in endemic areas...... with shifting trends in enteric fever. This knowledge is crucial, both to control the disease and to manage cases. Additionally, salmonella serovars that cause human infection can change over time and location. In areas of Asia, multidrug-resistant Salmonella enterica serovar Typhi (S Typhi) has been the main...... cause of enteric fever, but now S Typhi is being displaced by infections with drug-resistant S enterica serovar Paratyphi A. New conjugate vaccines are imminent and new treatments have been promised, but the engagement of local medical and public health institutions in endemic areas is needed to allow...

  20. Rat-bite fever

    Science.gov (United States)

    Streptobacillary fever; Streptobacillosis; Haverhill fever; Epidemic arthritic erythema; Spirillary fever; Sodoku ... Rat-bite fever can be caused by 2 different bacteria, Streptobacillus moniliformis or Spirillum minus. Both of these are found in ...

  1. Kid's Guide to Fever

    Science.gov (United States)

    ... in the Operating Room? A Kid's Guide to Fever KidsHealth > For Kids > A Kid's Guide to Fever ... some lighter-weight pajamas. previous continue Fighting a Fever For almost all kids, fevers aren't a ...

  2. Dengue fever (image)

    Science.gov (United States)

    Dengue fever, or West Nile fever, is a mild viral illness transmitted by mosquitoes which causes fever, ... second exposure to the virus can result in Dengue hemorrhagic fever, a life-threatening illness.

  3. Tick-borne rickettsial pathogens in questing ticks, removed from humans and animals in Mexico

    Science.gov (United States)

    Vargas-Sandoval, Margarita; Torres, Javier

    2016-01-01

    Tick-borne rickettsial diseases (TBRD) are commonly encountered in medical and veterinary clinical settings. The control of these diseases is difficult, requiring disruption of a complex transmission chain involving a vertebrate host and ticks. The geographical distribution of the diseases is related to distribution of the vector, which is an indicator of risk for the population. A total of 1,107 ticks were collected by tick dragging from forests, ecotourism parks and hosts at 101 sites in 22 of the 32 states of Mexico. Collected ticks were placed in 1.5 mL cryovials containing 70% ethanol and were identified to species. Ticks were pooled according to location/host of collection, date of collection, sex, and stage of development. A total of 51 ticks were assayed by polymerase chain reaction (PCR) to confirm species identification using morphological methods. A total of 477 pools of ticks were assayed using PCR techniques for selected tick-borne pathogens. Anaplasma phagocytophilum was the most commonly detected pathogen (45 pools), followed by, Ehrlichia (E.) canis (42), Rickettsia (R.) rickettsii (11), E. chaffeensis (8), and R. amblyommii (1). Rhipicephalus sanguineus was the tick most frequently positive for selected pathogens. Overall, our results indicate that potential tick vectors positive for rickettsial pathogens are distributed throughout the area surveyed in Mexico. PMID:26726019

  4. Tick-borne rickettsial pathogens in questing ticks, removed from humans and animals in Mexico.

    Science.gov (United States)

    Sosa-Gutierrez, Carolina G; Vargas-Sandoval, Margarita; Torres, Javier; Gordillo-Pérez, Guadalupe

    2016-09-30

    Tick-borne rickettsial diseases (TBRD) are commonly encountered in medical and veterinary clinical settings. The control of these diseases is difficult, requiring disruption of a complex transmission chain involving a vertebrate host and ticks. The geographical distribution of the diseases is related to distribution of the vector, which is an indicator of risk for the population. A total of 1107 were collected by tick drag from forests, ecotourism parks and hosts at 101 sites in 22 of the 32 states of Mexico. Collected ticks were placed in 1.5 mL cryovials containing 70% ethanol and were identified to species. Ticks were pooled according to location/host of collection, date of collection, sex, and stage of development. A total of 51 ticks were assayed by polymerase chain reaction (PCR) to confirm species identification using morphological methods. A total of 477 pools of ticks were assayed using PCR techniques for selected tick-borne pathogens. Anaplasma phagocytophilum was the most commonly detected pathogen (45 pools), followed by, Ehrlichia (E.) canis (42), Rickettsia (R.) rickettsii (11), E. chaffeensis (8), and R. amblyommii (1). Rhipicephalus sanguineus was the tick most frequently positive for selected pathogens. Overall, our results indicate that potential tick vectors positive for rickettsial pathogens are distributed throughout the area surveyed in Mexico.

  5. Shell damage in the Tehuelche scallop Aequipecten tehuelchus caused by Polydora rickettsi (Polychaeta: Spionidae) infestation.

    Science.gov (United States)

    Diez, M E; Orensanz, J M; Márquez, F; Cremonte, F

    2013-10-01

    The different types of shell damage caused to the commercially valuable Tehuelche scallop (Aequipecten tehuelchus) by the polychaete Polydora rickettsi are described. X-rays, computerized tomography, shell sections, scanning electron microscopy, Energy Dispersive X-ray analysis (EDAX), mineralogical analyses and geometric morphometrics were applied to that end. Scallop shells presented three types of damage: (1) spots, (2) calcareous alterations, and (3) mud blisters. Microstructural alterations consisted of a simple conchiolin membranous layer in the case of spots, a series of interleaved layers of different degree of calcifications in calcareous alterations, and two different surface morphologies (muddy and mucous layers) in mud blisters. Damage was localized mainly along concentric growth rings, coincidentally with the location of most burrows, as shown by X-ray. Mineralogical analysis showed that in all cases (including non-infested shells) calcite was the calcium carbonate polymorph present. Geometric morphometrics showed that only 5% of shape variation was explained by infestation with P. rickettsi, irrespective of the type of damage. Number of worms per infested shell varied significantly among four beds. Left shells (upward-oriented) were significantly more affected than right shells, which are in closer contact with the bottom.

  6. Identification and characterization of genomic loci unique to the Brazilian purpuric fever clonal group of H. influenzae biogroup aegyptius: functionality explored using meningococcal homology.

    Science.gov (United States)

    Li, Ming-Shi; Farrant, Jayne L; Langford, Paul R; Kroll, J Simon

    2003-02-01

    Brazilian purpuric fever (BPF) is a fulminant septicaemic infection of young children, caused by a clonal group of strains of Haemophilus influenzae biogroup aegyptius (Hae), an organism previously solely associated with conjunctivitis. Their special capacity to invade from the initial site of conjunctival infection is unexplained. A polymerase chain reaction (PCR)-amplified subtractive hybridization technique was used to identify genes specific to the BPF clonal group. A copy of bacteriophage HP1 and 46 further chromosomal loci were identified in the BPF but not in the conjunctivitis strain of Hae. Sixteen were characterized further, and one - encoding an analogue of the Legionella pneumophila epithelial cell entry-enhancing protein EnhC - was investigated in depth. Two genes, bpf001 and bpf002, unique to the BPF clonal group were identified between homologues of HI1276 and HI1277 in a complex locus close to H. influenzae genetic island 1, recently identified in pathogenic H. influenzae type b. Bpf001 encodes a protein homologous to EnhC and to the previously uncharacterized product of the meningococcal gene NMB0419. Functional studies of bpf001 proving intractable, NMB0419 was chosen as a surrogate for investigation and shown to modulate bacterial interaction with monolayers of human respiratory epithelial cells, promoting invasion, the first stage (for Hae) in the pathogenesis of BPF.

  7. Scarlet Fever

    Centers for Disease Control (CDC) Podcasts

    2011-06-09

    Katherine Fleming-Dutra, pediatrician, discusses scarlet fever, its cause, how to treat it, and how to prevent its spread.  Created: 6/9/2011 by National Center for Immunization and Respiratory Diseases (NCIRD).   Date Released: 6/9/2011.

  8. Yellow fever

    Directory of Open Access Journals (Sweden)

    Prata Aluízio

    2000-01-01

    Full Text Available With the infestation by Aedes aegypti, urban yellow fever might already exist. This did not occur because of either the lacking of a sufficient contact between the diseased individual and the A. aegypti or perhaps because this, after sixty years without transmitting the virus, needs an adaptation phase to infecting again.

  9. Q fever

    Science.gov (United States)

    ... Coxiella burnetii . These bacteria can infect: Sheep Goats Cattle Dogs Cats Birds Rodents Ticks Infected animals shed ... The main treatment for Q fever is antibiotics. For early-stage Q ... If you have the infection for more than 6 months, it is called ...

  10. Evidence of three new members of malignant catarrhal fever virus group in Muskox (Ovibos moschatus), Nubian ibex (Capra nubiana), and gemsbok (Oryx gazella)

    Science.gov (United States)

    Li, H.; Gailbreath, K.; Bender, L.C.; West, K.; Keller, J.; Crawford, T.B.

    2003-01-01

    Six members of the malignant catarrhal fever (MCF) virus group of ruminant rhadinoviruses have been identified to date. Four of these viruses are clearly associated with clinical disease: alcelaphine herpesvirus 1 (AlHV-1) carried by wildebeest (Connochaetes spp.); ovine herpesvirus 2 (OvHV-2), ubiquitous in domestic sheep; caprine herpesvirus 2 (CpHV-2), endemic in domestic goats; and the virus of unknown origin found causing classic MCF in white-tailed deer (Odocoileus virginianus; MCFV-WTD). Using serology and polymerase chain reaction with degenerate primers targeting a portion of the herpesviral DNA polymerase gene, evidence of three previously unrecognized rhadinoviruses in the MCF virus group was found in muskox (Ovibos moschatus), Nubian ibex (Capra nubiana), and gemsbok (South African oryx, Oryx gazella), respectively. Based on sequence alignment, the viral sequence in the muskox is most closely related to MCFV-WTD (81.5% sequence identity) and that in the Nubian ibex is closest to CpHV-2 (89.3% identity). The viral sequence in the gemsbok is most closely related to AlHV-1 (85.1% identity). No evidence of disease association with these viruses has been found. ?? Wildlife Disease Association 2003.

  11. Evidence of three new members of malignant catarrhal fever virus group in muskox (Ovibos moschatus), Nubian ibex (Capra nubiana), and gemsbok (Oryx gazella).

    Science.gov (United States)

    Li, Hong; Gailbreath, Katherine; Bender, Louis C; West, Keith; Keller, Janice; Crawford, Timothy B

    2003-10-01

    Six members of the malignant catarrhal fever (MCF) virus group of ruminant rhadinoviruses have been identified to date. Four of these viruses are clearly associated with clinical disease: alcelaphine herpesvirus 1 (AlHV-1) carried by wildebeest (Connochaetes spp.); ovine herpesvirus 2 (OvHV-2), ubiquitous in domestic sheep; caprine herpesvirus 2 (CpHV-2), endemic in domestic goats; and the virus of unknown origin found causing classic MCF in white-tailed deer (Odocoileus virginianus; MCFV-WTD). Using serology and polymerase chain reaction with (degenerate primers targeting a portion of the herpesviral DNA polymerase gene, evidence of three previously unrecognized rhadinoviruses in the MCF virus group was found in muskox (Ovibos moschatus), Nubian ibex (Capra nubiana), and gemsbok (South African oryx, Oryx gazella), respectively. Base on sequence alignment, the viral sequence in the muskox is most closely related to MCFV-WTD (81.5% sequence identity) and that in the Nubian ibex is closest to CpHV-2 (89.3% identity). The viral sequence in the gemsbok is most closely related to AlHV-1 (85.1% identity). No evidence of disease association with these viruses has been found.

  12. 黑龙江口岸斑点热群立克次体调查研究%INVESTIGATION OF SPOTTED FEVER GROUP RICKETTSIA IN HEILONGJIANG PORT

    Institute of Scientific and Technical Information of China (English)

    鞠文东; 程成; 付维明; 王延禄; 呼满霞; 梁慧杰; 王红霞; 徐宁; 耿聪

    2015-01-01

    为了解黑龙江口岸地区斑点热群立克次体在人群、鼠类、蜱类中的分布特征,针对黑龙江省9个中俄边境口岸,采集出入境人群的血液样本215份、鼠类样本204份、蜱类样本188份,利用半巢式PCR方法对所有样本进行斑点热群立克次体特异性片段扩增,通过基因测序对斑点热群立克次体分型。结果在哈尔滨机场及嘉荫两个口岸的大仓鼠及小家鼠中检测到2例劳氏立克次体Rickettsia raoultii,为首次在黑龙江口岸鼠样本中检测出劳氏立克次体;在188份蜱样本中,检出斑点热群立克次体阳性样本101例,感染率达53.7%,其中劳氏立克次体89例,新塔拉塞维奇立克次体Candidatus Rickettsia tarasevichiae 11例,黑龙江立克次体Rickettsia heilongjiangii 1例,同样首次在黑龙江口岸全沟硬蜱中检测到新塔拉塞维奇立克次体。黑龙江中俄边境口岸开展SFGR的长期监测具有非常重要的公共卫生学意义。%To understand the distribution characteristics of spotted fever group Rickettsia in the residencies, rodents and ticks in Heilongjiang ports, total 9 port area along with Sino-Russian border were sampled to test the species and infection rates of spotted fever group Rickettsia from 188 ticks and 204 rodents.Moreover, 215 humans entry or exit from these ports were also include for screening the possible infection the rickettsia organisms under their permissions.Results from semi-nested PCR and sequences indicated that two Rickettsia raoultii detected in Cricetulus triton and Mus musculus Linnaeus respectively.None rickettsia organism were found in the human samples.While in ticks, 90 R.raoultii, 11 Candidatus Rickettsia tarasevichiae and 1 R.heilongiangii were found.The preliminary suggested the risk of emerged spotted fever pathogens in these areas and the necessary and urgent of long term monitoring on tick borne diseases.

  13. [Milk fever].

    Science.gov (United States)

    Dumont, M

    1989-05-01

    Infectious complications following delivery were, in the past, attributed to "milk fever": these were milk congestion, milk deposits, rancid milk, etc., that were held responsible. The milk was reabsorbed into the blood of the patient and settled in the peritoneum ("milk peritonitis"), in the broad ligaments (pelvic abscess), in the thighs (phlebitis) and also in the breasts (breast abscess). This belief, originated by Aristotle, was accepted by excellent authors like Andre Levret (1703-1780), one of the most famous French obstetricians and Nicolas Puzos, at the same time. More recently, authors alluded to it and blamed "milk fever" for being at the origin of dramatic pictures which they described in their novels, like Victor Hugo and Guy de Maupassant, for instance.

  14. Typhoid fever.

    Science.gov (United States)

    Wain, John; Hendriksen, Rene S; Mikoleit, Matthew L; Keddy, Karen H; Ochiai, R Leon

    2015-03-21

    Control of typhoid fever relies on clinical information, diagnosis, and an understanding for the epidemiology of the disease. Despite the breadth of work done so far, much is not known about the biology of this human-adapted bacterial pathogen and the complexity of the disease in endemic areas, especially those in Africa. The main barriers to control are vaccines that are not immunogenic in very young children and the development of multidrug resistance, which threatens efficacy of antimicrobial chemotherapy. Clinicians, microbiologists, and epidemiologists worldwide need to be familiar with shifting trends in enteric fever. This knowledge is crucial, both to control the disease and to manage cases. Additionally, salmonella serovars that cause human infection can change over time and location. In areas of Asia, multidrug-resistant Salmonella enterica serovar Typhi (S Typhi) has been the main cause of enteric fever, but now S Typhi is being displaced by infections with drug-resistant S enterica serovar Paratyphi A. New conjugate vaccines are imminent and new treatments have been promised, but the engagement of local medical and public health institutions in endemic areas is needed to allow surveillance and to implement control measures. Copyright © 2015 Elsevier Ltd. All rights reserved.

  15. Prevalence of antibodies to spotted fever group Rickettsia spp. and Ehrlichia spp. in coyotes (Canis latrans) in Oklahoma and Texas, USA.

    Science.gov (United States)

    Starkey, Lindsay A; West, Misti D; Barrett, Anne W; Saucier, Jill M; O'Connor, Tom P; Paras, Kelsey L; Reiskind, Michael H; Reichard, Mason V; Little, Susan E

    2013-07-01

    Coyotes (Canis latrans) are commonly infested with ticks, including Amblyomma americanum, the predominant vector of Ehrlichia chaffeensis and Ehrlichia ewingii; Dermacentor variabilis, an important vector of Rickettsia rickettsii; and Amblyomma maculatum, a major vector of Rickettsia parkeri, a spotted fever group (SFG) Rickettsia. To determine the degree to which coyotes are infected with or exposed to tick-borne bacterial disease agents, serum samples collected from coyotes in Oklahoma and Texas were tested for antibodies reactive to R. rickettsii, Ehrlichia canis, E. chaffeensis, E. ewingii, Borrelia burgdorferi, and Anaplasma phagocytophilum by indirect fluorescent antibody (IFA) testing or enzyme-linked immunosorbent assay (ELISA). Of the coyotes tested, 60% (46/77) and 64% (47/74) had antibodies reactive to R. rickettsii and E. chaffeensis, respectively, on IFA. Additionally, 5% (4/77) had antibodies reactive to E. canis, but not B. burgdorferi or A. phagocytophilum, on SNAP(®) 4Dx(®) ELISA; subsequent serologic analysis by plate ELISA using species-specific peptides revealed antibodies to E. ewingii, E. canis, and E. chaffeensis in 46% (23/50), 18% (9/50), and 4% (2/50) of serum samples, respectively. Taken together, these data indicate that coyotes in this region are commonly exposed to SFG Rickettsia and E. ewingii and that further consideration of coyotes as a component of the maintenance cycle for these pathogens may be warranted.

  16. Resistance to serum bactericidal activity distinguishes Brazilian purpuric fever (BPF) case strains of Haemophilus influenzae biogroup aegyptius (H. aegyptius) from non-BPF strains. Brazilian Purpuric Fever Study Group.

    OpenAIRE

    Porto, M H; Noel, G J; Edelson, P J

    1989-01-01

    We studied the ability of normal human serum to lyse H. influenzae biogroup aegyptius (H. aegyptius) isolates recovered from patients with Brazilian purpuric fever (BPF clone) or non-BPF clone strains. BPF clone isolates, although similar to non-BPF clone isolates with regard to the ability to fix C3 to their surfaces, could be distinguished from non-BPF clone strains by their resistance to lysis in vitro following incubation with normal adult human serum.

  17. Resistance to serum bactericidal activity distinguishes Brazilian purpuric fever (BPF) case strains of Haemophilus influenzae biogroup aegyptius (H. aegyptius) from non-BPF strains. Brazilian Purpuric Fever Study Group.

    Science.gov (United States)

    Porto, M H; Noel, G J; Edelson, P J

    1989-04-01

    We studied the ability of normal human serum to lyse H. influenzae biogroup aegyptius (H. aegyptius) isolates recovered from patients with Brazilian purpuric fever (BPF clone) or non-BPF clone strains. BPF clone isolates, although similar to non-BPF clone isolates with regard to the ability to fix C3 to their surfaces, could be distinguished from non-BPF clone strains by their resistance to lysis in vitro following incubation with normal adult human serum.

  18. STUDY OF RISK FACTORS AND LABORATORY PROFILE IN UNDER 15 YEARS AGE GROUP CHILDREN WITH ACUTE RHEUMATIC FEVER AND RHEUMATIC HEART DISEASE

    Directory of Open Access Journals (Sweden)

    Ramu

    2015-03-01

    Full Text Available CONTEXT : BACKGROUND : Acute Rheumatic fever / Rheumatic Heart disease is the most common acquired child hood heart disease diagnosis made in India and is consistently associated with poverty and overcrowding. There is no single symptom , sign or laboratory test that is diagnostic of Acute Rheumatic fever and carditis . Revised , edited and updated Jones criteria are guidelines to assist practitioners and are not a substitute for clinical judgment . The main concern in liberalizing these criteria in developed countries may be over diagnosis of Acute Rheumatic fever. AIMS & OBJECTIVES: To study the risk factors and laboratory profile in children with Acute Rheumatic fever / Rheumatic Heart d isease. MATERIALS & METHODS: The Study was conducted for 2 years period in a tertiary care hospital on less than 15 years children diagnosed as Acute Rheumatic fever / Rheumatic Heart disease. RESULTS: In our study all the cases (100% , 36 cases belongs to Lower socio economic status. Overcrowding is noted in all 36 cases (100% and we noticed rural predilection in 91.7% (33 cases cases. CONCLUSION: Basing on the results of our study we conclude that lower socio economic status , overcrowding (100% cases a nd rural predilection (91.7% are frequent associate risk factors of Acute Rheumatic fever / Rheumatic Heart disease. Further we found Anemia (88.89% , positive C.R.P (86.11% , and A.S.O titer more than 400 I.U/ml in (69.44% as common laboratory abnormali ties.

  19. A STUDY OF PROFILE AND PATTERNS OF “JOINT INVOLVEMENT” IN UNDER 15 YEARS AGE GROUP CHILDREN WITH ACUTE RHEUMATIC FEVER AND RHEUMATIC HEART DISEASE

    Directory of Open Access Journals (Sweden)

    Bhavani Shankar

    2015-03-01

    Full Text Available CONTEXT (BACKGROUND: Acute Rheumatic fever / Rheumatic Heart disease is the most common acquired childhood heart disease diagnosis made in India. Poly Arthritis is one of the common manifestations of the disease and making it one among many differential diagnoses for sub - acute arthritis. AIMS & OBJECTIVES: To study the profile and patterns of joint involvement in children with Acute Rheumatic fever / Rheumatic Heart dise ase. MATERIALS & METHODS: The Study was conducted in a tertiary care hospital for 2 years period on less than 15 years children diagnosed as Acute Rheumatic fever / Rheumatic Heart disease as per Jones criteria (U pdated 1992. RESULTS: Joint involvement is one of the common manifestations of Acute Rheumatic fever / Rheumatic Heart disease. In our study Joint involvement is found in 50% cases (18 out of 36 cases i.e., 87.5% (7 out of 8cases of first attack cases and 39.28 %( 11 out 28 cases of reactivation cases. Further we found Polyarthritis is the predominant pattern of joint involvement. CONCLUSION: Basing on the results of our study we conclude that Joint involvement was observed in majority of cases, more so in first attack cases of Acute Rheumatic fever. Further Polyarthritis is the predominant pattern in our study. We found Knee Joint involvement as most common joint to be involved in children with Acute Rheumatic fever / Rheumatic Heart disease.

  20. Antibody to a 145-kilodalton outer membrane protein has bactericidal activity and protective activity against experimental bacteremia caused by a Brazilian purpuric fever isolate of Haemophilus influenzae biogroup aegyptius. The Brazilian Purpuric Fever Study Group.

    Science.gov (United States)

    Rubin, L G; Rizvi, A

    1991-12-01

    The immunologic basis for protection against Brazilian purpuric fever, a septicemic infection associated with Haemophilus influenzae biogroup aegyptius bacteremia, is unknown. Passive immunization of infant rats with antiserum to whole bacterial cells of the homologous strain protects them from experimental bacteremia following bacterial challenge. In immunoblotting, antibody to a 145-kDa protein (P145) was present in protective antisera but not in nonprotective antisera. As judged by analysis of the antibodies eluted from whole bacterial cells and the agglutination of bacteria by antisera to P145, this protein is surface exposed. We prepared monospecific rat antisera to this protein by three methods: (i) immunization with whole bacterial cells and absorption with a Brazilian purpuric fever strain not expressing P145, (ii) immunization with gel-purified P145, and (iii) immunization with a P145-expressing transformant of a laboratory H. influenzae strain expressing this protein and absorption of the antiserum with the laboratory H. influenzae strain. These antisera had low antilipooligosaccharide antibody titers, were reactive only with P145, and had bactericidal activity in vitro. Following passive immunization, these antisera partially protected infant rats from bacteremia resulting from intraperitoneal challenge with bacteria. As assessed by immunoblotting, pooled adult human sera contained antibodies reactive with P145. Antibody to P145 may contribute to protection against Brazilian purpuric fever.

  1. Rickettsial endosymbiont in the "early-diverging" streptophyte green alga Mesostigma viride.

    Science.gov (United States)

    Yang, Ashley; Narechania, Apurva; Kim, Eunsoo

    2016-04-01

    A bacterial endosymbiont was unexpectedly found in the "axenic" culture strain of the streptophyte green alga Mesostigma viride (NIES-995). Phylogenetic analyses based on 16S rRNA gene sequences showed that the symbiont belongs to the order Rickettsiales, specifically to the recently designated clade "Candidatus Megaira," which is closely related to the well-known Rickettsia clade. Rickettsiales bacteria of the "Ca. Megaira" clade are found in a taxonomically diverse array of eukaryotic hosts, including chlorophycean green algae, several ciliate species, and invertebrates such as Hydra. Transmission electron microscopy, fluorescence in situ hybridi-zation, and SYBR Green I staining experiments revealed that the endosymbiont of M. viride NIES-995 is rod shaped, typically occurs in clusters, and is surrounded by a halo-like structure, presumably formed by secretory substances from the bacterium. Two additional M. viride strains (NIES-296 and NIES-475), but not SAG50-1, were found to house the rickettsial endosymbiont. Analyses of strain NIES-995 transcriptome data indicated the presence of at least 91 transcriptionally active genes of symbiont origins. These include genes for surface proteins (e.g., rOmpB) that are known to play key roles in bacterial attachment onto host eukaryotes in related Rickettsia species. The assembled M. viride transcriptome includes transcripts that code for a suite of predicted algal-derived proteins, such as Ku70, WASH, SCAR, and CDC42, which may be important in the formation of the algal-rickettsial association.

  2. Periodic Fever: A Review on Clinical, Management and Guideline for Iranian Patients - Part II

    OpenAIRE

    Ahmadinejad, Zahra; Mansouri, Sedigeh; Ziaee, Vahid; Aghighi, Yahya; Moradinejad, Mohammad-Hassan; Fereshteh-Mehregan, Fatemeh

    2014-01-01

    Periodic fever syndromes are a group of diseases characterized by episodes of fever with healthy intervals between febrile episodes. In the first part of this paper, we presented a guideline for approaching patients with periodic fever and reviewed two common disorders with periodic fever in Iranian patients including familial Mediterranean fever (FMF) and periodic fever syndromes except for periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA). In this part, we revi...

  3. Demgue Fever

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    登革热的病名源于西班牙语,是形容患者由于发烧、关节疼痛导致走路时步履蹒跚、步态造作。研究者根据其症状,称其为"关节热"或"碎骨热"。1869年,英国伦敦皇家内科学会正式将其命名为"登革热"(dengue fever,DF)。

  4. [Typhoid fever].

    Science.gov (United States)

    Marchou, B

    1996-01-15

    Endemic in regions with poor hygienic conditions, Enteric fevers are imported in France by returning travellers. They are caused by Salmonella strains, mainly S. Typhi, transmitted via fecal-oral route. Salmonella reach the blood stream after proliferating in mesenteric lymph nodes. At an initial stage blood and bone marrow cultures, later on Widal-Felix serology permit diagnosis. Antibiotics have rendered death exceptional. Quinolones and ceftriaxone allow treatments shorter than 10 days. Immunization (Typhim Vi) and improvement of hygienic standards are the cornerstone of prevention.

  5. Allergies and Hay Fever

    Science.gov (United States)

    ... an ENT Doctor Near You Allergies and Hay Fever Allergies and Hay Fever Patient Health Information News media interested in covering ... suffer from nasal allergies, commonly known as hay fever. An ear, nose, and throat specialist can help ...

  6. Rocky Mountain Spotted Fever

    Science.gov (United States)

    ... facebook share with twitter share with linkedin Rocky Mountain Spotted Fever Rocky Mountain spotted fever is a ... New Mexico. Why Is the Study of Rocky Mountain Spotted Fever a Priority for NIAID? Tickborne diseases ...

  7. Viral Hemorrhagic Fevers

    Science.gov (United States)

    ... 4 viruses that cause two other hemorrhagic fevers, dengue hemorrhagic fever and yellow fever. Virus Families Information ... 2014 Content source: Centers for Disease Control and Prevention National Center for Emerging and Zoonotic Infectious Diseases ( ...

  8. Dengue Fever Testing

    Science.gov (United States)

    ... AACC products and services. Advertising & Sponsorship: Policy | Opportunities Dengue Fever Testing Share this page: Was this page helpful? Also known as: Dengue Fever Antibodies; Dengue Fever Virus Formal name: Dengue ...

  9. Rickettsia massiliae and Rickettsia conorii Israeli Spotted Fever Strain Differentially Regulate Endothelial Cell Responses.

    Science.gov (United States)

    Bechelli, Jeremy; Smalley, Claire; Milhano, Natacha; Walker, David H; Fang, Rong

    2015-01-01

    Rickettsiae primarily target microvascular endothelial cells. However, it remains elusive how endothelial cell responses to rickettsiae play a role in the pathogenesis of rickettsial diseases. In the present study, we employed two rickettsial species with high sequence homology but differing virulence to investigate the pathological endothelial cell responses. Rickettsia massiliae is a newly documented human pathogen that causes a mild spotted fever rickettsiosis. The "Israeli spotted fever" strain of R. conorii (ISF) causes severe disease with a mortality rate up to 30% in hospitalized patients. At 48 hours post infection (HPI), R. conorii (ISF) induced a significant elevation of IL-8 and IL-6 while R. massiliae induced a statistically significant elevated amount of MCP-1 at both transcriptional and protein synthesis levels. Strikingly, R. conorii (ISF), but not R. massiliae, caused a significant level of cell death or injury in HMEC-1 cells at 72 HPI, demonstrated by live-dead cell staining, annexin V staining and lactate dehydrogenase release. Monolayers of endothelial cells infected with R. conorii (ISF) showed a statistically significant decrease in electrical resistance across the monolayer compared to both R. massiliae-infected and uninfected cells at 72 HPI, suggesting increased endothelial permeability. Interestingly, pharmacological inhibitors of caspase-1 significantly reduced the release of lactate dehydrogenase by R. conorii (ISF)-infected HMEC-1 cells, which suggests the role of caspase-1 in mediating the death of endothelial cells. Taken together, our data illustrated that a distinct proinflammatory cytokine profile and endothelial dysfunction, as evidenced by endothelial cell death/injury and increased permeability, are associated with the severity of rickettsial diseases.

  10. A STUDY OF PROFILE AND PATTERNS OF “JOINT INVOLVEMENT” IN UNDER 15 YEARS AGE GROUP CHILDREN WITH ACUTE RHEUMATIC FEVER AND RHEUMATIC HEART DISEASE

    OpenAIRE

    2015-01-01

    CONTEXT (BACKGROUND): Acute Rheumatic fever / Rheumatic Heart disease is the most common acquired childhood heart disease diagnosis made in India. Poly Arthritis is one of the common manifestations of the disease and making it one among many differential diagnoses for sub - acute arthritis. AIMS & OBJECTIVES: To study the profile and patterns ...

  11. Fever: First Aid

    Science.gov (United States)

    First aid Fever: First aid Fever: First aid By Mayo Clinic Staff A fever is a rise in body temperature. It's usually a sign of infection. The ... 2 C) or higher Should I treat a fever? When you or your child is sick, the ...

  12. Ecology of a tick-borne spotted fever in southern Brazil.

    Science.gov (United States)

    Krawczak, Felipe S; Binder, Lina C; Oliveira, Caroline S; Costa, Francisco B; Moraes-Filho, Jonas; Martins, Thiago F; Sponchiado, Jonas; Melo, Geruza L; Gregori, Fábio; Polo, Gina; Oliveira, Stefan V; Labruna, Marcelo B

    2016-10-01

    Rio Grande do Sul is the southernmost state of Brazil, bordering Uruguay. Clinical cases of spotted fever group (SFG) rickettsiosis were recently reported in Rio Grande do Sul. None of these cases was lethal, and all were confirmed by seroconversion to R. rickettsii antigens. Because serological cross-reactions are well known to occur between different SFG agents, the SFG agent responsible for the clinical cases remains unknown in Rio Grande do Sul, where no rickettsial agent is known to infect ticks. During 2013-2014, ticks and blood sera samples were collected from domestic dogs and wild small mammals, and from the vegetation in a SFG-endemic area of Rio Grande do Sul. Dogs were infested by Amblyomma ovale adult ticks, whereas small mammals were infested by immature stages of A. ovale, Ixodes loricatus, and adults of I. loricatus. Ticks collected on vegetation were adults of A. ovale, and immature stages of A. ovale, Amblyomma dubitatum, and Amblyomma longirostre. Three Rickettsia species were detected: Rickettsia bellii in I. loricatus, Rickettsia amblyommii in A. longirostre, and a Rickettsia parkeri-like agent (Rickettsia sp. strain Atlantic rainforest) in A. ovale. Seroreactivity to SFG antigens were detected in 19.7 % (27/137) canine and 37.5 % (15/40) small mammal sera, with highest titers to R. parkeri. Results indicate that the R. parkeri-like agent, strain Atlantic rainforest, is circulating between A. ovale ticks, dogs and small mammals in the study area, suggesting that this SFG pathogen could be one of the etiological agents of SFG clinical cases in Rio Grande do Sul.

  13. Evidence of acute rickettsioses among patients presumed to have chikungunya fever during the chikungunya outbreak in Sri Lanka.

    Science.gov (United States)

    Premaratna, R; Halambarachchige, L P; Nanayakkara, D M; Chandrasena, T G A N; Rajapakse, R P V J; Bandara, N K B K R G W; de Silva, H J

    2011-12-01

    Chikungunya fever (CGF) and rickettsioses are known to cause acute onset febrile illnesses associated with severe arthritis. Rickettsial arthritis is curable with the use of appropriate anti-rickettsial antibiotics, however the arthritis of CGF tends to have a prolonged course leading to protracted disability. The aim of this study was to investigate the contribution of CGF and rickettsioses to cases of fever and arthritis during a presumed CGF outbreak in Sri Lanka. Fifty-eight consecutive patients with presumed CGF were further investigated to determine the occurrence of rickettsioses among them, and to identify differences in clinical, hematological, and biochemical parameters between the two diseases. Nearly a third of the patients had serological evidence of rickettsioses accounting for their illness. The presence of a late onset major joint arthropathy sparing the small joints of the hands and feet, and the occurrence of a late onset discrete maculopapular rash over the trunk and extremities, suggested rickettsioses over CGF. White blood cell count, erythrocyte sedimentation rate, C-reactive protein, and liver function tests were not helpful in differentiating rickettsioses from CGF. Patients with rickettsioses and arthritis who received an empirical course of doxycycline recovered faster than those who did not receive specific treatment. The establishment of rapid diagnostic methods able to differentiate the etiological agents of fever and arthritis, such as CGF and rickettsioses, would be beneficial in endemic settings. Copyright © 2011 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  14. Fever during anaesthesia.

    Science.gov (United States)

    Negishi, Chiharu; Lenhardt, Rainer

    2003-12-01

    Fever occurs when pyrogenic stimulation activates thermal control centres. Fever is common during the perioperative period, but rare during anaesthesia. Although only a limited number of studies are available to explain how anaesthesia affects fever, general anaesthesia seems to inhibit fever by decreasing the thermoregulatory-response thresholds to cold. Opioids also inhibit fever; however, the effect is slightly less than that of general anaesthesia. In contrast, epidural anaesthesia does not affect fever. This suggests that hyperthermia, which is often associated with epidural infusions during labour or in the post-operative period, may be a true fever caused by inflammatory activation. Accordingly, this fever might be diminished in patients who receive opioids for pain treatment. Post-operative fever is a normal thermoregulatory response usually of non-infectious aetiology. Fever may be important in the host defence mechanisms and should not be routinely treated lest the associated risks exceed the benefits.

  15. The Eurasian otter (Lutra lutra) as a potential host for rickettsial pathogens in southern Italy

    Science.gov (United States)

    D’Alessio, Nicola; Cerrone, Anna; Lucibelli, Maria Gabriella; Borriello, Giorgia; Aloise, Gaetano; Auriemma, Clementina; Riccone, Nunzia; Galiero, Giorgio

    2017-01-01

    Canine monocytic ehrlichiosis and rickettsiosis are zoonotic tick-borne diseases of canids caused by the intracellular obligate bacteria Ehrlichia canis and Rickettsia species respectively. In this study, we investigated using standard and real-time PCR and sequencing, the occurrence and molecular characterization of E. canis and Rickettsia species in the Eurasian otter (Lutra lutra) from the southern Italian population. Samples were screened by using molecular assays also for Neospora caninum, Toxoplasma gondii, Clamydophyla spp., Coxiella burnetii, Leishmania spp., Cryptosporidium spp., and Giardia spp. detection, and helminths were studied by traditional methods. Out of six carcasses tested, three were positive for E. canis and co-infection with Rickettsia sp. occurred in one of those. Sequences of the 16S rRNA E. canis gene were identical to each other but differed from most of those previously found in red foxes (Vulpes vulpes) and wolves (Canis lupus) from southern Italy. Helminths included just cystacanths of Sphaerirostris spp. from the intestine of two Eurasian otters and the nematode Angiostrongylus vasorum from the lungs of a single Eurasian otter. None of the samples was positive for the other investigated selected pathogens. This study is the first report on the evidence of infection by rickettsial pathogens in the Eurasian otter. The present result prompts some inquiries into the pathogenic role of those bacteria for the isolated sub-populations of the endangered Eurasian otter in southern Italy. PMID:28267780

  16. The Eurasian otter (Lutra lutra) as a potential host for rickettsial pathogens in southern Italy.

    Science.gov (United States)

    Santoro, Mario; D'Alessio, Nicola; Cerrone, Anna; Lucibelli, Maria Gabriella; Borriello, Giorgia; Aloise, Gaetano; Auriemma, Clementina; Riccone, Nunzia; Galiero, Giorgio

    2017-01-01

    Canine monocytic ehrlichiosis and rickettsiosis are zoonotic tick-borne diseases of canids caused by the intracellular obligate bacteria Ehrlichia canis and Rickettsia species respectively. In this study, we investigated using standard and real-time PCR and sequencing, the occurrence and molecular characterization of E. canis and Rickettsia species in the Eurasian otter (Lutra lutra) from the southern Italian population. Samples were screened by using molecular assays also for Neospora caninum, Toxoplasma gondii, Clamydophyla spp., Coxiella burnetii, Leishmania spp., Cryptosporidium spp., and Giardia spp. detection, and helminths were studied by traditional methods. Out of six carcasses tested, three were positive for E. canis and co-infection with Rickettsia sp. occurred in one of those. Sequences of the 16S rRNA E. canis gene were identical to each other but differed from most of those previously found in red foxes (Vulpes vulpes) and wolves (Canis lupus) from southern Italy. Helminths included just cystacanths of Sphaerirostris spp. from the intestine of two Eurasian otters and the nematode Angiostrongylus vasorum from the lungs of a single Eurasian otter. None of the samples was positive for the other investigated selected pathogens. This study is the first report on the evidence of infection by rickettsial pathogens in the Eurasian otter. The present result prompts some inquiries into the pathogenic role of those bacteria for the isolated sub-populations of the endangered Eurasian otter in southern Italy.

  17. Genetic Diversity of Tick-Borne Rickettsial Pathogens; Insights Gained from Distant Strains

    Directory of Open Access Journals (Sweden)

    Sebastián Aguilar Pierlé

    2014-01-01

    Full Text Available The ability to capture genetic variation with unprecedented resolution improves our understanding of bacterial populations and their ability to cause disease. The goal of the pathogenomics era is to define genetic diversity that results in disease. Despite the economic losses caused by vector-borne bacteria in the Order Rickettsiales, little is known about the genetic variants responsible for observed phenotypes. The tick-transmitted rickettsial pathogen Anaplasma marginale infects cattle in tropical and subtropical regions worldwide, including Australia. Genomic analysis of North American A. marginale strains reveals a closed core genome defined by high levels of Single Nucleotide Polymorphisms (SNPs. Here we report the first genome sequences and comparative analysis for Australian strains that differ in virulence and transmissibility. A list of genetic differences that segregate with phenotype was evaluated for the ability to distinguish the attenuated strain from virulent field strains. Phylogenetic analyses of the Australian strains revealed a marked evolutionary distance from all previously sequenced strains. SNP analysis showed a strikingly reduced genetic diversity between these strains, with the smallest number of SNPs detected between any two A. marginale strains. The low diversity between these phenotypically distinct bacteria presents a unique opportunity to identify the genetic determinants of virulence and transmission.

  18. [Rheumatic fever].

    Science.gov (United States)

    Cherkashin, D V; Kumchin, A N; Shchulenin, S N; Svistov, A S

    2013-01-01

    This lecture-style paper highlights all major problems pertinent to rheumatic fever Definition of acute RF and chronic rheumatic heart disease is proposed and desirability of the use of these terms in clinical practice is explained. Present-day epidemiology of RF is described with reference to marked differences in its prevalence in developed and developing countries. Modern classification of acute RF is described as adopted by the Russian Association of Rheumatologists and recommended for the use in Russian medical facilities. Discussion of etiological issues is focused on such virulence factors as beta-hemolytic streptococcus A and genetic predisposition confirming hereditary nature of RE Its clinical features are described along with laboratory and instrumental methods applied for its diagnostics. Large and small diagnostic criteria of RF are considered. Special attention is given to the treatment of RF and its complications (antibiotic, pathogenetic, and drug therapy). Its primary and secondary prophylaxis is discussed in detail, preparations for the purpose are listed (with doses and duration of application). In conclusion, criteria for the efficacy of therapy are presented along with indications for hospitalization and emergency treatment.

  19. Clinical manifestations of patients with chikungunya fever at different age groups%不同年龄组基孔肯雅热患者的临床表现比较

    Institute of Scientific and Technical Information of China (English)

    翟洁卿; 吴福全; 黄育波; 李鸿超; 陈桂轩; 林炳亮

    2011-01-01

    目的 分析不同年龄组基孔肯雅热患者的临床表现.方法 130例基孔肯雅热患者,按年龄分为三组:<30岁、30~岁、≥60岁组,分析其临床症状的差异.结果 三组患者均出现发热,皮疹的发生率分别为86.8%、91.4%、90.9%,关节痛的比例分别为86.8%、91.4%、95.5%,关节痛持续时间超过14d的比例分别为2.6%、30.0%、36.4%;与<30岁组比较,30~岁和≥60岁组患者出现关节痛持续时间超过14 d以及累及3个或以上关节的比例高,差异均有统计学意义(x2= 13.026,P=0.001;x2=6.792,P=0.034).结论 基孔肯雅热主要表现为发热、皮疹、关节痛,中、老年组患者出现关节疼痛持续时间较长,累及的关节多.%Objective To analyze clinical manifestations of different age group patients with chikungunya fever. Methods According to the age, 130 patients with chikungunya fever were divided into 3 groups (Group 1: less than thirty years; Group 2: from thirty to fifty-nine years; Group 3; over sixty years). Results All the patients in three groups had fever, and 86.8% of patients in group 1, 91.4% in group 2 and 95.5% in group 3 had rash. The arthralgia rates of group 1, 2 and 3 were 86.8%, 91.4% and 95.5% respectively. And 2.6% of group 1 patients, 30.0% of group 2, and 36.4% of group 3 were persistently with arthralgia more than 14 days. The rates of having arthraglia more than 14 days and not less than 3 joints of patients in group 2 and group 3 were higher than that in group 1 (x2= 13.026, P=0.001; x2=6.792, P=0.034). Conclusion The main symptoms of chikungunya fever were fever, rash and arthralgia. Older patients had a longer time of rathralgia and more joints injured.

  20. Ticks and rickettsial infection in the wildlife of two regions of the Brazilian Amazon.

    Science.gov (United States)

    Soares, Herbert S; Barbieri, Amália R M; Martins, Thiago F; Minervino, Antonio H H; de Lima, Júlia T R; Marcili, Arlei; Gennari, Solange M; Labruna, Marcelo B

    2015-01-01

    During 2009-2012, wild animals and their ticks were sampled in two areas within the Amazon biome of Brazil, in the states of Mato Grosso and Pará. Animal tissues, blood, and ticks were molecularly tested for Rickettsia and Coxiella DNA. A total of 182 wild animals were sampled, comprising 28 mammalian, five avian, and three reptilian species. Animal tissues or blood were all negative for Rickettsia or Coxiella DNA. A total of 454 ticks (22 larvae, 226 nymphs, 127 males, 79 females) were collected from 52 (28.6%) animals, and identified into 15 species: Amblyomma cajennense, A. naponense, A. humerale, A. nodosum, A. goeldii, A. oblongoguttatum, A. longirostre, A. calcaratum, A. coelebs, A. pacae, A. geayii, A. rotundatum, A. auricularium, A. ovale, and Haemaphysalis juxtakochi. While no Coxiella DNA was identified in ticks, six Rickettsia species were detected in the ticks. "Candidatus Rickettsia amblyommii" was the most common agent, detected in four tick species, A. cajennense, A. auricularium, A. longirostre, and A. humerale. The second most common agent, R. bellii, was detected in A. humerale and A. naponense. Rickettsia rhipicephali was detected in H. juxtakochi, and R. felis in A. humerale. Two possible new Rickettsia species were detected in A. naponense ticks, namely, a novel spotted fever group agent close-related to R. africae in Pará, and a novel Canadensis group agent in Mato Grosso. Results of the present study expand our knowledge on the tick fauna, and on the yet infantile knowledge of tick-borne rickettsiae in the Amazon biome.

  1. Typhoid fever and paratyphoid fever: Systematic review to estimate global morbidity and mortality for 2010

    Science.gov (United States)

    Buckle, Geoffrey C.; Walker, Christa L. Fischer; Black, Robert E.

    2012-01-01

    Background Typhoid and paratyphoid fever remain important causes of morbidity worldwide. Accurate disease burden estimates are needed to guide policy decisions and prevention and control strategies. Methods We conducted a systematic literature review of the PubMed and Scopus databases using pre-defined criteria to identify population-based studies with typhoid fever incidence data published between 1980 and 2009. We also abstracted data from annual reports of notifiable diseases in countries with advanced surveillance systems. Typhoid and paratyphoid fever input data were grouped into regions and regional incidence and mortality rates were estimated. Incidence data were extrapolated across regions for those lacking data. Age-specific incidence rates were derived for regions where age-specific data were available. Crude and adjusted estimates of the global typhoid fever burden were calculated. Results Twenty-five studies were identified, all of which contained incidence data on typhoid fever and 12 on paratyphoid fever. Five advanced surveillance systems contributed data on typhoid fever; 2 on paratyphoid fever. Regional typhoid fever incidence rates ranged from typhoid fever episodes in 2010 was 13.5 million (interquartile range 9.1–17.8 million). The adjusted estimate accounting for the low sensitivity of blood cultures for isolation of the bacteria was 26.9 million (interquartile range 18.3–35.7 million) episodes. These findings are comparable to the most recent analysis of global typhoid fever morbidity, which reported crude and adjusted estimates of 10.8 million and 21.7 million typhoid fever episodes globally in 2000. Conclusion Typhoid fever remains a significant health burden, especially in low- and middle-income countries. Despite the availability of more recent data on both enteric fevers, additional research is needed in many regions, particularly Africa, Latin America and other developing countries. PMID:23198130

  2. Heterogeneous Associations of Ecological Attributes with Tick-Borne Rickettsial Pathogens in a Periurban Landscape.

    Science.gov (United States)

    Raghavan, Ram K; Goodin, Douglas G; Dryden, Michael W; Hroobi, Ali; Gordon, David M; Cheng, Chuanmin; Nair, Arathy D; Jakkula, Laxmi U M R; Hanzlicek, Gregg A; Anderson, Gary A; Ganta, Roman R

    2016-09-01

    The variations in prevalence levels of two tick-borne rickettsial pathogens, Ehrlichia chaffeensis and Ehrlichia Ewingii, in a periurban environment were evaluated along with their ecological determinants. Tick life stage and sex, month of tick collection, landscape fragmentation, and ecological covariates specific to pasture and woodland sites were considered as explanatory covariates. Questing lone star ticks (Amblyomma americanum) were collected by flagging for an hour once every week during mid-April through mid-August in years 2013 and 2014. A total of 4357 adult and nymphal ticks (woodland = 2720 and pasture = 1637) were collected and assessed for pathogen prevalence by molecular methods. Female A. americanum ticks were more infected with E. chaffeensis than males or nymphs in woodland areas [♂ = 6.05%; ♀ = 12.0%; nymphs = 2.09%] and pastures [♂ = 8.05%; ♀ = 12.03%; nymphs = 3.33%], and the prevalence was influenced by edge density in the landscape. Higher E. ewingii infection was noted among female A. americanum ticks within woodland areas [♂ = 1.89%; ♀ = 2.14%; nymphs = 1.57%], but no such difference was evident in pastures [♂ = 1.03%; ♀ = 1.33%; nymphs = 1.12%]. Prevalence of E. ewingii was influenced by edge contrast index, and the percentage of pasture perimeter that was less than 20 meters from woodland areas. This study elucidates the complexity of tick-borne pathogen ecology and points to the need for further studies on the role of reservoir hosts, particularly that played by small vertebrates, which is not fully understood in the region.

  3. Evaluation of Children with Recurrent Fever

    Directory of Open Access Journals (Sweden)

    Soner Sertan Kara

    2016-09-01

    Full Text Available Aim: Data on recurrent fever in children is limited. The aim of this study is to evaluate the children with this common symptom. Material and Method: We enrolled 138 patients with frequent fever. Twelve febrile episodes/year was determined as the cut-off for %u201Crecurrent fever%u201D. Children with %u226412 and >12 febrile episodes/year were included in Group I and Group II, respectively. Their demographic data, symptoms, and clinical and laboratory findings were compared. All children were followed for two years for definitive diagnosis.Results: Fifty-four (39.1% children experienced recurrent fever according to our criteria. Group I children experienced more frequent sneezing, whereas Group II children experienced more frequent vomiting compared to the other group (p=0.05 and p=0.02, respectively. Febrile episodes were seen more frequently in the winter season in Group I compared to Group II (p=0.03. Age, sex, other clinical symptoms, physical examination findings, and attendance at day care center/school in two groups were not different. Group II children had higher C-reactive protein levels (p=0.001. There was no difference in other laboratory parameters between the two groups. After two years, two patients in Group II were diagnosed with Familial Mediterranean Fever syndrome and immunoglobulin-G2 subgroup deficiency, while one patient in Group I was diagnosed with periodic fever, aphtous stomatitis, pharyngitis, and adenitis syndrome. Discussion: To investigate only those children presenting with fever episodes of at least once a month may not be discriminative. To construct an algorithm for diagnosis and treatment, it would be better to follow recurrent fever patients for a longer duration rather than initially categorizing them according to the number of episodes.

  4. Familial Mediterranean fever

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/000363.htm Familial Mediterranean fever To use the sharing features on this page, please enable JavaScript. Familial Mediterranean fever (FMF) is a rare disorder passed down through ...

  5. Fever due to levamisole

    Directory of Open Access Journals (Sweden)

    Gupta R

    2003-05-01

    Full Text Available Fever is rarely caused by levamisole. We report a 26-year-old woman who repeatedly developed fever 4-12 hrs after taking levamisole. The association was confirmed by repeated provocation tests.

  6. Q fever in Greenland

    DEFF Research Database (Denmark)

    Koch, Anders; Svendsen, Claus Bo; Christensen, Jens Jorgen

    2010-01-01

    We report a patient with Q fever endocarditis in a settlement in eastern Greenland (Isortoq, Ammassalik area). Likely animal sources include sled dogs and seals. Q fever may be underdiagnosed in Arctic areas but may also represent an emerging infection.......We report a patient with Q fever endocarditis in a settlement in eastern Greenland (Isortoq, Ammassalik area). Likely animal sources include sled dogs and seals. Q fever may be underdiagnosed in Arctic areas but may also represent an emerging infection....

  7. Q fever in Greenland

    DEFF Research Database (Denmark)

    Koch, Anders; Svendsen, Claus Bo; Christensen, Jens Jorgen

    2010-01-01

    We report a patient with Q fever endocarditis in a settlement in eastern Greenland (Isortoq, Ammassalik area). Likely animal sources include sled dogs and seals. Q fever may be underdiagnosed in Arctic areas but may also represent an emerging infection.......We report a patient with Q fever endocarditis in a settlement in eastern Greenland (Isortoq, Ammassalik area). Likely animal sources include sled dogs and seals. Q fever may be underdiagnosed in Arctic areas but may also represent an emerging infection....

  8. [Acute rheumatic fever].

    Science.gov (United States)

    Maier, Alexander; Kommer, Vera

    2016-03-01

    We report on a young women with acute rheumatic fever. Acute rheumatic fever has become a rare disease in Germany, especially in adults. This carries the risk that it can be missed in the differential diagnostic considerations of acute rheumatic disorders and febrile status. If rheumatic fever is not diagnosed and treated correctly, there is a considerable risk for rheumatic valvular heart disease. In this article diagnosis, differential diagnosis and therapy of rheumatic fever are discussed extensively.

  9. Rat Bite Fever

    Science.gov (United States)

    ... Español Text Size Email Print Share Rat Bite Fever Page Content Article Body Rat-bite fever is a disease that occurs in humans who ... ingestion of contaminated food or milk products (Haverhill fever). Most cases in the United States are caused ...

  10. Seasonal Allergies (Hay Fever)

    Science.gov (United States)

    ... 1- to 2-Year-Old Seasonal Allergies (Hay Fever) KidsHealth > For Parents > Seasonal Allergies (Hay Fever) Print A A A What's in this article? ... are at work. Seasonal allergies , sometimes called "hay fever" or seasonal allergic rhinitis, are allergy symptoms that ...

  11. Relapsing fever

    Science.gov (United States)

    ... and Sudan. Famine, war, and the movement of refugee groups often results in LBRF epidemics. Symptoms Symptoms ... be done include: Blood smear to determine the cause of the infection Blood antibody tests (sometimes used, ...

  12. Detection of Rickettsia rickettsii in the tick Amblyomma cajennense in a new Brazilian spotted fever-endemic area in the state of Minas Gerais

    Directory of Open Access Journals (Sweden)

    Elizângela Guedes

    2005-12-01

    Full Text Available The present study evaluated rickettsial infection in Amblyomma spp. ticks collected in a farm in Coronel Pacheco, a Brazilian spotted fever (BSF endemic area. A total of 78 A. cajennense and 78 A. dubitatum free-living adult ticks were collected and tested by polymerase chain reaction (PCR targeting a fragment of the rickettsial gene gltA. Only one pool of three A. cajennense ticks showed the expected product by PCR. This pool was further tested by PCR using sets of primers targeting the rickettsial genes gltA, ompA, and ompB. All reactions yielded the expected bands that by sequencing, showed 100% identity to the corresponding sequences of the Rickettsia rickettsii gene fragments gltA (1063-bp, ompA (457-bp, and ompB (720-bp. The minimal infection rate of R. rickettii in the A. cajennense population was 1.28% (at least one infected tick within 78 ticks.The present study showed molecular evidence for the presence of R. rickettsii in A. cajennense from a BSF-endemic area in Coronel Pacheco, state of Minas Gerais. Although R. rickettsii has been previously reported infecting A. cajennense ticks in Brazil and other Latin American countries, the present study performed the first molecular characterization of R. rickettsii from the tick A. cajennense.

  13. Detection of Rickettsia rickettsii in the tick Amblyomma cajennense in a new Brazilian spotted fever-endemic area in the state of Minas Gerais.

    Science.gov (United States)

    Guedes, Elizângela; Leite, Romário C; Prata, Márcia C A; Pacheco, Richard C; Walker, David H; Labruna, Marcelo B

    2005-12-01

    The present study evaluated rickettsial infection in Amblyomma spp. ticks collected in a farm in Coronel Pacheco, a Brazilian spotted fever (BSF) endemic area. A total of 78 A. cajennense and 78 A. dubitatum free-living adult ticks were collected and tested by polymerase chain reaction (PCR) targeting a fragment of the rickettsial gene gltA. Only one pool of three A. cajennense ticks showed the expected product by PCR. This pool was further tested by PCR using sets of primers targeting the rickettsial genes gltA, ompA, and ompB. All reactions yielded the expected bands that by sequencing, showed 100% identity to the corresponding sequences of the Rickettsia rickettsii gene fragments gltA (1063-bp), ompA (457-bp), and ompB (720-bp). The minimal infection rate of R. rickettii in the A. cajennense population was 1.28% (at least one infected tick within 78 ticks). The present study showed molecular evidence for the presence of R. rickettsii in A. cajennense from a BSF-endemic area in Coronel Pacheco, state of Minas Gerais. Although R. rickettsii has been previously reported infecting A. cajennense ticks in Brazil and other Latin American countries, the present study performed the first molecular characterization of R. rickettsii from the tick A. cajennense.

  14. Molecular characteristics of emerging spotted fever group Rickettsiae and Anaplasma phagocytophilum in Hebei province, China%河北新发斑点热及人粒细胞无形体病实验室调查分析

    Institute of Scientific and Technical Information of China (English)

    孙印旗; 王勇; 姜霞; 姚娜; 钱振宇; 刘晓丽; 陈创夫; 张丽娟

    2015-01-01

    目的:对河北省新发蜱传斑点热群立克次体及人粒细胞无形体进行分子流行病学特征分析。方法对2009-2012年在河北省辛集、迁安及定州市收集的101份临床可疑立克次体病病例急性期血液DNA样本,采用2套巢氏PCR法分别扩增斑点热群立克次体热休克蛋白基因(groEL)和人粒细胞无形体16S rRNA基因并测序,序列采用NCBI网站进行Blast分析后,选择不同地区、不同宿主来源相应基因,使用DNAStar MegAlign同源分析。结果10.9%(11/101)的病例groEL扩增阳性,同源分析当地斑点热群立克次体groEL基因分为2个序列型,尽管有限片段无法区别立克次体种,但PCR阳性病例血清与我国常见黑龙江立克次体、西伯利亚立克次体、海南斑点热群立克次体及蚤传斑点热立克次体无抗原抗体反应,提示可能为新发斑点热。人粒细胞无形体16S rRNA基因扩增阳性率为8.9%(9/101),且病例急性期血清人粒细胞无形体IgM抗体全部阳性,其中3例急性期与恢复期血清发生IgG抗体转换。16S rRNA基因测序成功的9个序列(341 bp)100%同源,并且与该地区无形体病例分离株CZ-HGA-2100%同源。结论河北地区可能存在新发蜱传人粒细胞无形体病例及新发斑点热。加强立克次体实验室诊断及鉴别诊断、进一步开展病原学、相关媒介及宿主流行病学调查均具有重要的临床及公共卫生意义。%Objective To better understand the molecular epidemiological characteristics of emerging spotted fever group Rickettsiae and Anaplasma phagocytophilum identified in Hebei province. Methods One hundred and one clinical probable cases of typhus were collected from Xinji city, Qianan city and Dingzhou city, Hebei province during 2009-2012 and 101 acute stage and 17 convalescence blood samples were collected. Sera separated from blood were used for detecting the IgM and IgG antibodies against

  15. Diagnostic criteria of acute rheumatic fever.

    Science.gov (United States)

    Burke, Rebecca J; Chang, Christopher

    2014-01-01

    Acute rheumatic fever is an inflammatory sequela of Group A Streptococcal pharyngitis that affects multiple organ systems. The incidence of acute rheumatic fever has been declining even before the use of antibiotics became widespread, however the disease remains a significant cause of morbidity and mortality in children, particularly in developing countries and has been estimated to affect 19 per 100,000 children worldwide. Acute rheumatic fever is a clinical diagnosis, and therefore subject to the judgment of the clinician. Because of the variable presentation, the Jones criteria were first developed in 1944 to aid clinicians in the diagnosis of acute rheumatic fever. The Jones criteria have been modified throughout the years, most recently in 1992 to aid clinicians in the diagnosis of initial attacks of acute rheumatic fever and to minimize overdiagnosis of the disease. Diagnosis of acute rheumatic fever is based on the presence of documented preceding Group A Streptococcal infection, in addition to the presence of two major manifestations or one major and two minor manifestations of the Jones criteria. Without documentation of antecedent Group A Streptococcal infection, the diagnosis is much less likely except in a few rare scenarios. Carditis, polyarthritis and Sydenham's chorea are the most common major manifestations of acute rheumatic fever. However, despite the predominance of these major manifestations of acute rheumatic fever, there can be significant overlap with other disorders such as Lyme disease, serum sickness, drug reactions, and post-Streptococcal reactive arthritis. This overlap between disease processes has led to continued investigation of the pathophysiology as well as development of new biomarkers and laboratory studies to aid in the diagnosis of acute rheumatic fever and distinction from other disease processes.

  16. Comparative efficacy of oral rifampin and topical chloramphenicol in eradicating conjunctival carriage of Haemophilus influenzae biogroup aegyptius. Brazilian Purpuric Fever Study Group.

    Science.gov (United States)

    Perkins, B A; Tondella, M L; Bortolotto, I M; Takano, O A; da Silva, G A; Irino, K; Brandileone, M C; Harrison, L H; Wenger, J D; Broome, C V

    1992-09-01

    Persistent conjunctival carriage of the Haemophilus influenzae biogroup aegyptius (Hae) strain (BPF clone) responsible for Brazilian purpuric fever (BPF) has been documented. Topical chloramphenicol is routinely used to treat conjunctivitis in areas affected by BPF in Brazil. Although the BPF clone is susceptible to chloramphenicol, we observed a number of children treated with topical chloramphenicol for conjunctivitis who still developed BPF. During an investigation of an outbreak of BPF in Mato Grosso State, Brazil, we compared oral rifampin (20 mg/kg/day for 4 days) with topical chloramphenicol for eradication of conjunctival carriage of H. influenzae biogroup aegyptius among children with presumed BPF clone conjunctivitis. Conjunctival samples were taken for culture on the day treatment was initiated and a mean of 8 and 21 days later. At 8 days the eradication rates for oral rifampin and topical chloramphenicol were 100 and 44%, respectively (P = 0.003); at 21 days they were 100 and 50% (P = 0.01). Oral rifampin was more effective than topical chloramphenicol for eradication of the BPF clone and may be useful in prevention of BPF.

  17. [Sacroiliitis in familial Mediterranean fever].

    Science.gov (United States)

    Connemann, B J; Steinhoff, J; Benstein, R; Sack, K

    1991-11-22

    A 15-year-old girl of Turkish descent had for one year complained of severe recurrent fever-associated deep back pains. Since she was three years of age she had suffered from repeated attacks of fever and severe abdominal pain which ceased spontaneously in 1-3 days. On physical examination the sacrum and iliosacral joints were very painful to percussion, and she limped. Radiography revealed symmetric destructive sacroiliitis. Despite the unusual location of the arthritis, the triad of fever, abdominal pain and arthritis, as well as her belonging to an ethnic "at risk" group, pointed to the diagnosis of familial mediterranean fever (FML) or recurrent hereditary polyserositis. This diagnosis was confirmed by a positive metaraminol provocation test in that infusion of metaraminol reproduced the typical pains. Collagen diseases, rheumatic disease, acute porphyria and chronic infectious processes were excluded. The sacroiliitis quickly responded to long-term administration of colchicine, 0.5 mg twice daily. The patient also has Hageman factor deficiency whose significance remains unclear.

  18. Effectiveness of fever education in a pediatric emergency department.

    Science.gov (United States)

    Baker, Mark D; Monroe, Kathy W; King, William D; Sorrentino, Annalise; Glaeser, Peter W

    2009-09-01

    This study was designed to assess the impact of a brief educational video shown to parents during an emergency department visit for minor febrile illnesses. We hypothesized that a video about home management of fever would reduce medically unnecessary return emergency department visits for future febrile episodes. A convenience sample of 280 caregivers presenting to one urban pediatric emergency department was enrolled in this prospective, randomized cohort study. All the caregivers presented with a child aged 3 to 36 months with complaint of fever and were independently triaged as nonemergent. A pretest and posttest were administered to assess baseline knowledge and attitudes about fever. One hundred forty subjects were randomized to view either an 11-minute video about home management of fever or a control video about child safety. Subjects were tracked prospectively, and all return visits for fever complaints were independently reviewed by 3 pediatric emergency physicians to determine medical necessity. There were no differences between the fever video and the control groups in baseline demographics (eg, demographically comparable). The fever video group had a significant improvement in several measures relating to knowledge and attitudes about childhood fever. There was no statistical difference between the intervention and control groups in subsequent return visits or in the determination of medical necessity. A brief standardized video about home management of fever improved caregiver knowledge of fever but did not decrease emergency department use or increase medical necessity for subsequent febrile episodes.

  19. African tick bite fever

    DEFF Research Database (Denmark)

    Johansen, Jakob Aaquist; Thybo, Søren

    2011-01-01

    The incident of spotted fever imported to Denmark is unknown. We present a classic case of African Tick Bite Fever (ATBF) to highlight a disease, which frequently infects wildlife enthusiasts and hunters on vacation in South Africa. ATBF has a good prognosis and is easily treated with doxycyclin...

  20. Haemoragisk Rift Valley Fever

    DEFF Research Database (Denmark)

    Fabiansen, Christian; Thybo, Søren

    2007-01-01

    A case of fatal hemorrhagic Rift Valley fever during an epidemic in Kenya's North Eastern Province in January 2007 is described.......A case of fatal hemorrhagic Rift Valley fever during an epidemic in Kenya's North Eastern Province in January 2007 is described....

  1. Rift Valley Fever Virus

    Science.gov (United States)

    Rift Valley fever virus (RVFV) is a mosquito-transmitted virus or arbovirus that is endemic in sub-Saharan Africa. In the last decade, Rift Valley fever (RVF) outbreaks have resulted in loss of human and animal life, as well as had significant economic impact. The disease in livestock is primarily a...

  2. Neonatal typhoid fever.

    OpenAIRE

    Chin, K C; Simmonds, E J; Tarlow, M J

    1986-01-01

    Three infants of Pakistani immigrant mothers developed typhoid fever in the neonatal period. All three survived, but two became chronic excretors of Salmonella typhi. The risk of an outbreak of typhoid fever in a maternity unit or special care baby unit is emphasized.

  3. Rat bite fever.

    NARCIS (Netherlands)

    Gaastra, W.; Boot, R.G.A.; Ho, H.; Lipman, L.J.A.

    2009-01-01

    Rat bite fever (RBF) is a bacterial zoonosis for which two causal bacterial species have been identified: Streptobacillis moniliformis and Spirillum minus. Haverhill fever (HF) is a form of S. moniliformis infection believed to develop after ingestion of contaminated food or water. Here the

  4. Advances in the development of vaccines for dengue fever

    Directory of Open Access Journals (Sweden)

    Simmons M

    2012-05-01

    Full Text Available Monika Simmons1, Nimfa Teneza-Mora1, Robert Putnak21Viral and Rickettsial Diseases Department, Naval Medical Research Center, 2Division of Viral Diseases, Walter Reed Army Institute of Research, Silver Spring, MD, USAAbstract: Dengue fever is caused by the mosquito-borne dengue virus (DENV serotypes 1–4, and is the most common arboviral infection of humans in subtropical and tropical regions of the world. There are currently no prophylaxis or treatment options in the form of vaccines or antivirals, leaving vector control the only method of prevention. A particular challenge with DENV is that a successful vaccine has to be effective against all four serotypes without predisposing for antibody-mediated enhanced disease. In this review, we discuss the current lead vaccine candidates in clinical trials, as well as some second-generation vaccine candidates undergoing preclinical evaluation. In addition, we discuss DENV epidemiology, clinical disease and strategies used for Flavivirus antivirals in the past, the development of new DENV therapeutics, and their potential usefulness for prophylaxis and treatment.Keywords: tetravalent dengue vaccine, live attenuated vaccine, purified inactivated vaccine, DNA vaccine, antibody-dependent enhancement, antivirals

  5. Detection of co-infection with Lyme spirochetes and Spotted fever group rickettsiae in a group of Haemaphysalis longicornis%一组长角血蜱中检出莱姆病螺旋体和斑点热群立克次体复合感染

    Institute of Scientific and Technical Information of China (English)

    孟真; 姜理平; 陆群英; 程苏云; 叶菊莲; 占利

    2008-01-01

    目的 了解浙江省山区野生动物和蜱中莱姆病、斑点热、埃立克体病(无形体病)的感染情况.方法 采用巢式PCR对采集的鼠、蜱标本进行莱姆病伯氏疏螺旋体、斑点热群立克次体、埃立克体(无形体)特异性核酸片段检测分析.结果 从121份鼠标本和105组蜱标本中检出阳性结果 14份.鼠标本中检出伯氏疏螺旋体5S~23S rDNA间隔区片段1份和埃立克体(无形体)16SrDNA 5'端片段2份.蜱标本中检出阳性11份,包括伯氏疏螺旋体5S~23S rDNA间隔区片段3份和斑点热群立克次体外膜蛋白OmpA基因5'端片段8份.其中1组长角血蜱成虫标本为伯氏疏螺旋体和斑点热群立克次体复合感染,5S~23S rRNA基因间隔区和ompA基因片段均阳性,分别与伯氏疏螺旋体法雷氏基因型和马赛立克次体株等关系较近.结论 在同一组长角血蜱成虫中同时检出莱姆病疏螺旋体和斑点热群立克次体复合感染.%Objective The present study was conducted to investigate the infection of Lyme disease, Spotted fever, Ehrlichiosis (anaplasmosisin) in wild animals and ticks in the mountain areas of Zhejiang province. Methods Nested polymerase chain reaction was used to amplify specific DNA sequences of Lyme spirochetes, Spotted fever group rickettsiae, Ehrlichia (anaplasma) from samples of mice and ticks. Results 14 positive samples were identified from 121 mice and 105 groups of ticks. Among mice samples, one positive 5S-23S rDNA intergenic spacer of Borreia burgdorferi and two 5' fragments of Ehrlichia (anaplasma) 16S rDNA were obtained. 11 positive results were detected from tick samples including three 5S-23S rDNA intergenic spacer regions of Borreia burgdorferi and eight 5' fragments of Spotted fever group rickettsiae outer member protein A gene. One group of adult ticks, Haemaphysalis longicornis, which had been collected from eastern mountain area were detected to have co-infected with Lyme spirochetes and

  6. Rickettsial infection in capybaras (Hydrochoerus hydrochaeris) from São Paulo, Brazil: serological evidence for infection by Rickettsia bellii and Rickettsia parkeri.

    Science.gov (United States)

    Pacheco, Richard C; Horta, Mauricio C; Moraes-Filho, Jonas; Ataliba, Alexandre C; Pinter, Adriano; Labruna, Marcelo B

    2007-09-01

    In Brazil, capybaras (Hydrochoerus hydrochaeris) are important hosts for Amblyomma ticks, which in turn can transmit rickettsiae to humans and animals. Therefore, capybaras are potential sentinels for rickettsial infection. The present study evaluated rickettsial infection in capybaras in different areas of the state of São Paulo, where rickettsiosis has never been reported. Materials and methods. Blood sera from 73 capybaras from six localities in São Paulo were tested by indirect immunofluorescence assay using Rickettsia rickettsii, Rickettsia parkeri, and Rickettsia bellii antigens. Capybara spleens were tested by PCR, targeting a fragment of the rickettsial gltA gene. Ticks were collected from each capybara sample and taxonomically identified to species. A total of 94 positively reacting capybara samples, 19 (26.0%), 25 (34.2%), and 50 (68.5%) capybara sera reacted to R. rickettsii, R. parkeri, and R. bellii, respectively. Twenty-five capybara sera showed titers to R. bellii at least four-fold higher than to any of the other two antigens. These sera were considered homologous to R. bellii. Using the same criteria, 3 capybara sera were considered homologous to R. parkeri. No sera were be considered homologous to R. rickettsii. No rickettsial DNA was detected in capybara spleen samples. Ticks collected on capybaras were Amblyomma dubitatum and Amblyomma cajennense. The first evidence is reported of R. bellii natural infection in vertebrate hosts, and the first evidence of R. parkeri infection in capybaras. While R. parkeri is known to infect and cause disease in humans, no similar evidence for human infection has been indicated by R. bellii.

  7. Q fever - early

    Science.gov (United States)

    ... if untreated. Other complications can include: Bone infection ( osteomyelitis ) Brain infection ( encephalitis ) Liver infection (chronic hepatitis) Lung ... 2015:chap 190. Read More Encephalitis Endocarditis Flu Osteomyelitis Pneumonia - adults (community acquired) Q fever Tick bite ...

  8. Dengue hemorrhagic fever

    Science.gov (United States)

    ... that is infected with the virus. The mosquito Aedes aegypti is the main species that spreads this ... especially if you have had dengue fever before. Prevention Because there is no way to prevent dengue ...

  9. Familial Mediterranean Fever

    Science.gov (United States)

    ... don't use genetic tests as the sole method of diagnosing familial Mediterranean fever. There's no cure ... may be options, though these treatments are considered experimental. Other medications include rilonacept (Arcalyst) and anakinra (Kineret). ...

  10. 唐山地区蜱传斑点热群立克次体分子流行病学%Molecular epidemiological of spotted fever group Rickettsia from ticks in Tangshan area

    Institute of Scientific and Technical Information of China (English)

    邹亚学; 贾青辉; 刘朋朋; 刘全; 高宏伟; 陈丽凤

    2011-01-01

    Two sets of specific primers,designed according to 16SrRNA for tick and the OmpA gene specific for spotted fever group Rickettsia(SFGR),were used to amplify 16SrRNA and OmpA gene from DNA samples extracted from Haemaphysalis longicornis in Tangshan area.The positive samples were sequenced and genetically analyzed by establishment of phylogenetic tree.Of 315 samples,25 samples were positive for SFGR and the infection rate reached to 7.94%.Phylogenetic analysis based on nucleotide sequence revealed that all positive strains were related and clustered together with Rickettsia sp.Japanese strain(93.30%),Rickettsia sp.Fujian strain(92.11%),Rickettsia sp.suifen strain(90.45%) and Rickettsia sp.Hulin strain(90.42%).The infection of spotted fever group Rickettsia in Tangshan area was serious,and the bacterium may be a novel species.%根据已发表的长角血蜱16SrRNA序列及斑点热群立克次体外膜蛋白A(OmpA)基因序列设计2对特异性引物,对唐山地区采集的长角血蜱进行PCR检测,并对阳性样本进行测序和序列分析,抽检样本建立分子系统进化树。结果表明,在315份蜱DNA样本中检测出25份阳性样本,阳性率为7.94%;序列分析结果显示唐山地区长角血蜱携带立克次体同处于一个分支,与日本株立克次体同源性最高(93.30%),其次是福建株立克次体(92.11%),黑龙江立克次体绥芬株(90.45%)、虎林株(90.42%)。结论得出唐山地区蜱传斑点热感染较严重,分子进化分析结果显示唐山地区蜱传斑点热群立克次体可能为一新种。

  11. Hepatic involvement in dengue Fever in children.

    Science.gov (United States)

    Jagadishkumar, Kalenahalli; Jain, Puja; Manjunath, Vaddambal G; Umesh, Lingappa

    2012-06-01

    Hepatic dysfunction is common in dengue infection and the degree of liver dysfunction in children varies from mild injury with elevation of transaminases to severe injury with jaundice. This study was undertaken to assess the spectrum of hepatic involvement in dengue infection. 110 children with serologically positive dengue fever aged between 2 months - 14 years were studied for their hepatic functions both clinically and biochemically after excluding malaria, enteric fever, Hepatitis A and Hepatitis B with relevant investigations. All cases were grouped into DF (Dengue fever), DHF (Dengue hemorrhagic fever) and DSS (Dengue shock syndrome) according to WHO criteria. The spectrum of hepatic manifestations included hepatomegaly (79%), hepatic tenderness (56%), jaundice (4.5%), raised levels of aspartate transaminase (AST)(93%), alanine transaminase (ALT)(78%), alkaline phosphatase (AP) (57%), prolonged prothrombin time (PT) (20%), reduced levels of serum albumin (66%) and abnormal abdomen ultrasound (65%). Hepatic dysfunction was observed more in DHF and DSS group compared to DF group. About 17.27% of children had >10 fold increase in the liver enzymes. There was no correlation between the degree of hepatic enlargement or hepatic tenderness with the abnormalities of liver functions. Any child with fever, jaundice and tender hepatomegaly in geographical areas where dengue is endemic, the diagnosis of dengue infection should be strongly considered.

  12. Paracetamol and fever management.

    Science.gov (United States)

    Warwick, C

    2008-11-01

    Paracetamol is one of the most commonly used legal drugs in the western world. Its availability is good, cost is low, and its uses include 'over-the-counter' (OTC) distribution, primary care prescribed therapy, secondary care 'post-operative' application and emergency treatment. Stated benefits of paracetamol include: the drug's analgesic effects, preference to aspirin in avoidance of Reye's syndrome, good patient tolerance, and iatrogenic complications are infrequent and minor. Stated cautions include hepatotoxic effect following minor doses and short duration use and users may incur compromised immune integrity. This paper is concerned with paracetamol's role in fever management. Public concern regarding, in particular, childhood fever and febrile convulsions is largely unwarranted. Despite paracetamol's reputation as a popular fever-reducing agent the drug is poorly effective in the control of febrility and febrile convulsions showing no important advantage compared with placebo. Paracetamol is probably grossly over-prescribed for fever management and its value more perceived than real. Greater efforts are needed to inform patients of the natural benefits of the biological strategy of fever and of the highly limited and in some cases contraindicated use of paracetamol in fever management.

  13. Emergence of Q Fever

    Directory of Open Access Journals (Sweden)

    E Angelakis

    2011-09-01

    Full Text Available Q fever is a worldwide zoonosis with many acute and chronic manifestations caused by the pathogen Coxiella burnetii. Farm animals and pets are the main reservoirs of infection, and transmission to human beings is mainly accomplished through inhalation of contaminated aerosols. Persons at greatest risk are those in contact with farm animals and include farmers, abattoir workers, and veterinarians. The organs most commonly affected during Q fever are the heart, the arteries, the bones and the liver. The most common clinical presentation is an influenza-like illness with varying degrees of pneumonia and hepatitis. Although acute disease is usually self-limiting, people do occasionally die from this condition. Endocarditis is the most serious and most frequent clinical presentation of chronic Q fever. Vascular infection is the second most frequent presentation of Q fever. The diagnosis of Q fever is based on a significant increase in serum antibody titers. The treatment is effective and well tolerated, but must be adapted to the acute or chronic pattern with the tetracyclines to be considered the mainstay of antibiotic therapy. For the treatment of Q fever during pregnancy the use of long-term cotrimoxazole therapy is proposed.

  14. Typhoid fever in Ethiopia.

    Science.gov (United States)

    Beyene, Getenet; Asrat, Daniel; Mengistu, Yohannes; Aseffa, Abrham; Wain, John

    2008-12-01

    This review focuses on the reports of salmonellosis by investigators in different parts of Ethiopia, in particular focusing on the levels of typhoid fever. Many of the reports are published in local journals that are not available online. There have been seven studies which diagnosed typhoid fever by laboratory culture and there is no coordinated epidemiological surveillance. All conducted research and reports from different health institutions in Ethiopia indicate that typhoid fever was still a common problem up to the most recent study in 2000 and that the extensive use of first-line drugs has led to the development of multiple drug resistance. In the sites covered by this review, the total number of published cases of typhoid fever dropped over time reflecting the decline in research capacity in the country. Data on the proportion of patients infected by different serovars of Salmonella suggest that the non-Typhi serovars of Salmonella are increasing. The published evidence suggests that typhoid fever is a current public health problem in Ethiopia although population based surveys, based on good microbiological diagnosis, are urgently needed. Only then can the true burden of enteric fever be estimated and the benefit of public health control measures, such as health education, safe water provision, improved food hygienic practices and eventually vaccination, be properly assessed.

  15. Molecular detection of spotted fever group rickettsia in Dermacentor silvarum from the Xunke Area,China%黑龙江逊克地区森林革蜱斑点热立克次体 DNA的检测

    Institute of Scientific and Technical Information of China (English)

    冯立; 王卓; 杨军; 于淼; 王立强; 邱广斌; 翟如波; 吴益民

    2014-01-01

    目的:调查黑龙江逊克地区蜱传斑点热自然疫源地,发现该地区蜱携带斑点热立克次体的种类。方法采用斑点热立克次体ompA和gltA 基因特异的PCR ,检测该地区森林革蜱的DNA样本,并对扩得阳性产物进行测序和聚类分析。结果从60只森林革蜱中检测有14只扩得斑点热立克次体ompA和gltA 基因片段,阳性率为23.33%。随机选择2只蜱的阳性片段进行测序,二者同源性为100%,ompA基因序列与Rickettsia sp .JL-02同源性为99.30%,与 Rickettsia raoultii为99.18%。结论黑龙江省逊克地区森林革蜱携带与 Rickettsia sp .JL-02株亲缘关系相近的斑点热群立克次体。%To identify the prevalence and the distribution of ticks infected with spotted fever group rickettsiae (SFGR) in Xunke Area of Heilongjiang Province ,China ,partial outer membrane protein A gene (ompA) and citrate synthase gene (gltA) specific fragments were assessed using the PCR method .The positive products were sequenced .Result showed that the pres-ence of SFGR was 14 of 60 in detection Dermacentor silvarum cases ,while the overall positive rate was 23 .33% .Its nucleotide sequence of ompA showed 99 .3% and 99 .18% similarity with nucleotide sequence of Rickettsia sp .JL-02 and Rickettsia rao-ultii respectively .And the evolutionary positions of SFGR species were similar with Rickettsiamontana and Rickettsiamassili-ae .It's concluded that the nature focus of tick-borne spotted fever did exist in the area of Xunke Area of Heilongjiang Province , China .

  16. Matrix-assisted laser desorption ionization-time of flight and comparative genomic analysis of M-18 group a Streptococcus strains associated with an acute rheumatic fever outbreak in northeast Italy in 2012 and 2013.

    Science.gov (United States)

    Gaibani, Paolo; Scaltriti, Erika; Foschi, Claudio; Baggio, Enrico; Tamburini, Maria Vittoria; Creti, Roberta; Pascucci, Maria Grazia; Fagioni, Marco; Ambretti, Simone; Comandatore, Francesco; Pongolini, Stefano; Landini, Maria Paola

    2015-05-01

    Acute rheumatic fever (ARF) is a postsuppurative sequela caused by Streptococcus pyogenes infections affecting school-age children. We describe here the occurrence of an ARF outbreak that occurred in Bologna province, northeastern Italy, between November 2012 and May 2013. Molecular analysis revealed that ARF-related group A Streptococcus (GAS) strains belonged to the M-18 serotype, including subtypes emm18.29 and emm18.32. All M-18 GAS strains shared the same antigenic profile, including SpeA, SpeB, SpeC, SpeL, SpeM, and SmeZ. Matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) analysis revealed that M-18 GAS strains grouped separately from other serotypes, suggesting a different S. pyogenes lineage. Single nucleotide polymorphisms and phylogenetic analysis based on whole-genome sequencing showed that emm18.29 and emm18.32 GAS strains clustered in two distinct groups, highlighting genetic variations between these subtypes. Comparative analysis revealed a similar genome architecture between emm18.29 and emm18.32 strains that differed from noninvasive emm18.0 strains. The major sources of differences between M-18 genomes were attributable to the prophage elements. Prophage regions contained several virulence factors that could have contributed to the pathogenic potential of emm18.29 and emm18.32 strains. Notably, phage ΦSPBO.1 carried erythrogenic toxin A gene (speA1) in six ARF-related M-18 GAS strains but not in emm18.0 strains. In addition, a phage-encoded hyaluronidase gene (hylP.2) presented different variants among M-18 GAS strains by showing internal deletions located in the α-helical and TSβH regions. In conclusion, our study yielded insights into the genome structure of M-18 GAS strains responsible for the ARF outbreak in Italy, thus expanding our knowledge of this serotype.

  17. First case series of emerging Rickettsial neonatal sepsis identified by polymerase chain reaction-based deoxyribonucleic acid sequencing

    Directory of Open Access Journals (Sweden)

    P Aarthi

    2013-01-01

    Full Text Available Purpose: To detect and identify the aetiological agent in the peripheral blood from the cases of neonatal sepsis. Materials and Methods: Four neonates from geographically different regions of South India presented with signs of neonatal sepsis and all the routine clinical and laboratory investigations were performed. Blood culture by Bac T Alert 3D was negative. To establish the aetiology, polymerase chain reaction (PCR for eubacterial genome and subsequent amplification with Gram positive and Gram negative primers were performed followed by deoxyribonucleic acid (DNA sequencing. Results: PCR for the detection of eubacterial genome was positive in all the four neonates and further amplification with designed Gram positive and Gram negative primers revealed the presence of Gram negative bacteria. The amplicons were identified as Orientia tsutsugamushi in three neonates and Coxiella burnetti in the other neonate. Multalin analysis was done to further characterise the strain variation among the three strains. Conclusion: PCR-based DNA sequencing is a rapid and reliable diagnostic tool to identify the aetiological agents of neonatal sepsis. This is the first case series of emerging Rickettsial neonatal sepsis in India .

  18. Behavioral fever in ectothermic vertebrates.

    Science.gov (United States)

    Rakus, Krzysztof; Ronsmans, Maygane; Vanderplasschen, Alain

    2017-01-01

    Fever is an evolutionary conserved defense mechanism which is present in both endothermic and ectothermic vertebrates. Ectotherms in response to infection can increase their body temperature by moving to warmer places. This process is known as behavioral fever. In this review, we summarize the current knowledge on the mechanisms of induction of fever in mammals. We further discuss the evolutionary conserved mechanisms existing between fever of mammals and behavioral fever of ectothermic vertebrates. Finally, the experimental evidences supporting an adaptive value of behavioral fever expressed by ectothermic vertebrates are summarized. Copyright © 2016 Elsevier Ltd. All rights reserved.

  19. Recurrent Fever in Children.

    Science.gov (United States)

    Torreggiani, Sofia; Filocamo, Giovanni; Esposito, Susanna

    2016-03-25

    Children presenting with recurrent fever may represent a diagnostic challenge. After excluding the most common etiologies, which include the consecutive occurrence of independent uncomplicated infections, a wide range of possible causes are considered. This article summarizes infectious and noninfectious causes of recurrent fever in pediatric patients. We highlight that, when investigating recurrent fever, it is important to consider age at onset, family history, duration of febrile episodes, length of interval between episodes, associated symptoms and response to treatment. Additionally, information regarding travel history and exposure to animals is helpful, especially with regard to infections. With the exclusion of repeated independent uncomplicated infections, many infective causes of recurrent fever are relatively rare in Western countries; therefore, clinicians should be attuned to suggestive case history data. It is important to rule out the possibility of an infectious process or a malignancy, in particular, if steroid therapy is being considered. After excluding an infectious or neoplastic etiology, immune-mediated and autoinflammatory diseases should be taken into consideration. Together with case history data, a careful physical exam during and between febrile episodes may give useful clues and guide laboratory investigations. However, despite a thorough evaluation, a recurrent fever may remain unexplained. A watchful follow-up is thus mandatory because new signs and symptoms may appear over time.

  20. Recurrent Fever in Children

    Directory of Open Access Journals (Sweden)

    Sofia Torreggiani

    2016-03-01

    Full Text Available Children presenting with recurrent fever may represent a diagnostic challenge. After excluding the most common etiologies, which include the consecutive occurrence of independent uncomplicated infections, a wide range of possible causes are considered. This article summarizes infectious and noninfectious causes of recurrent fever in pediatric patients. We highlight that, when investigating recurrent fever, it is important to consider age at onset, family history, duration of febrile episodes, length of interval between episodes, associated symptoms and response to treatment. Additionally, information regarding travel history and exposure to animals is helpful, especially with regard to infections. With the exclusion of repeated independent uncomplicated infections, many infective causes of recurrent fever are relatively rare in Western countries; therefore, clinicians should be attuned to suggestive case history data. It is important to rule out the possibility of an infectious process or a malignancy, in particular, if steroid therapy is being considered. After excluding an infectious or neoplastic etiology, immune-mediated and autoinflammatory diseases should be taken into consideration. Together with case history data, a careful physical exam during and between febrile episodes may give useful clues and guide laboratory investigations. However, despite a thorough evaluation, a recurrent fever may remain unexplained. A watchful follow-up is thus mandatory because new signs and symptoms may appear over time.

  1. Influences on parents' fever management: beliefs, experiences and information sources.

    Science.gov (United States)

    Walsh, Anne; Edwards, Helen; Fraser, Jenny

    2007-12-01

    To identify parents' knowledge, beliefs, management and sources of information about fever management. Despite numerous studies exploring parents' management of childhood fever; negative beliefs about fever and overuse of antipyretics and health services for mild fevers and self-limiting viral illnesses continue to be reported. Qualitative design using semi-structured interviews and discussions. Fifteen metropolitan parents whose children were aged six months to five years, volunteered to participate in individual interviews or group discussions. Recruitment was through Playgroup Queensland's online newsletter and letters from two childcare centres to all parents. Verbatim and audio data were collected by an experienced moderator using a semi-structured interview guide. Two transcripts were independently analysed by two researchers; categories, sub-headings and codes were independently developed, crosschecked and found comparable. Remaining transcripts were analysed using developed categories and codes. Fever, determined through behavioural changes, was perceived as 'good', a warning that something was wrong. High fever, reported as 38.0-39.1 degrees C, was considered harmful; it must be prevented or reduced irrespective of concerns about antipyretics. Positive febrile experiences reduced concern about fever. Negative experiences such as febrile convulsions, media reports of harm, not receiving a definitive diagnosis, inaccessibility to regular doctors and receiving conflicting information about fever management increased the concerns. Parents seek information about fever from multiple sources such as doctors, books and other parents. Parents' experiences with and information sources about fever and fever management influenced their knowledge, beliefs and practices. Positive experiences reduce concerns, health service usage and sometimes antipyretic usage. Negative experiences increase concerns, monitoring and antipyretic and health service usage. Health

  2. Yellow fever vaccination in the Americas.

    Science.gov (United States)

    1984-01-01

    Outbreaks of yellow fever in recent years in the Americas have prompted concern about the possible urbanization of jungle fever. Vaccination, using the 17D strain of yellow fever virus, provides an effective, practical method of large scale protection against the disease. Because yellow fever can reappear in certain areas after a 2-year dormancy period, some countries maintain routine vaccination programs in areas where jungle yellow fever is endemic. The size of the endemic area (approximately half of South America), transportation and communication difficulties, and the inability to ensure a reliable cold chain are problems facing these programs. In addition, the problem of reaching dispersed and isolated populations has been addressed by the use of mobile teams, radio monitoring, and educational methods. During yellow fever outbreaks, many countries institute massive vaccination campaigns, targeted at temporary workers and migrants. Because epidemics in South America may involve extensive areas, these campaigns may not effectively address the problem. The ped-o-jet injector method, used in Brazil and Colombia, should be used in outbreak situations, as it is effective for large-scale vaccination. Vaccine by needle, suggested for maintenance programs, should be administered to those above 1 year of age. An efficient monitoring method to avoid revaccination, and to assess immunity, should be developed. The 17D strain produces seroconversion in 95% of recipients, and most is prepared in Brazil and Colombia. But, problems with storage methods, instability in seed lots, and difficulties in large-scale production were identified in 1981 by the Pan American Health Organization and WHO. The group recommended modernization of current production techniques and further research to develop a vaccine that could be produced in cell cultures. Brazil and Colombia have acted on these recommendations, modernizing vaccine production and researching thermostabilizing media for

  3. Natural history of tick-borne spotted fever in the USA. Susceptibility of small mammals to virulent Rickettsia rickettsii.

    Science.gov (United States)

    Burgdorfer, W; Friedhoff, K T; Lancaster, J L

    1966-01-01

    In the ecology of spotted fever rickettsiae, one of the as yet unsolved problems concerns the significance of small animals in the distribution of Rickettsia rickettsii in nature. In the Bitter Root Valley of western Montana, a great variety of rodents, rabbits and hares are known to serve as the preferred hosts for the immature stages of the vector tick, Dermacentor andersoni.The authors analyse the susceptibility of various species of small mammals to virulent R. rickettsii and evaluate their efficiency as sources of infection for larval ticks. The results demonstrate that meadow-mice, Columbian ground-squirrels, golden-mantled ground-squirrels, chipmunks and snowshoe hares (the latter to a lesser extent), when bitten by infected ticks, respond with rickettsiaemias of sufficient length and degree to infect normal larval D. andersoni. High infection rates were obtained in ticks that fed during periods of high rickettsial concentrations in the blood.

  4. A prospective study of fever in the intensive care unit.

    Science.gov (United States)

    Circiumaru, B; Baldock, G; Cohen, J

    1999-07-01

    To determine the epidemiology of fever on the intensive care unit (ICU). Prospective, observational study. Nine-bed general ICU in a 500-bed tertiary care inner city institution. 100 consecutive admissions of 93 patients over a 4-month period between July and October 1996. All patients were seen and examined by one investigator within 24 h of ICU admission. Patients were followed up on a daily basis throughout their ICU stay, and all clinical and laboratory data were recorded during the admission. Fever (core temperature > or = 38.4 degrees C) was present in 70% of admissions, and it was caused by infective and non-infective processes in approximately equal number. Most fevers occurred early in the course of the admission, within the first 1-2 days, and most lasted less than 5 days. The median Acute Physiology and Chronic Health Evaluation (APACHE) II score was 15 (+/- 0.6). The 70 episodes associated with fever at any time were associated with a significantly higher APACHE II score on admission than the afebrile episodes (15.8 +/- 6.1 vs 12.1 +/- 6.7, p = 0.04). The most common cause of non-infective fever was in the group designated post-operative fever (n = 34). All the patients in the post-operative fever group were febrile on day 0 or day 1; their mean admission APACHE score was 12.4 (+/- 4.4) compared to 15.9 (+/- 7.1) for the remaining patients (p = 0.01). Fever alone was not associated with a higher mortality: 26/70 (37%) of febrile patients died, compared to 8/30 (27%) of afebrile patients, (chi 2 = 1.23, p = 0.38). Prolonged fever (> 5 days) occurred in 16 patients. In 13 cases, fever was due to infection, and in the remaining 3 both infective and non-infective processes occurred concurrently. The mortality in the group with prolonged fever was 62.5% (10/16) compared to 29.6% (16/54) in patients with fever of less than 5 days' duration, a highly significant difference (p Fever is a common event on the intensive care unit. It usually occurs early in the

  5. Pathogenesis of Lassa fever.

    Science.gov (United States)

    Yun, Nadezhda E; Walker, David H

    2012-10-09

    Lassa virus, an Old World arenavirus (family Arenaviridae), is the etiological agent of Lassa fever, a severe human disease that is reported in more than 100,000 patients annually in the endemic regions of West Africa with mortality rates for hospitalized patients varying between 5-10%. Currently, there are no approved vaccines against Lassa fever for use in humans. Here, we review the published literature on the life cycle of Lassa virus with the specific focus put on Lassa fever pathogenesis in humans and relevant animal models. Advancing knowledge significantly improves our understanding of Lassa virus biology, as well as of the mechanisms that allow the virus to evade the host's immune system. However, further investigations are required in order to design improved diagnostic tools, an effective vaccine, and therapeutic agents.

  6. Pathogenesis of Lassa Fever

    Directory of Open Access Journals (Sweden)

    David H. Walker

    2012-10-01

    Full Text Available Lassa virus, an Old World arenavirus (family Arenaviridae, is the etiological agent of Lassa fever, a severe human disease that is reported in more than 100,000 patients annually in the endemic regions of West Africa with mortality rates for hospitalized patients varying between 5-10%. Currently, there are no approved vaccines against Lassa fever for use in humans. Here, we review the published literature on the life cycle of Lassa virus with the specific focus put on Lassa fever pathogenesis in humans and relevant animal models. Advancing knowledge significantly improves our understanding of Lassa virus biology, as well as of the mechanisms that allow the virus to evade the host’s immune system. However, further investigations are required in order to design improved diagnostic tools, an effective vaccine, and therapeutic agents.

  7. Vaccines against typhoid fever.

    Science.gov (United States)

    Guzman, Carlos A; Borsutzky, Stefan; Griot-Wenk, Monika; Metcalfe, Ian C; Pearman, Jon; Collioud, Andre; Favre, Didier; Dietrich, Guido

    2006-05-01

    Because of high infectivity and significant disease burden, typhoid fever constitutes a major global health problem. Implementation of adequate food handling practices and establishment of safe water supplies are the cornerstone for the development of an effective prevention program. However, vaccination against typhoid fever remains an essential tool for the effective management of this disease. Currently, there are two well tolerated and effective licensed vaccines. One is based on defined subunit virulence (Vi) polysaccharide antigen and can be administered either intramuscularly or subcutaneously and the other is based on the use of live attenuated bacteria for oral administration. The advantages and disadvantages of the various approaches taken in the development of a vaccine against typhoid fever are discussed, along with the potential for future vaccine candidates.

  8. Vaccines for preventing typhoid fever.

    Science.gov (United States)

    Anwar, Elspeth; Goldberg, Elad; Fraser, Abigail; Acosta, Camilo J; Paul, Mical; Leibovici, Leonard

    2014-01-02

    Typhoid fever and paratyphoid fever continue to be important causes of illness and death, particularly among children and adolescents in south-central and southeast Asia. Two typhoid vaccines are commercially available, Ty21a (oral) and Vi polysaccharide (parenteral), but neither is used routinely. Other vaccines, such as a new, modified, conjugated Vi vaccine called Vi-rEPA, are in development. To evaluate the efficacy and adverse effects of vaccines used to prevent typhoid fever. In June 2013, we searched the Cochrane Infectious Diseases Group Specialized Register, CENTRAL, MEDLINE, EMBASE, LILACS, and mRCT. We also searched relevant conference proceedings up to 2013 and scanned the reference lists of all included trials. Randomized and quasi-randomized controlled trials (RCTs) comparing typhoid fever vaccines with other typhoid fever vaccines or with an inactive agent (placebo or vaccine for a different disease). Two review authors independently applied inclusion criteria and extracted data. We computed vaccine efficacy per year of follow-up and cumulative three-year efficacy, stratifying for vaccine type and dose. The outcome addressed was typhoid fever, defined as isolation of Salmonella typhi in blood. We calculated risk ratios (RRs) and efficacy (1-RR as a percentage) with 95% confidence intervals (CIs). In total, 18 RCTs were included in this review; 12 evaluated efficacy (Ty21a: five trials; Vi polysaccharide: six trials; Vi-rEPA: one trial), and 11 reported on adverse events. Ty21a vaccine (oral vaccine, three doses) A three-dose schedule of Ty21a vaccine prevents around one-third to one-half of typhoid cases in the first two years after vaccination (Year 1: 35%, 95% CI 8% to 54%; Year 2: 58%, 95% CI 40% to 71%; one trial, 20,543 participants; moderate quality evidence; data taken from a single trial conducted in Indonesia in the 1980s). No benefit was detected in the third year after vaccination. Four additional cluster-RCTs have been conducted, but the

  9. Division of the genus Borrelia into two genera (corresponding to Lyme disease and relapsing fever groups) reflects their genetic and phenotypic distinctiveness and will lead to a better understanding of these two groups of microbes (Margos et al. (2016) There is inadequate evidence to support the division of the genus Borrelia. Int. J. Syst. Evol. Microbiol. doi: 10.1099/ijsem.0.001717).

    Science.gov (United States)

    Barbour, Alan G; Adeolu, Mobolaji; Gupta, Radhey S

    2017-01-27

    This rebuttal Letter responds to a Letter in the IJSEM by Margos et al. challenging division of the genus Borrelia into two genera. We discuss here point-by-point the issues raised by Margos et al. and show that much of their criticism is unfounded and in several cases based on misreading of the presented results. We summarize here the extensive evidence based on genomic, genetic and phenotypic properties showing that the members of the family Borreliaceae (containing mainly the genus Borrelia) comprises two distinct and cohesive groups of microbes, differing in diseases they cause and other phenotypes. Prior to the proposed division, Borrelia spp. causing Lyme disease (LD) were already functionally treated as a distinct group, referred to as "B. burgdorferi sensu lato" to distinguish them from the other cluster of Borrelia spp. which includes all known species causing relapsing fever (RF). With the more explicit division of Borreliaceae species into two genus level groups, which are distinguishable from each other based on numerous unique genetic and molecular characteristics, the attention can now be focused on the biological significance of different molecular characteristics differentiating the two groups. The clear distinction of the LD and the RF groups of microbes based on numerous highly reliable markers, which are expected to be present even in uncharacterized members of these two groups, should aid in the improved diagnosis as well treatment of both these diseases, which is hindered by the conflation of a common name for agents causing two different types of diseases.

  10. [Acute fever in children].

    Science.gov (United States)

    Gras-Le Guen, Christèle; Launay, Élise

    2015-05-01

    Fever in children is a very common symptom associated most of the time with a viral infection. However, in 7% of children, fever without source is the first symptom of a serious bacterial infection such as pneumonia, meningitis, pyelonephritis or bacteremia. The key point in clinical examination of these children is the early identification of toxic signs. Because SBI prevalence is higher in very young children (1-3 month-aged), they required a specific management with some systematic complementary investigations and a broad indication of probabilistic antibiotherapy treatment.

  11. [Fever of unknown origin].

    Science.gov (United States)

    Salzberger, B; Müller-Schilling, M; Fleck, M

    2013-04-01

    Fever of unknown origin (FUO) is defined as sustained unexplained fever despite intensive diagnostic evaluation and represents a particular diagnostic challenge. It can be classified into different categories, e.g. classical, nosocomial, neutropenic and HIV-associated FUO, which is based on the patient-specific clinical and immunological situation. Infections, malignant diseases and non-infectious inflammatory diseases have to be considered as the most important causes of FUO; however, no definitive diagnosis can be established in a substantial number of FUO patients despite an extensive diagnostic work-up. The present review focuses on the important diagnostic aspects as well as therapeutic options in FUO patients.

  12. [What is happening to acute rheumatic fever?].

    Science.gov (United States)

    Stéphan, J L

    1994-12-01

    Rheumatic fever is an inflammatory disease of the heart, joints, central nervous system and subcutaneous tissues that develops after a nasopharyngeal infection by one of the group A beta-haemolytic streptococci. The pathogenesis remains an enigma. As the disease has been less florid and some of the more characteristic manifestations less common in developed countries, it has become more difficult to establish the diagnosis on clinical grounds. Rheumatic fever and its sequellae are still active in developing countries. Carditis is a dominant feature of this social disease. Renewed educational efforts concerning this preventable disorder are needed among both physicians and the public.

  13. Marburg Hemorrhagic Fever (Marburg HF)

    Science.gov (United States)

    ... CDC Cancel Submit Search The CDC Marburg hemorrhagic fever (Marburg HF) Note: Javascript is disabled or is ... first recognized in 1967, when outbreaks of hemorrhagic fever occurred simultaneously in laboratories in Marburg and Frankfurt, ...

  14. Crimean-Congo Haemorrhagic Fever

    Science.gov (United States)

    ... Questions & answers Features Multimedia Contacts Crimean-Congo haemorrhagic fever Fact sheet N°208 January 2013 Key facts ... the principal tick vector. The Crimean-Congo haemorrhagic fever virus in animals and ticks The hosts of ...

  15. Typhoid Fever, Below the Belt

    National Research Council Canada - National Science Library

    Raveendran, Kamakshi Mahadevan; Viswanathan, Stalin

    2016-01-01

    ... (sexually transmitted infections) aetiologies. Typhoid fever is endemic in the tropics. Except "rose spots", skin manifestations in typhoid fever are unusual, and they are missed due to pigmented skin...

  16. Q Fever: Statistics and Epidemiology

    Science.gov (United States)

    ... Statistics Reporting and In-Depth Information Other Ricketssial Zoonosis Diseases Anaplasmosis Ehrlichiosis Other Spotted Fever Rocky Mountain ... 60–64 years. Top of Page Other Ricketssial Zoonosis Diseases Anaplasmosis Ehrlichiosis Other Spotted Fever Rocky Mountain ...

  17. Q Fever Update, Maritime Canada

    Science.gov (United States)

    Marrie, Thomas J.; Campbell, Nancy; McNeil, Shelly A.; Webster, Duncan

    2008-01-01

    Since the 1990s, reports of Q fever in Nova Scotia, Canada, have declined. Passive surveillance for Q fever in Nova Scotia and its neighboring provinces in eastern Canada indicates that the clinical manifestation of Q fever in the Maritime provinces is pneumonia and that incidence of the disease may fluctuate. PMID:18258080

  18. Fever in acute pulmonary embolism.

    Science.gov (United States)

    Stein, P D; Afzal, A; Henry, J W; Villareal, C G

    2000-01-01

    Although fever has been reported in several case series of acute pulmonary embolism (PE), the extent to which fever may be caused by PE, and not associated disease, has not been adequately sorted out. Clarification of the frequency and severity of fever in acute PE may assist in achieving an accurate clinical impression, and perhaps avoid an inadvertent exclusion of the diagnosis. The purpose of this investigation is to evaluate the extent to which fever is caused by acute PE. Patients participated in the Prospective Investigation of Pulmonary Embolism Diagnosis (PIOPED). Temperature was evaluated among patients with angiographically proven PE. A determination of whether other causes of fever were present was based on a retrospective analysis of discharge summaries, PIOPED summaries, and a computerized list of all discharge diagnoses. Among patients with PE and no other source of fever, fever was present in 43 of 311 patients (14%). Fever in patients with pulmonary hemorrhage or infarction was not more frequent than among those with no pulmonary hemorrhage or infarction, 39 of 267 patients (15%) vs 4 of 44 patients (9%; not significant). Clinical evidence of deep venous thrombosis was often present in patients with PE and otherwise unexplained fever. Low-grade fever is not uncommon in PE, and high fever, although rare, may occur. Fever need not be accompanied by pulmonary hemorrhage or infarction.

  19. Hereditary periodic fever syndromes

    NARCIS (Netherlands)

    McDermott, MF; Frenkel, J

    Hereditary periodic fever syndromes are defined by recurrent attacks of generalised inflammation for which no infectious or auto-immune cause can be identified. For most of these disorders, the molecular basis has recently been elucidated. This has opened the prospect of novel therapeutic

  20. Fever of unknown origin

    NARCIS (Netherlands)

    Mulders-Manders, C.; Simon, A.; Bleeker-Rovers, C.P.

    2015-01-01

    More than 50 years after the first definition of fever of unknown origin (FUO), it still remains a diagnostic challenge. Evaluation starts with the identification of potential diagnostic clues (PDCs), which should guide further investigations. In the absence of PDCs a standardised diagnostic

  1. Breathing Valley Fever

    Centers for Disease Control (CDC) Podcasts

    2014-02-04

    Dr. Duc Vugia, chief of the Infectious Diseases Branch in the California Department of Public Health, discusses Valley Fever.  Created: 2/4/2014 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 2/5/2014.

  2. Lithotrites and postoperative fever

    DEFF Research Database (Denmark)

    Chu, David I; Lipkin, Michael E; Wang, Agnes J

    2013-01-01

    OBJECTIVE: To compare the risks of fever from different lithotrites after percutaneous nephrolithotomy (PNL). MATERIALS AND METHODS: The Clinical Research Office of the Endourological Society (CROES) PNL database is a prospective, multi-institutional, international PNL registry. Of 5,803 total pa...

  3. [Fever without focus and fever of unknown origin in childhood].

    Science.gov (United States)

    Ritz, Nicole

    2013-01-30

    Fever is one of the most common presenting symptoms in children. In the majority of cases the underlying cause is easily diagnosed and if necessary a treatment initiated. In case of absent localising symptoms and signs (fever without a focus) investigations rapidly need to be undertaken in particular in newborns and infants. Persisting daily fever for more than two weeks are called fever of unknown origin. Diagnosis of etiology of fever of unknown origin is challenging. In approximately half of the cases an infectious cause is found; inflammatory and mailgnant diseases account for 5 to 10% of the cases. Despite a systematic and interdisciplinary approach the etiology remains unknown in up to a quarter of cases. This review discusses differential diagnoses, suggested investigations and treatment for fever without a focus and fever of unknown origin.

  4. Detection and identification of Rickettsia and rickettsial diseases%立克次体与立克次体病的检测与鉴定

    Institute of Scientific and Technical Information of China (English)

    张骁鹏; 李炘檑; 郑波; 胡晓梅

    2015-01-01

    立克次体是一类严格细胞内寄生的原核细胞型微生物,已被列入生物战剂名录。立克次体病是一类严重威胁人类健康的人兽共患的自然疫源性疾病。立克次体严格的细胞寄生性决定了立克次体病的诊断不同于传统方法,需根据流行病学资料、临床症状和体征及实验室检测进行综合判断,通常实验室检测是明确诊断的主要依据。从病原体的分离和培养到目前的基因水平比对,立克次体的检测技术虽发展了100多年,但人类尚未实现早期快速诊断立克次体病的目标。本文主要综述了立克次体与立克次体病检测与鉴定的研究进展。%Rickettsia is an obligate intracellular parasitic bacterium which has been included in the list of biowarfare agents .Rickettsial diseases are zoonotic ,natural focal diseases ,and also threats to human health seriously .Different from the standard detection methods for other bacteria , the diagnosis of rickettsial diseases needs a collective consideration of the epidemiological data ,clinical symptoms and laboratory test results .Although Rickettsia detection technology has been developed for more than 100 years ,early rapid diagnosis is still difficult . Current progresses on Rickettsia and rickettsial disease detection , including pathogen isolation and molecular detections ,are reviewed in this paper .

  5. Fever of unknown origin in elderly patients

    Directory of Open Access Journals (Sweden)

    Turkulov Vesna

    2011-01-01

    Full Text Available Introduction. Causes of fever of unknown origin are different. It is considered that it can be caused with over 200 different clinical entities. Aetiological causes differ according to different categories of age. Febricity in the elderly is at most the result of autoimmune processes, malignancies, bacterial infections and vasculitis. Objective. The aim of this study was to determine the most common characteristics of fever, the most common laboratory, bacterial and viral tests and to analyze applied therapy in patients with unknown febrile state, and to affirm final diagnosis in elderly patients, as well as younger than 65 years old, and to define outcome of disease in both groups of patients. Methods. Research comprised 100 patients who had been treated at the Infectious Disease Clinic of the Clinical Centre of Vojvodina in Novi Sad, during a three-year period, and in whom fever of unknown origin had been diagnosed. Patients were divided into two homogenous groups of 50 people. The first one (S consisted of patients older than 65 years, and the second, control group (K was constituted of patients younger than the age of 65. All of them were chosen by random sample method. Results. Average results of standard laboratory parameters of infection were obtained, such as erythrocyte sedimentation rate (ESR, fibrinogen, CRP, and especially leukocyte, and those were significantly higher in the group of elderly patients. The cause had not been found in 10% of elderly patient group, and in the younger group, not even in the third of patients. Among known causative agents dominant were infections, usually of respiratory and urinary tract, in both tested groups. Even 28% of the elderly had sepsis, and 10% endocarditis. Malignant diseases were more frequent in group of the elderly patients, and immune i.e. systematic disorders were evenly noticed in both groups of patients. Conclusion. Despite advanced studies in medicine, and existence of modern

  6. Laboratory Validation of the Sand Fly Fever Virus Antigen Assay

    Science.gov (United States)

    2015-12-01

    TOSV), sandfly fever Sicilian virus (SFSV), sandfly fever Naples virus (SFNV), and Punta Toro virus (Tesh 1988, Alkan et al. 2013). These viruses pose a...SFFVA against arthropod- borne phleboviruses that are not members of the SF virus group (Heartland viruses ) or are members of the SF virus group but not...less virus in wild infected flies. The proprietary grinding solution provided with the kit will inactivate most arbo- viruses , preventing them

  7. Fever of unknown origin.

    Science.gov (United States)

    Mulders-Manders, Catharina; Simon, Anna; Bleeker-Rovers, Chantal

    2015-06-01

    More than 50 years after the first definition of fever of unknown origin (FUO), it still remains a diagnostic challenge. Evaluation starts with the identification of potential diagnostic clues (PDCs), which should guide further investigations. In the absence of PDCs a standardised diagnostic protocol should be followed with PET-CT as the imaging technique of first choice. Even with a standardised protocol, in a large proportion of patients from western countries the cause for FUO cannot be identified. The treatment of FUO is guided by the final diagnosis, but when no cause is found, antipyretic drugs can be prescribed. Corticosteroids should be avoided in the absence of a diagnosis, especially at an early stage. The prognosis of FUO is determined by the underlying cause. The majority of patients with unexplained FUO will eventually show spontaneous remission of fever. We describe the definition, diagnostic workup, causes and treatment of FUO. © Royal College of Physicians 2015. All rights reserved.

  8. Ebola haemorrhagic fever

    Science.gov (United States)

    Feldmann, Heinz; Geisbert, Thomas W

    2012-01-01

    Ebola viruses are the causative agents of a severe form of viral haemorrhagic fever in man, designated Ebola haemorrhagic fever, and are endemic in regions of central Africa. The exception is the species Reston Ebola virus, which has not been associated with human disease and is found in the Philippines. Ebola virus constitutes an important local public health threat in Africa, with a worldwide effect through imported infections and through the fear of misuse for biological terrorism. Ebola virus is thought to also have a detrimental effect on the great ape population in Africa. Case-fatality rates of the African species in man are as high as 90%, with no prophylaxis or treatment available. Ebola virus infections are characterised by immune suppression and a systemic inflammatory response that causes impairment of the vascular, coagulation, and immune systems, leading to multiorgan failure and shock, and thus, in some ways, resembling septic shock. PMID:21084112

  9. Molecular identification of rickettsial endosymbionts in the non-phagotrophic volvocalean green algae.

    Directory of Open Access Journals (Sweden)

    Kaoru Kawafune

    Full Text Available BACKGROUND: The order Rickettsiales comprises gram-negative obligate intracellular bacteria (also called rickettsias that are mainly associated with arthropod hosts. This group is medically important because it contains human-pathogenic species that cause dangerous diseases. Until now, there has been no report of non-phagotrophic photosynthetic eukaryotes, such as green plants, harboring rickettsias. METHODOLOGY/PRINCIPAL FINDINGS: We examined the bacterial endosymbionts of two freshwater volvocalean green algae: unicellular Carteria cerasiformis and colonial Pleodorina japonica. Epifluorescence microscopy using 4'-6-deamidino-2-phenylindole staining revealed the presence of endosymbionts in all C. cerasiformis NIES-425 cells, and demonstrated a positive correlation between host cell size and the number of endosymbionts. Strains both containing and lacking endosymbionts of C. cerasiformis (NIES-425 and NIES-424 showed a >10-fold increase in cell number and typical sigmoid growth curves over 192 h. A phylogenetic analysis of 16 S ribosomal (rRNA gene sequences from the endosymbionts of C. cerasiformis and P. japonica demonstrated that they formed a robust clade (hydra group with endosymbionts of various non-arthropod hosts within the family Rickettsiaceae. There were significantly fewer differences in the 16 S rRNA sequences of the rickettsiacean endosymbionts between C. cerasiformis and P. japonica than in the chloroplast 16 S rRNA or 18 S rRNA of the host volvocalean cells. Fluorescence in situ hybridization demonstrated the existence of the rickettsiacean endosymbionts in the cytoplasm of two volvocalean species. CONCLUSIONS/SIGNIFICANCE: The rickettsiacean endosymbionts are likely not harmful to their volvocalean hosts and may have been recently transmitted from other non-arthropod organisms. Because rickettsias are the closest relatives of mitochondria, incipient stages of mitochondrial endosymbiosis may be deduced using both strains with

  10. Korean Hemorrhagic Fever.

    Science.gov (United States)

    1981-03-31

    infectious virus was present in this organ at least 440 days after infection. Virus was recovered from kidney and parotid glands from about 15 to 43...beginning 10-15 days after inoculation. This type of host response provides excellent experimental evidence confirming the long-held epidemiological ...30. Vasyuta, Yu, S. The epidemiology of haemorrhagic fever with renal syndrome in the E.S.F.S.R.Zh. Mikrobiol. Epidemiol. Immunol., 32: 49-56, 1961. 31

  11. Understanding rheumatic fever.

    Science.gov (United States)

    Azevedo, Pedro Ming; Pereira, Rosa Rodrigues; Guilherme, Luiza

    2012-05-01

    Through a comprehensive review of the recent findings on rheumatic fever, we intend to propose a new physiopathologic model for this disease. A Medline search was performed for all articles containing the terms rheumatic fever or rheumatic heart disease in title or abstract from 1970 to 2011. Best evidence qualitative technique was used to select the most relevant. The scientific interest on rheumatic fever has notably diminished throughout the twentieth century as evidenced by the comparison of the proportion of articles in which RF was a subject in 1950 (0.26%) and today (0.03%) [Pubmed]. However, RF remains a major medical and social problem in the developing world and in the so-called hotspots, where it still causes around 500.000 deaths each year, not too different from the pre-antibiotic era. The role of genetic factors in RF susceptibility is discussed. Familiar aggregation, similarity of disease patterns between siblings, identical twin, and HLA correlation studies are evidence for a genetic influence on RF susceptibility. The suspect-involved genes fall mainly into those capable of immunologic mediation. Molecular mimicry explains the triggering of RF, but an intense and sustained inflammation is needed to cause sequels. Also, RF patients vary greatly in terms of symptoms. It is likely that a genetic background directing immune response towards a predominantly Th1 or Th2 pattern contributes to these features. The recent findings on rheumatic fever provide important insight on its physiopathology that helps understanding this prototype post-infectious autoimmune disease giving insights on other autoimmune conditions.

  12. Epidural Analgesia and Fever at Labor

    Directory of Open Access Journals (Sweden)

    Ye. M. Shifman

    2008-01-01

    Full Text Available Objective: to study the incidence of labor fever under epidural analgesia (EA and to evaluate its impact on the courses of puerperium and early neonatality. Subjects and methods. The paper presents the data of a prospective study of the course of labor, puerperium, and early neonatality in 397 women in whom labors occurred at the Republican Peritoneal Center in 2006. A study group included 324 parturients in whom labor pain was relieved by EA. A comparison group comprised 55 parturients in whom no analgesics were used at labor. Results. There were no significant statistical differences between the groups in the incidence of labor fever and complicated puerperium and in that of neonatal pyoseptic diseases. Key words: labor hyperthermia, epidural analgesia, labor pain relief.

  13. A Q fever case mimicking crimean-congo haemorrhagic fever

    Directory of Open Access Journals (Sweden)

    O Karabay

    2011-01-01

    Full Text Available Coxiella burnetii is the bacterium that causes Q fever. Human infection is mainly transmitted from cattle, goats and sheep. The disease is usually self-limited. Pneumonia and hepatitis are the most common clinical manifestations. In this study, we present a case of Q fever from the western part of Turkey mimicking Crimean-Congo haemorrhagic fever (CCHF in terms of clinical and laboratory findings.

  14. Hemorrhagic Fever with renal syndrome and its history in Iran.

    Science.gov (United States)

    Ardalan, Mohammadreza; Chinikar, Sadegh; Mohajel Shoja, Mohammadali

    2014-11-01

    Hemorrhagic fever with renal syndrome (HFRS) is a serious human disease of zoonotic viral origin. A group of different viruses that belong to the family of hemorrhagic fever could represent with HFRS. The basic pathophysiologic feature is virus-induced leaky microcirculation. There is no effective antiviral treatment against them. Because of rapid environmental changes, global warming, and increased global traveling, different hemorrhagic fever syndromes could be found anywhere in the world and beyond their old endemic borders. This review is a brief overview of HFRS in Iran during the early and mid-twentieth century.

  15. Sadfly fever: two case reports.

    Science.gov (United States)

    Özkale, Yasemin; Özkale, Murat; Kiper, Pinar; Çetinkaya, Bilin; Erol, İlknur

    2016-06-01

    Sandfly fever, also known as 'three-day fever' or 'pappataci fever' or 'Phlebotomus fever' is a viral infection that causes self-limited influenza-like symptoms and characterized by a rapid onset. The disease occurs commonly in endemic areas in summer months and especially in August during which sandflies are active. In this article, two siblings who presented with high fever, redness in the eyes, headache, weakness, malaise and inability to walk, who were found to have increased liver function tests and creatine kinase levels and who were diagnosed with sadfly fever with positive sadfly IgM and IgG antibodies are reported because of the rarity of this disease.

  16. [Prospective study of patients with prolonged fever].

    Science.gov (United States)

    Calderón, E; Legorreta, J; Sztabinski, G; Hernández, M; Wilkins, A; Gómez, D; Dávila, A

    1975-01-01

    A prospective study was made in 283 patients who attended IMAN's Children's Hospital, with fever the main symptom. A clinical and paraclinical procedure was designed for the study of each patient. 112 patients were eliminated because they did not follow the established criteria. All patients had acute infectious diseases considered trivial; 85% were 3 weeks to 2 years of age. They all had an antibacterial treatment without precise diagnosis. It was considered that on admission the patients showed a normal course in the natural history of the basic disease. The study group included 171 patients 2 months to 13 years of age; 62.5% had fever due to infection, 12.2% to collagenopathies, 7% to neoplasias 5.2% to miscellaneous causes and 12.8% were not diagnosed. The most common infectious causes for prolonged fever were tuberculosis, upper respiratory infections, amoebic liver abscess, typhoid fever and malaria. Careful questioning and clinical examination were enough to enlighten diagnosis in more than 80% of the patients.

  17. Chikungunya fever presenting with protracted severe pruritus.

    Science.gov (United States)

    Cunha, Burke A; Leonichev, Victoria B; Raza, Muhammad

    2016-01-01

    Travelers returning from the tropics often present with rash/fever. Those with rash/fever and myalgias/arthralgias are most likely due to chikungunya fever, dengue fever, or Zika virus. In these arthropod viral transmitted infections, the rash may be pruritic. The case presented here is that of chikungunya fever remarkable for the intensity and duration of her pruritis.

  18. Post-operative fever in orthopaedic surgery: How effective is the 'fever workup?'

    Science.gov (United States)

    Ashley, Blair; Spiegel, David A; Cahill, Patrick; Talwar, Divya; Baldwin, Keith D

    2017-01-01

    Defining the appropriate threshold at which to initiate a fever workup is imperative to promote patient safety, appropriate resource utilization, and antibiotic stewardship. Our group performed a systematic review of the available literature on perioperative fever (POF) workups in orthopaedic patients to evaluate the frequency, timing and utility of blood cultures (BC) and other investigations in the POF workup, to determine the clinical relevance of any infections and to evaluate their cost effectiveness. Studies were identified by searching MEDLINE, EMBASE, Pubmed, Cochrane and Google Scholar for articles through September 2016. Forty-nine articles were retrieved and 22 articles met the pre-determined inclusion criteria. Proportions of positive studies were noted and averaged using random effects analysis. Post-operative pyrexia ranged in prevalence between 8.1% and 87.3%. The studies routinely performed during a fever workup had wide ranges of diagnostic yield, including chest X-rays from 0% to 40%, urinalyses from 8.2% to 38.7%, urine cultures from 0% to 22.4% and BC from 0% to 13.3%. Only two patients with positive BC developed clinical sepsis. Cost per fever evaluation ranged from $350 to $950. The findings of this review suggest that early post-operative fever is an expected event following orthopaedic surgery. Based on the available literature, any kind of workup in the absence of localizing symptoms in the third post-operative day or before is unwarranted and is an inappropriate use of hospital resources.

  19. Retrospective Examination of Q Fever Endocarditis: An Underdiagnosed Disease in the Mainland of China

    Science.gov (United States)

    Han, Xiao; Hsu, Jeffrey; Miao, Qi; Zhou, Bao-Tong; Fan, Hong-Wei; Xiong, Xiao-Lu; Wen, Bo-Hai; Wu, Lian; Yan, Xiao-Wei; Fang, Quan; Chen, Wei

    2017-01-01

    Background: Q fever endocarditis, a chronic illness caused by Coxiella burnetii, can be fatal if misdiagnosed or left untreated. Despite a relatively high positive rate of Q fever serology in healthy individuals in the mainland of China, very few cases of Q fever endocarditis have been reported. This study summarized cases of Q fever endocarditis among blood culture negative endocarditis (BCNE) patients and discussed factors attributing to the low diagnostic rate. Methods: We identified confirmed cases of Q fever endocarditis among 637 consecutive patients with infective endocarditis (IE) in the Peking Union Medical College Hospital between 2006 and 2016. The clinical findings for each confirmed case were recorded. BCNE patients were also examined and each BCNE patient's Q fever risk factors were identified. The risk factors and presence of Q fever serologic testing between BCNE patients suspected and unsuspected of Q fever were compared using the Chi-squared or Chi-squared with Yates’ correction for continuity. Results: Among the IE patients examined, there were 147 BCNE patients, of whom only 11 patients (7.5%) were suspected of Q fever and undergone serological testing for C. burnetii. Six out of 11 suspected cases were diagnosed as Q fever endocarditis. For the remaining136 BCNE patients, none of them was suspected of Q fever nor underwent relevant testing. Risk factors for Q fever endocarditis were comparable between suspected and unsuspected patients, with the most common risk factors being valvulopathy in both groups. However, significantly more patients had consulted the Infectious Diseases Division and undergone comprehensive diagnostic tests in the suspected group than the unsuspected group (100% vs. 63%, P = 0.03). Conclusions: Q fever endocarditis is a serious yet treatable condition. Lacking awareness of the disease may prevent BCNE patients from being identified, despite having Q fever risk factors. Increasing awareness and guideline adherence are

  20. Fever in the pediatric patient.

    Science.gov (United States)

    Wing, Robyn; Dor, Maya R; McQuilkin, Patricia A

    2013-11-01

    Fever is the most common reason that children and infants are brought to emergency departments. Emergency physicians face the challenge of quickly distinguishing benign from life-threatening conditions. The management of fever in children is guided by the patient's age, immunization status, and immune status as well as the results of a careful physical examination and appropriate laboratory tests and radiographic views. In this article, the evaluation and treatment of children with fevers of known and unknown origin are described. Causes of common and dangerous conditions that include fever in their manifestation are also discussed. Copyright © 2013 Elsevier Inc. All rights reserved.

  1. Typhoid fever in paediatric patients in Quetta, Balochistan, Pakistan.

    Science.gov (United States)

    Naeem Khan, Muhammad; Shafee, Muhammad; Hussain, Kamran; Samad, Abdul; Arif Awan, Muhammad; Manan, Abdul; Wadood, Abdul

    2013-07-01

    To determine the seropositivity of typhoid fever in febrile pediatric patients presenting to tertiary care center. This observational study was conducted at Children Hospital Quetta (CHQ) from July 2011 to March 2012. The children with three or more days fever, no obvious focus of infection and clinically suspected of typhoid fever were screened. Sterile Blood samples were obtained from febrile patients and Widal and Typhidot® tests were performed for the diagnosis of Typhoid fever in the suspected populations. Total of 2964 clinically suspected patients were screened for typhoid fever. Of these, 550 (18.6%) patients were positive serologically. The higher prevalence of the disease in hot summer season and increasing pattern of the disease was observed in summer days. The disease was higher in school age children under 5-10 years. Although non-significant association was observed on sex basis. The findings highlight the considerable burden of typhoid fever in pre-school and school-aged children. The variation in the disease pattern has also been observed under seasonal variation and different age groups, all of which need to be considered in deliberations to control the typhoid fever.

  2. Environmental Transmission of Typhoid Fever in an Urban Slum.

    Science.gov (United States)

    Akullian, Adam; Ng'eno, Eric; Matheson, Alastair I; Cosmas, Leonard; Macharia, Daniel; Fields, Barry; Bigogo, Godfrey; Mugoh, Maina; John-Stewart, Grace; Walson, Judd L; Wakefield, Jonathan; Montgomery, Joel M

    2015-12-01

    Enteric fever due to Salmonella Typhi (typhoid fever) occurs in urban areas with poor sanitation. While direct fecal-oral transmission is thought to be the predominant mode of transmission, recent evidence suggests that indirect environmental transmission may also contribute to disease spread. Data from a population-based infectious disease surveillance system (28,000 individuals followed biweekly) were used to map the spatial pattern of typhoid fever in Kibera, an urban informal settlement in Nairobi Kenya, between 2010-2011. Spatial modeling was used to test whether variations in topography and accumulation of surface water explain the geographic patterns of risk. Among children less than ten years of age, risk of typhoid fever was geographically heterogeneous across the study area (p = 0.016) and was positively associated with lower elevation, OR = 1.87, 95% CI (1.36-2.57), p typhoid fever did not vary geographically or with elevation among individuals more than ten years of age [corrected]. Our results provide evidence of indirect, environmental transmission of typhoid fever among children, a group with high exposure to fecal pathogens in the environment. Spatially targeting sanitation interventions may decrease enteric fever transmission.

  3. Risk factors for shock in children with dengue fever

    Directory of Open Access Journals (Sweden)

    Sriram Pothapregada

    2015-01-01

    Full Text Available Objectives: To evaluate and analyze the clinical and laboratory parameters that were predictive of the development of shock in children with dengue fever. Subjects and Methods: Retrospective study carried out from August 2012 to July 2014 at a tertiary care hospital in Puducherry. Results: Two hundred and fifty-four children were admitted with dengue fever and among them dengue fever without shock was present in 159 children (62.5% and dengue fever with shock was present in 95 cases (37.4%. Various clinical and laboratory parameters were analyzed using univariate and multivariate logistic regression between the two groups and a P value of 20% with concomitant platelet count 6 years, hepatomegaly, pain in the abdomen, and oliguria were the most common risk factors associated with shock in children with dengue fever. There were six deaths (2.4% and out of them four presented with impaired consciousness (66.6% at the time of admission. Conclusion: Age >6 years, hepatomegaly, abdomen pain, and oliguria were the most common risk factors for shock in children with dengue fever. Impaired consciousness at admission was the most ominous sign for mortality in dengue fever. Hence, these features should be identified early, monitored closely, and managed timely.

  4. Risk factors for shock in children with dengue fever.

    Science.gov (United States)

    Pothapregada, Sriram; Kamalakannan, Banupriya; Thulasingham, Mahalakshmy

    2015-11-01

    To evaluate and analyze the clinical and laboratory parameters that were predictive of the development of shock in children with dengue fever. Retrospective study carried out from August 2012 to July 2014 at a tertiary care hospital in Puducherry. Two hundred and fifty-four children were admitted with dengue fever and among them dengue fever without shock was present in 159 children (62.5%) and dengue fever with shock was present in 95 cases (37.4%). Various clinical and laboratory parameters were analyzed using univariate and multivariate logistic regression between the two groups and a P value of 20% with concomitant platelet count 6 years, hepatomegaly, pain in the abdomen, and oliguria were the most common risk factors associated with shock in children with dengue fever. There were six deaths (2.4%) and out of them four presented with impaired consciousness (66.6%) at the time of admission. Age >6 years, hepatomegaly, abdomen pain, and oliguria were the most common risk factors for shock in children with dengue fever. Impaired consciousness at admission was the most ominous sign for mortality in dengue fever. Hence, these features should be identified early, monitored closely, and managed timely.

  5. Fever's glass ceiling.

    Science.gov (United States)

    Mackowiak, P A; Boulant, J A

    1996-03-01

    The importance of an upper limit of the febrile response has been recognized since the time of Hippocrates. Although the precise temperature defining this limit varies according to the site at which body temperature is measured, human core temperature is almost never permitted to rise above 41 degrees C-42 degrees C during fever. There are compelling physiological reasons for such an upper limit of regulated body temperature. The mechanisms by which the limit is maintained are most likely complex and involve special properties of thermoregulatory neurons themselves, circulating endogenous antipyretics (such as arginine vasopressin and alpha-melanocyte-stimulating hormone), and soluble receptors for the (pyrogenic) cytokine mediators of the febrile response.

  6. Familial Mediterranean Fever (FMF

    Directory of Open Access Journals (Sweden)

    Onur Albayrak

    2009-08-01

    Full Text Available Familial Mediterranean Fever (FMF is an autosomal recessive genetic disease that affects males and females. FMF gene is on the short arm of chromosome 16. It is most often found in Jews, Arabs, Turks, and Armenians. Amyloidosis is charecterized by the deposition of a particular protein between the cells in the tissue. It is a potentially serious complication of FMF. The kidney is a prime target for the amyloid. [Archives Medical Review Journal 2009; 18(4.000: 260-267

  7. Ebola hemorrhagic Fever.

    Science.gov (United States)

    Burnett, Mark W

    2014-01-01

    Ebola hemorrhagic fever is an often-fatal disease caused by a virus of the Filoviridae family, genus Ebolavirus. Initial signs and symptoms of the disease are nonspecific, often progressing on to a severe hemorrhagic illness. Special Operations Forces Medical Providers should be aware of this disease, which occurs in sporadic outbreaks throughout Africa. Treatment at the present time is mainly supportive. Special care should be taken to prevent contact with bodily fluids of those infected, which can transmit the virus to caregivers. 2014.

  8. Hemorrhagic Fever with Renal Syndrome (HFRS)

    Science.gov (United States)

    ... this page: About CDC.gov . Share Compartir Hemorrhagic Fever with Renal Syndrome (HFRS) On this Page What ... is HFRS prevented? Suggested Reading What is hemorrhagic fever with renal syndrome? Hemorrhagic fever with renal syndrome ( ...

  9. What about My Child and Rheumatic Fever?

    Science.gov (United States)

    ... Cardiovascular Conditions What About My Child and Rheumatic Fever? Rheumatic fever is an inflammatory reaction that can occur after ... strep throat infections don’t lead to rheumatic fever. When they do, the time between the strep ...

  10. Genetics Home Reference: familial Mediterranean fever

    Science.gov (United States)

    ... Facebook Twitter Home Health Conditions familial Mediterranean fever familial Mediterranean fever Printable PDF Open All Close All Enable Javascript to view the expand/collapse boxes. Description Familial Mediterranean fever is an inherited condition characterized by recurrent episodes ...

  11. Travelers' Health: Typhoid and Paratyphoid Fever

    Science.gov (United States)

    ... in an Area with Zika? Find a Clinic Yellow Fever Vaccinations Clinics FAQ Disease Directory Resources Resources for ... CE Courses and Training Presentations for Health Professionals Yellow Fever Vaccine Course About the Yellow Fever Vaccine Course ...

  12. Dengue fever presenting as acute acalculus cholecystitis.

    Science.gov (United States)

    Joshipura, Vismit P; Soni, Harshad N; Patel, Nitin R; Haribhakti, Sanjiv P

    2007-06-01

    Classically dengue fever presents as fever with myalgia. A patient of dengue fever presented with classical symptoms and signs of acute acalculous cholecystitis. Serology and ultrasound examination identified dengue as the aetiology. Patient was treated successfully by conservative measures.

  13. Genetic identification of Rickettsia sp. strain Atlantic rainforest in an endemic area of a mild spotted fever in Rio Grande do Sul state, Southern Brazil.

    Science.gov (United States)

    Figueiredo Voizzoni, Vinicius; Barbosa Silva, Arannadia; Medeiros Cardoso, Karen; Barbosa Dos Santos, Fernanda; Stenzel, Barbara; Amorim, Marinete; Vilges de Oliveira, Stefan; Salles Gazeta, Gilberto

    2016-10-01

    Rickettsia sp. strain Atlantic rainforest causes a less severe rickettsiosis, with two cases confirmed until now. The tick species Amblyomma ovale is appointed as the main vector of this bacterium. The southern region of Brazil has reported patients with spotted fever who have milder symptoms. In 2013, during an investigation of rickettsiosis cases, an A. ovale tick was found attached to a man in an area where there were two cases. The parasite was processed for molecular analysis and the rickettsial infection was confirmed based on phylogenetic analysis of genes ompA, ompB and geneD (sca4). In the present study the human pathogenic Rickettsia sp. strain Atlantic rainforest was identified in the state of Rio Grande do Sul, Southern Brazil. Since A. ovale, its main vector, is found frequently parasitizing dogs, animals that can cross international borders freely in southern Brazil, this bacteria can bring major concerns in terms of public health.

  14. Trends of fluid requirement in dengue fever and dengue haemorrhagic fever: a single centre experience in Sri Lanka.

    Science.gov (United States)

    Kularatne, Senanayake A M; Weerakoon, Kosala G A D; Munasinghe, Ruwan; Ralapanawa, Udaya K; Pathirage, Manoji

    2015-04-08

    Meticulous fluid management is the mainstay of treatment in dengue fever that is currently governed by consensus guidelines rather than by strong research evidence. To examine this issue we audited the fluid requirement of a cohort of adult patients with dengue fever (DF) and dengue haemorrhagic fever (DHF) in a tertiary care clinical setting. This retrospective cohort study was conducted from July 2012 to January 2013 in Teaching Hospital, Peradeniya, Sri Lanka. Adult patients with confirmed dengue infection managed according to the national and WHO guidelines were included. Their fluid requirement was audited once data collection was over in both DF and DHF groups. Out of 302 patients, 209 (69%) had serological confirmation of dengue infection, comprising 62 (30%) patients gone into critical phase of DHF. Mean age of the DHF group was 30 years (range 12-63 years) and included more males (n = 42, 68%, p fever on admission and total duration of fever were 4 days and 6 days respectively. DHF group had high incidence of vomiting, abdominal pain and flushing, lowest platelet counts and highest haematocrit values compared to DF group. In DHF group, the mean total daily requirements of fluid from 2(nd) to 7(th) day were 2123, 2733, 2846, 2981, 3139 and 3154 milliliters respectively to maintain a safe haematocrit value and the vital parameters. However, in DF group the fluid requirement was lowest on 3(rd) day (2158 milliliters). DHF group had significantly high fluid requirement on 5(th) -7(th) day compared to DF group (p fever and again on 5(th) to 7(th) day of fever. Despite being an audit, these finding could be useful in future updates of guidelines and designing research.

  15. Cutting edge issues in rheumatic fever.

    Science.gov (United States)

    Chang, Christopher

    2012-04-01

    Although the incidence of acute rheumatic fever and rheumatic heart disease has decreased significantly in regions of the world where antibiotics are easily accessible, there remains a high incidence in developing nations as well as in certain regions where there is a high incidence of genetic susceptibility. These diseases are a function of poverty, low socioeconomic status, and barriers to healthcare access, and it is in the developing world that a comprehensive prevention program is most critically needed. Development of group A streptococcal vaccines has been under investigation since the 1960s and 50 years later, we still have no vaccine. Factors that contribute to this lack of success include a potential risk for developing vaccine-induced rheumatic heart disease, as well as difficulties in covering the many serological subtypes of M protein, a virulence factor found on the surface of the bacterium. Yet, development of a successful vaccine program for prevention of group A streptococcal infection still offers the best chance for eradication of rheumatic fever in the twenty-first century. Other useful approaches include continuation of primary and secondary prevention with antibiotics and implementation of health care policies that provide patients with easy access to antibiotics. Improved living conditions and better hygiene are also critical to the prevention of the spread of group A streptococcus, especially in impoverished regions of the world. The purpose of this article is to discuss current and recent developments in the diagnosis, pathogenesis, and management of rheumatic fever and rheumatic heart disease.

  16. Mayaro fever virus, Brazilian Amazon.

    Science.gov (United States)

    Azevedo, Raimunda S S; Silva, Eliana V P; Carvalho, Valéria L; Rodrigues, Sueli G; Nunes-Neto, Joaquim P; Monteiro, Hamilton; Peixoto, Victor S; Chiang, Jannifer O; Nunes, Márcio R T; Vasconcelos, Pedro F C

    2009-11-01

    In February 2008, a Mayaro fever virus (MAYV) outbreak occurred in a settlement in Santa Barbara municipality, northern Brazil. Patients had rash, fever, and severe arthralgia lasting up to 7 days. Immunoglobulin M against MAYV was detected by ELISA in 36 persons; 3 MAYV isolates sequenced were characterized as genotype D.

  17. Mayaro Fever Virus, Brazilian Amazon

    Science.gov (United States)

    Azevedo, Raimunda S.S.; Silva, Eliana V.P.; Carvalho, Valéria L.; Rodrigues, Sueli G.; Neto, Joaquim P. Nunes; Monteiro, Hamilton A.O.; Peixoto, Victor S.; Chiang, Jannifer O.; Nunes, Márcio R.T.

    2009-01-01

    In February 2008, a Mayaro fever virus (MAYV) outbreak occurred in a settlement in Santa Barbara municipality, northern Brazil. Patients had rash, fever, and severe arthralgia lasting up to 7 days. Immunoglobulin M against MAYV was detected by ELISA in 36 persons; 3 MAYV isolates sequenced were characterized as genotype D. PMID:19891877

  18. Q fever: The Dutch Policy

    NARCIS (Netherlands)

    Bruschke, C.J.M.; Roest, H.I.J.; Coutinho, R.A.

    2016-01-01

    Between 2007 and 2010, the Netherlands experienced an unprecedented outbreak of Q fever of more than 4000 human cases. Q fever infections of dairy goats, leading to abortion waves, were considered to be the cause of this outbreak. Measures to combat the outbreak had to be taken based on limited scie

  19. Febre amarela Yellow fever

    Directory of Open Access Journals (Sweden)

    Pedro Fernando da Costa Vasconcelos

    2003-04-01

    Full Text Available A febre amarela é doenca infecciosa não-contagiosa causada por um arbovírus mantido em ciclos silvestres em que macacos atuam como hospedeiros amplificadores e mosquitos dos gêneros Aedes na África, e Haemagogus e Sabethes na América, são os transmissores. Cerca de 90% dos casos da doença apresentam-se com formas clínicas benignas que evoluem para a cura, enquanto 10% desenvolvem quadros dramáticos com mortalidade em torno de 50%. O problema mostra-se mais grave em África onde ainda há casos urbanos. Nas Américas, no período de 1970-2001, descreveram-se 4.543 casos. Os países que mais diagnosticaram a doença foram o Peru (51,5%, a Bolívia (20,1% e o Brasil (18,7%. Os métodos diagnósticos utilizados incluem a sorologia (IgM, isolamento viral, imunohistoquímica e RT-PCR. A zoonose não pode ser erradicada, mas, a doença humana é prevenível mediante a vacinação com a amostra 17D do vírus amarílico. A OMS recomenda nova vacinação a cada 10 anos. Neste artigo são revistos os principais conceitos da doença e os casos de mortes associados à vacina.Yellow fever is an infectious and non-contagious disease caused by an arbovirus, the yellow fever virus. The agent is maintained in jungle cycles among primates as vertebrate hosts and mosquitoes, especially Aedes in Africa, and Haemagogus and Sabethes in America. Approximately 90% of the infections are mild or asymptomatic, while 10% course to a severe clinical picture with 50% case-fatality rate. Yellow fever is largely distributed in Africa where urban epidemics are still reported. In South America, between 1970-2001, 4,543 cases were reported, mostly from Peru (51.5%, Bolivia (20.1% and Brazil (18.7%. The disease is diagnosed by serology (detection of IgM, virus isolation, immunohistochemistry and RT-PCR. Yellow fever is a zoonosis and cannot be eradicated, but it is preventable in man by using the 17D vaccine. A single dose is enough to protect an individual for at least

  20. Yellow Fever Vaccine: What You Need to Know

    Science.gov (United States)

    ... www. immunize. org/ vis 1 What is yellow fever? Yellow fever is a serious disease caused by the ... serious cases) 2 How can I prevent yellow fever? Yellow fever vaccine Yellow fever vaccine can prevent yellow ...

  1. Brazilian spotted fever: a reemergent zoonosis

    Directory of Open Access Journals (Sweden)

    H. Greca

    2008-01-01

    Full Text Available Brazilian spotted fever is caused by the bacterium Rickettsia rickettsii, which is the most pathogenic species of the spotted-fever rickettsiae group and is transmitted by the bite of infected ticks. Amblyomma cajennense is the most important tick species involved in the cycle of this zoonosis in Brazil as it presents low host specificity, great number of natural reservoirs and wide geographic distribution. It was first described in the state of São Paulo in 1929 and later in Rio de Janeiro, Minas Gerais and Bahia. The number of cases decreased in the 1940's with the development of new plague control techniques and antibiotics. In the last decades, the number of new cases has increased. The current review aimed at reporting some of the epidemiological and public health aspects of this reemergent disease with new foci, mainly in the southeastern region of Brazil.

  2. Diagnostic criteria of familial Mediterranean fever.

    Science.gov (United States)

    Berkun, Yackov; Eisenstein, Eli M

    2014-01-01

    Familial Mediterranean fever (FMF) is the most prevalent monogenic autoinflammatory disease, mainly affecting ethnic groups living at Mediterranean basin. FMF is characterized by recurrent, self-limited episodes of fever and serositis. The diagnosis is difficult in the presence of atypical signs, which may result in significant delay in initiating treatment. As autoinflammatory diseases may have overlapping symptoms, strict diagnostic criteria are essential. Since the discovery that mutations in the gene MEFV underlie FMF, molecular genetic testing has been used as a diagnostic adjunct, especially in atypical cases. However, despite progress in the understanding of FMF disease mechanisms during the past 15 years; the diagnosis is still based on clinical criteria. Several sets of diagnostic criteria have been proposed and used. Existing diagnostic criteria should be modified to include genetic data, and need to be more widely validated. Copyright © 2014 Elsevier B.V. All rights reserved.

  3. Chikungunya fever presenting with acute optic neuropathy.

    Science.gov (United States)

    Mohite, Abhijit Anand; Agius-Fernandez, Adriana

    2015-07-28

    Chikungunya fever is a vector borne virus that typically causes a self-limiting systemic illness with fever, skin rash and joint aches 2 weeks after infection. We present the case of a 69-year-old woman presenting with an acute unilateral optic neuropathy as a delayed complication of Chikungunya virus (CHIKV) infection contracted during a recent trip to the West Indies. She presented to our ophthalmology department with acute painless visual field loss in the right eye and a recent flu-like illness. She was found to have a right relative afferent pupillary defect (RAPD) with unilateral optic disc swelling. Serology confirmed recent CHIKV infection. Treatment with intravenous methylprednisolone was delayed while awaiting MRI scans and serology results. At 5-month follow-up, there was a persistent right RAPD and marked optic atrophy with a corresponding inferior scotoma in the visual field. 2015 BMJ Publishing Group Ltd.

  4. Long chain fatty acid (Lcfa) abnormalities in hyper Igd syndrome (Hids) and Familial Mediterranean Fever (Fmf): new insight into heritable periodic fevers

    NARCIS (Netherlands)

    Simon, A.; Drenth, J.P.H.; Matern, D.; Goetzman, E.S.; Hager, E.J.; Gibson, K.M.

    2013-01-01

    OBJECTIVE: To examine essential fatty acids (EFAs) in hyper-IgD syndrome (HIDS) and Familial Mediterranean Fever (FMF). METHODS: EFAs were determined in sera derived from an archival, cross-sectional group of HIDS/FMF patients, stratified for presence and absence of fever. Control populations

  5. Long chain fatty acid (Lcfa) abnormalities in hyper Igd syndrome (Hids) and Familial Mediterranean Fever (Fmf): new insight into heritable periodic fevers

    NARCIS (Netherlands)

    Simon, A.; Drenth, J.P.H.; Matern, D.; Goetzman, E.S.; Hager, E.J.; Gibson, K.M.

    2013-01-01

    OBJECTIVE: To examine essential fatty acids (EFAs) in hyper-IgD syndrome (HIDS) and Familial Mediterranean Fever (FMF). METHODS: EFAs were determined in sera derived from an archival, cross-sectional group of HIDS/FMF patients, stratified for presence and absence of fever. Control populations includ

  6. ETIOLOGY OF YELLOW FEVER

    Science.gov (United States)

    Noguchi, Hideyo

    1922-01-01

    Analysis of the records of instances in which non-immune persons contracted yellow fever notwithstanding vaccination shows that the onset of disease occurs soon after vaccination, the longest period being 13 days. Since the average incubation period in yellow fever is 6 days, it seems that infection must have taken place in some instances during the period while protection was developing. These instances led to a study of the possibility of immediate protection by means of the anti-icteroides serum. It had already been shown that the immune serum protects at once against experimental Leptospira icteroides infection, but it remained to determine how long the protection would last. Guinea pigs were given different quantities of the immune serum and subsequently injected, at various intervals, with a virulent strain of Leptospira icteroides. Complete protection enduring 5 days was obtained with as minute a quantity of serum as 0.002 cc. per 1,000 gm. of body weight. After 5 days, however, the immune substance rapidly diminished, and to keep the animal protected for as long as 10 days it was necessary to give 100 times as much, or 0.2 cc. For a man weighing 80 kilos, 0.16 cc. (0.002 x 80) would theoretically be sufficient to protect for at least 5 days, 1.6 cc. for 7 days, and 16 cc. for 10 days. This temporary protection may be a valuable antecedent to that furnished by vaccination, since the final effect of the latter cannot be expected until at least 9 to 10 days have passed. PMID:19868677

  7. Familial Mediterranean fever is no longer a rare disease in Japan

    OpenAIRE

    Migita, Kiyoshi; Izumi, Yasumori; Jiuchi, Yuka; Iwanaga, Nozomi; Kawahara, Chieko; Agematsu, Kazunaga; Yachie, Akihiro; Masumoto, Junya; Fujikawa, Keita; Yamasaki, Satoshi; Nakamura, Tadashi; Ubara, Yoshifumi; Koga, Tomohiro; Nakashima, Yoshikazu; Shimizu, Toshimasa

    2016-01-01

    Background The aim of this study was to evaluate the clinical manifestations and prevalence of familial Mediterranean fever (FMF) in Japanese patients with unexplained fever and rheumatic manifestations. Methods We enrolled 601 patients with unexplained fever or suspected FMF throughout Japan between 2009 and 2015. Patients were divided into three groups according to Tel Hashomer criteria: sure FMF, probable FMF, and non-FMF patients, including definitive rheumatic diseases. Mutation detectio...

  8. Rhombencephalitis associated with Dengue fever.

    Science.gov (United States)

    Verma, Rajesh; Bharti, Kavita; Mehta, Mannan; Bansod, Amrit

    2016-05-01

    Dengue infection is gradually disseminating throughout the world in alarming proportions. It is a arbovirus infection,transmitted by aedes mosquitoes. It is a multi-systemic disorder associated with varied neurological complications. There is increased trend of development of neurological complications in dengue fever. The neurological complications arising due to dengue infection can be categorized into central and neuromuscular complications. The central nervous system disorders reported with dengue fever are encephalopathy,encephalitis and myelitis.Here we report a case of rhombencephalitis associated with dengue fever. The literature does not mention rhombencephalitis occurring with dengue illness.

  9. Fluoroquinolones for treating typhoid and paratyphoid fever (enteric fever).

    Science.gov (United States)

    Effa, Emmanuel E; Lassi, Zohra S; Critchley, Julia A; Garner, Paul; Sinclair, David; Olliaro, Piero L; Bhutta, Zulfiqar A

    2011-10-05

    Typhoid and paratyphoid are febrile illnesses, due to a bacterial infection, which remain common in many low- and middle-income countries. The World Health Organization (WHO) currently recommends the fluoroquinolone antibiotics in areas with known resistance to the older first-line antibiotics. To evaluate fluoroquinolone antibiotics for treating children and adults with enteric fever. We searched The Cochrane Infectious Disease Group Specialized Register (February 2011); Cochrane Central Register of Controlled Trials (CENTRAL), published in The Cochrane Library (2011, Issue 2); MEDLINE (1966 to February 2011); EMBASE (1974 to February 2011); and LILACS (1982 to February 2011). We also searched the metaRegister of Controlled Trials (mRCT) in February 2011. Randomized controlled trials examining fluoroquinolone antibiotics, in people with blood, stool or bone marrow culture-confirmed enteric fever. Two authors independently assessed the trial's methodological quality and extracted data. We calculated risk ratios (RR) for dichotomous data and mean difference for continuous data with 95% confidence intervals (CI).Comparative effectiveness has been interpreted in the context of; length of treatment, dose, year of study, known levels of antibiotic resistance, or proxy measures of resistance such as the failure rate in the comparator arm. Twenty-six studies, involving 3033 patients, are included in this review.Fluoroquinolones versus older antibiotics (chloramphenicol, co-trimoxazole, amoxicillin and ampicillin)In one study from Pakistan in 2003-04, high clinical failure rates were seen with both chloramphenicol and co-trimoxazole, although resistance was not confirmed microbiologically. A seven-day course of either ciprofloxacin or ofloxacin were found to be superior. Older studies of these comparisons failed to show a difference (six trials, 361 participants).In small studies conducted almost two decades ago, the fluoroquinolones were demonstrated to have fewer

  10. Body Temperature Measurement Skills and Fever Knowledge of Caregivers with a Child Having Cancer

    Directory of Open Access Journals (Sweden)

    Begul Yagci-Kupeli

    2013-08-01

    Full Text Available Purpose: We did not encounter a study dealing with the knowledge of fever and attitudes of caregivers having children with a diagnosis of malignant disease toward fever in English literature. Materials and Methods: Caregivers of 124 pediatric oncology patients and 72 patients without any malignant disease were recruited and interviewed using a 26-item questionnaire about fever and its management in two hospital clinics in Diyarbakir, Turkey. Results: Seventy point one percent of the mothers in oncology group were illiterate and in 75% of the cases, caregiver was the mother of the patient. Most of the caregivers in control group (72.2% knew at least one harmful effect of high fever (p=0.001. The primary method of measurement however was palpation in both groups. 41.9% of the caregivers in oncology group knew the correct measurement of fever, but only 2.7% in control group (p=0.001. Resources of fever konowledge was mainly doctors and nurses in oncology group (p=0.001. Conclusion: Pediatric health care providers must have more initiative and exploit oppportunities on parental understanding of fever and its management. Educational interventions are needed to correct caregivers’ misconceptions about fever and to promote appropriate management of febrile pediatric oncology patients. [Cukurova Med J 2013; 38(4.000: 706-711

  11. Secondary bacteraemia in adult patients with prolonged dengue fever.

    Science.gov (United States)

    Premaratna, R; Dissanayake, D; Silva, F H D S; Dassanayake, M; de Silva, H J

    2015-03-01

    Although dengue management guidelines do not advice on use of antibiotics in dengue shock syndrome, unrecognised bactraemia is likely to contribute to morbidity and mortality. To assess the occurance of secondary bacteraemia in adult patients with prolonged dengue fever. A prospective study was conducted recruiting patients with confirmed acute dengue infection who had prolonged fever (>5 days). Two sets of blood cultures were taken in such patients prior to institution of antibiotic therapy. Demographic, clinical, haematological and biochemical parameters were recorded. Development of ascites and pleural effusions were detected using ultrasonography. Fourty patients (52.5% males) with a mean age of 29.8 years (SD 13.6) were studied. The average duration of fever was 7.9 days (SD 1.8). Ten patients (25%) had bacterial isolates in their blood cultures; Staphylococcus aureus (n=2), coliforms (n=3), pseudomonas (n=1) and 4 had mixed growths. The culture positive group had severe body aches at admission and higher fever, third space fluid accumulation, a significant drop in platelets and a higher CRP. A quarter of dengue patients with prolonged fever had a bacterial isolate. Culture positive patients appeared more ill with body aches and had higher degrees of fever during the latter part of the illness. Increased vascular permeability may predispose to bacterial seepage into blood. Although white cell count is not helpful in detecting bacteraemia, low platelet count and elevation of CRP seem to be helpful.

  12. Discriminating fever behavior in house flies.

    Directory of Open Access Journals (Sweden)

    Robert D Anderson

    Full Text Available Fever has generally been shown to benefit infected hosts. However, fever temperatures also carry costs. While endotherms are able to limit fever costs physiologically, the means by which behavioral thermoregulators constrain these costs are less understood. Here we investigated the behavioral fever response of house flies (Musca domestica L. challenged with different doses of the fungal entomopathogen, Beauveria bassiana. Infected flies invoked a behavioral fever selecting the hottest temperature early in the day and then moving to cooler temperatures as the day progressed. In addition, flies infected with a higher dose of fungus exhibited more intense fever responses. These variable patterns of fever are consistent with the observation that higher fever temperatures had greater impact on fungal growth. The results demonstrate the capacity of insects to modulate the degree and duration of the fever response depending on the severity of the pathogen challenge and in so doing, balance the costs and benefits of fever.

  13. Advanced Vaccine Candidates for Lassa Fever

    Directory of Open Access Journals (Sweden)

    Igor S. Lukashevich

    2012-10-01

    Full Text Available Lassa virus (LASV is the most prominent human pathogen of the Arenaviridae. The virus is transmitted to humans by a rodent reservoir, Mastomys natalensis, and is capable of causing lethal Lassa Fever (LF. LASV has the highest human impact of any of the viral hemorrhagic fevers (with the exception of Dengue Fever with an estimated several hundred thousand infections annually, resulting in thousands of deaths in Western Africa. The sizeable disease burden, numerous imported cases of LF in non-endemic countries, and the possibility that LASV can be used as an agent of biological warfare make a strong case for vaccine development. Presently there is no licensed vaccine against LF or approved treatment. Recently, several promising vaccine candidates have been developed which can potentially target different groups at risk. The purpose of this manuscript is to review the LASV pathogenesis and immune mechanisms involved in protection. The current status of pre-clinical development of the advanced vaccine candidates that have been tested in non-human primates will be discussed. Major scientific, manufacturing, and regulatory challenges will also be considered.

  14. Advanced vaccine candidates for Lassa fever.

    Science.gov (United States)

    Lukashevich, Igor S

    2012-10-29

    Lassa virus (LASV) is the most prominent human pathogen of the Arenaviridae. The virus is transmitted to humans by a rodent reservoir, Mastomys natalensis, and is capable of causing lethal Lassa Fever (LF). LASV has the highest human impact of any of the viral hemorrhagic fevers (with the exception of Dengue Fever) with an estimated several hundred thousand infections annually, resulting in thousands of deaths in Western Africa. The sizeable disease burden, numerous imported cases of LF in non-endemic countries, and the possibility that LASV can be used as an agent of biological warfare make a strong case for vaccine development. Presently there is no licensed vaccine against LF or approved treatment. Recently, several promising vaccine candidates have been developed which can potentially target different groups at risk. The purpose of this manuscript is to review the LASV pathogenesis and immune mechanisms involved in protection. The current status of pre-clinical development of the advanced vaccine candidates that have been tested in non-human primates will be discussed. Major scientific, manufacturing, and regulatory challenges will also be considered.

  15. Clinical pathogenesis of typhoid fever

    National Research Council Canada - National Science Library

    Raffatellu, Manuela; Wilson, R Paul; Winter, Sebastian E; Bäumler, Andreas J

    2008-01-01

    ...: gastroenteritis and typhoid fever. Clinical observations suggest that gastroenteritis, caused by non-typhoidal Salmonella serovars, is characterized by a massive neutrophil influx, which keeps the infection localized to the intestinal mucosa...

  16. Q fever in French Guiana.

    Science.gov (United States)

    Eldin, Carole; Mahamat, Aba; Demar, Magalie; Abboud, Philippe; Djossou, Félix; Raoult, Didier

    2014-10-01

    Coxiella burnetii, the causative agent of Q fever, is present worldwide. Recent studies have shown that this bacterium is an emerging pathogen in French Guiana and has a high prevalence (24% of community-acquired pneumonia). In this review, we focus on the peculiar epidemiology of Q fever in French Guiana. We place it in the context of the epidemiology of the disease in the surrounding countries of South America. We also review the clinical features of Q fever in this region, which has severe initial presentation but low mortality rates. These characteristics seem to be linked to a unique genotype (genotype 17). Finally, we discuss the issue of the animal reservoir of C. burnetii in French Guiana, which is still unknown. Further studies are necessary to identify this reservoir. Identification of this reservoir will improve the understanding of the Q fever epidemic in French Guiana and will provide new tools to control this public health problem.

  17. Childhood Fever: parental beliefs and management.

    Science.gov (United States)

    Stephenson, M J; Rosencrantz, A; Kneller, P

    1988-01-01

    Childhood fever is often seen in family-practice. Clinical experience has shown the authors that parental anxiety often initiates early, aggressive treatment of fever with antipyretics. The authors studied parents' beliefs and practices relating to fever control in their children, and who or what their information sources were. The findings indicate that parents are commonly misinformed about the nature of childhood fever and its management, and that physicians need to learn more about conveying information on fever to patients.

  18. Ebola and Marburg haemorrhagic fever.

    Science.gov (United States)

    Rougeron, V; Feldmann, H; Grard, G; Becker, S; Leroy, E M

    2015-03-01

    Ebolaviruses and Marburgviruses (family Filoviridae) are among the most virulent pathogens for humans and great apes causing severe haemorrhagic fever and death within a matter of days. This group of viruses is characterized by a linear, non-segmented, single-stranded RNA genome of negative polarity. The overall burden of filovirus infections is minimal and negligible compared to the devastation caused by malnutrition and other infectious diseases prevalent in Africa such as malaria, dengue or tuberculosis. In this paper, we review the knowledge gained on the eco/epidemiology, the pathogenesis and the disease control measures for Marburg and Ebola viruses developed over the last 15 years. The overall progress is promising given the little attention that these pathogen have achieved in the past; however, more is to come over the next decade given the more recent interest in these pathogens as potential public and animal health concerns. Licensing of therapeutic and prophylactic options may be achievable over the next 5-10 years.

  19. Familial Mediterranean fever in siblings.

    Science.gov (United States)

    Özçakar, Z Birsin; Erdogan, Beyza Doganay; Elhan, Atilla H; Yalçinkaya, Fatoş

    2012-11-01

    Genetic and environmental factors have been implicated in disease severity and development of amyloidosis in familial Mediterranean fever (FMF). We investigated similarities in clinical characteristics, disease severity, and treatment response within siblings with FMF. The study group consisted of 2 or more siblings who were followed in our center with the diagnosis of FMF. Siblings were evaluated for demographic data, clinical and laboratory disease features, genetic analysis of MEFV mutations, and disease severity score. The intraclass correlation coefficient (ICC), which can be interpreted as the expected correlation between 2 siblings, was used to reflect within-family similarity. The study included 67 pediatric patients from 31 different families. When we investigated the similarity of siblings after adjusting for genetic effects, we found very low ICC with p > 0.05 in the majority of clinical features, disease severity, and colchicine dosages. However, age at disease onset, age at onset of therapy, attack-free acute-phase reactant levels, and presence of amyloidosis were found to be similar within siblings (relatively high ICC with p < 0.05). Siblings with FMF had different clinical findings and disease severity. They had similar amyloidogenic potential, proven by both similar presence of amyloid and increased levels of acute-phase reactants between attacks. Our findings strongly support that genetic factors may be more dominant in the development of amyloidosis.

  20. Fever, febrile seizures and epilepsy

    OpenAIRE

    2007-01-01

    Seizures induced by fever (febrile seizures) are the most common type of pathological brain activity in infants and children. These febrile seizures and their potential contribution to the mechanisms of limbic (temporal lobe) epilepsy have been a topic of major clinical and scientific interest. Key questions include the mechanisms by which fever generates seizures, the effects of long febrile seizures on neuronal function and the potential contribution of these seizures to epilepsy. This revi...

  1. Determination of hearing levels in patients with Familial Mediterranean Fever.

    Science.gov (United States)

    Cevik, Cengiz; Silfeler, Ibrahim; Arica, Vefik; Yengil, Erhan; Akbay, Ercan; Sarac, Tuba; Basarslan, Fatmagul; Akoglu, Ertap

    2013-12-01

    Familial Mediterranean Fever is the most common congenital, periodic fever condition that affects over 100,000 people worldwide. In the literature, there is limited number of studies about hearing levels in children with Familial Mediterranean Fever. In the present study, we aimed to investigate hearing levels and cochlear functions by using Distortion product Otoacoustic Emission and High Frequency Audiometry (250-20,000 Hz) in pediatric patients with Familial Mediterranean Fever. The study included 62 children with Familial Mediterranean Fever and 27 healthy children with similar age and gender. After otoscopic examination, both groups underwent audiological evaluation including High Frequency Audiometry (250-20,000 Hz) and Distortion product Otoacoustic Emissions. The results obtained were assessed among groups. In addition, these results were compared regarding colchicine use, age at the onset of disease and duration of the diseases in the Familial Mediterranean Fever group. Of the Familial Mediterranean Fever patients, 93.5% were on colchicine therapy and mean duration of colchicine use was 19.9 ± 13.9 months. The mean age at diagnosis was 6.57 ± 2.86 years (min-max: 2-14) and mean duration of disease was 23 ± 17 months (min-max: 6-84). Pure tone audiometry values, and hearing levels between 9000 and 20,000 Hz were similar and within normal range in both groups. The Distortion product Otoacoustic Emissions responses at the frequencies of 1020, 2040, 3000, 4080 and 5040 Hz were similar for both groups. To the best of our knowledge, this is the first study evaluating hearing levels at the frequencies of 18k Hz and 20k Hz in children with Familial Mediterranean Fever in the literature. In children with Familial Mediterranean Fever, Pure tone audiometry values, hearing values obtained at all frequencies from 250 to 20,000 Hz, and Distortion product Otoacoustic Emissions levels were within normal range. Furthermore, hearing levels were found to be similar to

  2. Once weekly azithromycin in secondary prevention of rheumatic fever.

    Science.gov (United States)

    Gopal, Rakesh; Harikrishnan, S; Sivasankaran, S; Ajithkumar, V K; Titus, T; Tharakan, J M

    2012-01-01

    Rheumatic fever and rheumatic heart disease (RHD) are still important problems in developing countries. Secondary prophylaxis which is the most cost-effective method in preventing recurrences of rheumatic fever is fraught with problems of drug compliance. The utility of 500 mg once weekly azithromycin (AZT), an orally effective long-acting antibiotic was evaluated against oral penicillin (phenoxy methyl penicillin 250 mg twice daily) in this study. Forty-eight consecutive patients (44% males, mean age 29.4 years) with established RHD were randomised into two groups-26 patients received AZT and 22 received oral penicillin. Patients were evaluated at randomisation, at 1 month, 3 months, and 6 months, clinically, serologically and by throat swab culture. End points were absence of streptococcal colonisation, infection or fever at the end of 6 months. During the study, 4 patients (15.4%) in the AZT group developed sore throat and fever, had positive throat culture and positive serology indicating streptococcal infection. None satisfied the criteria for rheumatic fever reactivation. None in the oral penicillin group developed streptococcal infection. In conclusion, weekly 500 mg of AZT is not effective in the prevention of streptococcal throat infection compared to oral penicillin therapy in adult patients with established RHD.

  3. Treatment of dengue fever

    Directory of Open Access Journals (Sweden)

    Rajapakse S

    2012-07-01

    Full Text Available Senaka Rajapakse,1,2 Chaturaka Rodrigo,1 Anoja Rajapakse31Department of Clinical Medicine, Faculty of Medicine, University of Colombo, Sri Lanka; 2Lincoln County Hospital, United Lincolnshire NHS Trust, Lincoln, UK; 3Kings Mill Hospital, Sherwood Forest NHS Foundation Trust, Mansfield, UKAbstract: The endemic area for dengue fever extends over 60 countries, and approximately 2.5 billion people are at risk of infection. The incidence of dengue has multiplied many times over the last five decades at an alarming rate. In the endemic areas, waves of infection occur in epidemics, with thousands of individuals affected, creating a huge burden on the limited resources of a country's health care system. While the illness passes off as a simple febrile episode in many, a few have a severe illness marked by hypovolemic shock and bleeding. Iatrogenic fluid overload in the management may further complicate the picture. In this severe form dengue can be fatal. Tackling the burden of dengue is impeded by several issues, including a lack of understanding about the exact pathophysiology of the infection, inability to successfully control the vector population, lack of specific therapy against the virus, and the technical difficulties in developing a vaccine. This review provides an overview on the epidemiology, natural history, management strategies, and future directions for research on dengue, including the potential for development of a vaccine.Keywords: dengue, treatment, fluid resuscitation

  4. Hereditary autoinflammatory syndromes : with emphasis on hyper-IgD and periodic fever syndrome

    NARCIS (Netherlands)

    Simon, A.

    2004-01-01

    The subject of this thesis is a group of rare hereditary disorders, collectively called auto-inflammatory syndromes, with a specific focus on the hyper-IgD and periodic fever syndrome. The autoinflammatory syndromes are characterized by lifelong recurrent episodes with fever, usually accompanied by

  5. Periodic Fever: A Review on Clinical, Management and Guideline for Iranian Patients - Part II.

    Science.gov (United States)

    Ahmadinejad, Zahra; Mansouri, Sedigeh; Ziaee, Vahid; Aghighi, Yahya; Moradinejad, Mohammad-Hassan; Fereshteh-Mehregan, Fatemeh

    2014-06-01

    Periodic fever syndromes are a group of diseases characterized by episodes of fever with healthy intervals between febrile episodes. In the first part of this paper, we presented a guideline for approaching patients with periodic fever and reviewed two common disorders with periodic fever in Iranian patients including familial Mediterranean fever (FMF) and periodic fever syndromes except for periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA). In this part, we review other autoinflammatory disorders including hyper IgD, tumor necrosis factor receptor-associated periodic syndrome (TRAPS), cryopyrin associated periodic syndromes, autoinflammatory bone disorders and some other rare autoinflammatory disorders such as Sweet's and Blau syndromes. In cryopyrin associated periodic syndromes group, we discussed chronic infantile neurologic cutaneous and articular (CINCA) syndrome, Muckle-Wells syndrome and familial cold autoinflammatory syndrome. Autoinflammatory bone disorders are categorized to monogenic disorders such as pyogenic arthritis, pyoderma ;gangraenosum and acne (PAPA) syndrome, the deficiency of interleukine-1 receptor antagonist (DIRA) and Majeed syndrome and polygenic background or sporadic group such as chronic recurrent multifocal osteomyelitis (CRMO) or synovitis, acne, pustulosis, hyperostosis and osteitis (SAPHO) syndrome are classified in sporadic group. Other autoinflammatory syndromes are rare causes of periodic fever in Iranian system registry.

  6. Hereditary autoinflammatory syndromes : with emphasis on hyper-IgD and periodic fever syndrome

    NARCIS (Netherlands)

    Simon, A.

    2004-01-01

    The subject of this thesis is a group of rare hereditary disorders, collectively called auto-inflammatory syndromes, with a specific focus on the hyper-IgD and periodic fever syndrome. The autoinflammatory syndromes are characterized by lifelong recurrent episodes with fever, usually accompanied by

  7. Incidence and Characteristics of Scarlet Fever, South Korea, 2008–2015

    Science.gov (United States)

    Park, Duck Woong; Kim, Sun-Hee; Park, Jung Wook; Kim, Min-Ji; Cho, Sun Ju; Park, Hye Jung; Jung, So Hyang; Seo, Mi Hee; Lee, Yong Seok; Kim, Byung Hee; Min, Hyeran; Lee, Su Ya; Ha, Dong Ryong; Kim, Eun Sun

    2017-01-01

    The incidence rate for scarlet fever in South Korea is rising. During 2008–2015, we collected group A Streptococcus isolates and performed emm and exotoxin genotyping and disk-diffusion antimicrobial tests. Scarlet fever in South Korea was most closely associated with emm types emm4, emm28, emm1, and emm3. In 2015, tetracycline resistance started increasing. PMID:28322696

  8. Periodic Fever: A Review on Clinical, Management and Guideline for Iranian Patients - Part II

    Science.gov (United States)

    Ahmadinejad, Zahra; Mansouri, Sedigeh; Ziaee, Vahid; Aghighi, Yahya; Moradinejad, Mohammad-Hassan; Fereshteh-Mehregan, Fatemeh

    2014-01-01

    Periodic fever syndromes are a group of diseases characterized by episodes of fever with healthy intervals between febrile episodes. In the first part of this paper, we presented a guideline for approaching patients with periodic fever and reviewed two common disorders with periodic fever in Iranian patients including familial Mediterranean fever (FMF) and periodic fever syndromes except for periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA). In this part, we review other autoinflammatory disorders including hyper IgD, tumor necrosis factor receptor–associated periodic syndrome (TRAPS), cryopyrin associated periodic syndromes, autoinflammatory bone disorders and some other rare autoinflammatory disorders such as Sweet’s and Blau syndromes. In cryopyrin associated periodic syndromes group, we discussed chronic infantile neurologic cutaneous and articular (CINCA) syndrome, Muckle-Wells syndrome and familial cold autoinflammatory syndrome. Autoinflammatory bone disorders are categorized to monogenic disorders such as pyogenic arthritis, pyoderma ;gangraenosum and acne (PAPA) syndrome, the deficiency of interleukine-1 receptor antagonist (DIRA) and Majeed syndrome and polygenic background or sporadic group such as chronic recurrent multifocal osteomyelitis (CRMO) or synovitis, acne, pustulosis, hyperostosis and osteitis (SAPHO) syndrome are classified in sporadic group. Other autoinflammatory syndromes are rare causes of periodic fever in Iranian system registry. PMID:25562014

  9. Cascading effect of economic globalization on human risks of scrub typhus and tick-borne rickettsial diseases.

    Science.gov (United States)

    Kuo, Chi-Chien; Huang, Jing-Lun; Shu, Pei-Yun; Lee, Pei-Lung; Kelt, Douglas A; Wang, Hsi-Chieh

    2012-09-01

    The increase in global travel and trade has facilitated the dissemination of disease vectors. Globalization can also indirectly affect vector-borne diseases through the liberalization of cross-border trade, which has far-reaching, worldwide effects on agricultural practices and may in turn influence vectors through the modification of the ecological landscape. While the cascading effect of economic globalization on vector-borne diseases, sometimes acting synergistically with regional agricultural policy, could be substantial and have significant economic, agricultural, and public health implications, research into this remains very limited. We evaluated how abandonment of rice paddies in Taiwan after joining the World Trade Organization, along with periodic plowing, an agricultural policy to reduce farm pests in abandoned fields can unexpectedly influence risks to diseases transmitted by ticks and chiggers (larval trombiculid mites), which we collected from their small-mammal hosts. Sampling was limited to abandoned (fallow) and plowed fields due to the challenge of trapping small mammals in flooded rice paddies. Striped field mice (Apodemus agrarius) are the main hosts for both vectors. They harbored six times more ticks and three times more chiggers in fallow than in plowed plots. The proportion of ticks infected with Rickettsia spp. (etiologic agent of spotted fever) was three times higher in fallow plots, while that of Orientia tsutsugamushi (scrub typhus) in chiggers was similar in both treatments. Fallow plots had more ground cover and higher vegetation than plowed ones. Moreover, ticks and chiggers in both field types were dominated by species known to infest humans. Because ticks and chiggers should exhibit very low survival in flooded rice paddies, we propose that farm abandonment in Taiwan, driven by globalization, may have inadvertently led to increased risks of spotted fever and scrub typhus. However, periodic plowing can unintentionally mitigate vector

  10. Acute Rheumatic Fever: Global Persistence of a Preventable Disease.

    Science.gov (United States)

    Bono-Neri, Francine

    2016-10-21

    The persistence of acute rheumatic fever continues to be seen globally. Once thought to be eradicated in various parts of the world, the disease came back with a vengeance secondary to a lack of diligence on the part of providers. Today, the global burden of group A streptococcal infection, the culprit of the numerous sequelae manifested in acute rheumatic fever, is considerable. Although a completely preventable disease, rheumatic fever continues to exist. It is a devastating disease that involves long-term, multisystem treatment and monitoring for patients who were unsuccessful at eradicating the precipitating group A streptococcal infection. Prevention is the key to resolving the dilemma of the disease's global burden, yet the method to yield its prevention still remains unknown. Thus, meticulous attention to implementing proper treatment is the mainstay and remains a top priority.

  11. Anticorpos anti-rickettsias do grupo da febre maculosa em equídeos e caninos no norte do Estado do Paraná, Brasil Anti rickettsia-antibody for spotted fever group in horses and dogs in the North of Paraná Stated, Brazil

    Directory of Open Access Journals (Sweden)

    F.H. Otomura

    2010-06-01

    Full Text Available The Brazilian Spotted Fever (BSF is a zoonosis that can be fatal if not trteated. As there are few studies of the BSF in the Paraná State, the occurrence of BSF was serologically investigated in dogs and horses by indirect immunofluorescence assay (IFA, in the North of that State, in animals that are regarded as sentinels for BSF. A total of 241 samples of sera of equine, four of asinine, and 29 of dogs were collected in nine farms of three municipalities in the North of Paraná: Arapongas, Douradina, and Umuarama. From fifteen samples of equine serum with positive titres for RIFI, eight (53.3 % had titre of 64 against R. rickettsii, two (13.3 % 128 against R. rickettsii, and five (33.3 % were reactants for R. parkeri and R. rickettsii, with titres ranging from 64 to 2048, and 128 to 1024, respectively. The results showed that domestic animals, sentinels for BSF, are under low exposition to ticks infected with spotted fever group Rickettsia, indicating low risk of human infection by these agents in the studied area.

  12. Typhoid fever vaccination strategies.

    Science.gov (United States)

    Date, Kashmira A; Bentsi-Enchill, Adwoa; Marks, Florian; Fox, Kimberley

    2015-06-19

    Typhoid vaccination is an important component of typhoid fever prevention and control, and is recommended for public health programmatic use in both endemic and outbreak settings. We reviewed experiences with various vaccination strategies using the currently available typhoid vaccines (injectable Vi polysaccharide vaccine [ViPS], oral Ty21a vaccine, and injectable typhoid conjugate vaccine [TCV]). We assessed the rationale, acceptability, effectiveness, impact and implementation lessons of these strategies to inform effective typhoid vaccination strategies for the future. Vaccination strategies were categorized by vaccine disease control strategy (preemptive use for endemic disease or to prevent an outbreak, and reactive use for outbreak control) and vaccine delivery strategy (community-based routine, community-based campaign and school-based). Almost all public health typhoid vaccination programs used ViPS vaccine and have been in countries of Asia, with one example in the Pacific and one experience using the Ty21a vaccine in South America. All vaccination strategies were found to be acceptable, feasible and effective in the settings evaluated; evidence of impact, where available, was strongest in endemic settings and in the short- to medium-term. Vaccination was cost-effective in high-incidence but not low-incidence settings. Experience in disaster and outbreak settings remains limited. TCVs have recently become available and none are WHO-prequalified yet; no program experience with TCVs was found in published literature. Despite the demonstrated success of several typhoid vaccination strategies, typhoid vaccines remain underused. Implementation lessons should be applied to design optimal vaccination strategies using TCVs which have several anticipated advantages, such as potential for use in infant immunization programs and longer duration of protection, over the ViPS and Ty21a vaccines for typhoid prevention and control. Copyright © 2015. Published by

  13. [Antigenic diversity of African swine fever viruses].

    Science.gov (United States)

    Sereda, A D; Balyshev, V M

    2011-01-01

    Data on the seroimmunotypic and hemadsorbing characteristics of African swine fever virus (ASF) are summarized. According to the results of immunological sampling in pigs and those of hemagglutination inhibition test, the known ASFV strains and isolates were divided into 11 groups, 8 were characterized as seroimmunogroups having their specific reference strains. A 110-140-kD ASFV serotype-specific nonstructural major glycoprotein was identified. It is suggested that it is the glycoprotein that corresponds to the genetic engineering detected virus-specific homolog of lymphocyte membrane protein CD2, gene deletion of which results in the loss of hemadsorbing properties by ASFV.

  14. Cotton Fever: Does the Patient Know Best?

    Science.gov (United States)

    Xie, Yingda; Pope, Bailey A; Hunter, Alan J

    2016-04-01

    Fever and leukocytosis have many possible etiologies in injection drug users. We present a case of a 22-year-old woman with fever and leukocytosis that were presumed secondary to cotton fever, a rarely recognized complication of injection drug use, after an extensive workup. Cotton fever is a benign, self-limited febrile syndrome characterized by fevers, leukocytosis, myalgias, nausea and vomiting, occurring in injection drug users who filter their drug suspensions through cotton balls. While this syndrome is commonly recognized amongst the injection drug user population, there is a paucity of data in the medical literature. We review the case presentation and available literature related to cotton fever.

  15. [Autoinflammatory syndromes/fever syndromes].

    Science.gov (United States)

    Schedel, J; Bach, B; Kümmerle-Deschner, J B; Kötter, I

    2011-05-01

    Hereditary periodic (fever) syndromes, also called autoinflammatory syndromes, are characterized by relapsing fever and additional manifestations such as skin rashes, mucosal manifestations, or joint symptoms. Some of these disorders present with organ involvement and serological signs of inflammation without fever. There is a strong serological inflammatory response with an elevation of serum amyloid A (SAA), resulting in an increased risk of secondary amyloidosis. There are monogenic disorders (familial mediterranean fever (FMF), hyper-IgD-syndrome (HIDS), cryopyrin-associated periodic syndromes (CAPS), "pyogenic arthritis, acne, pyoderma gangrenosum" (PAPA), and "pediatric granulomatous arthritis (PGA) where mutations in genes have been described, which in part by influencing the function of the inflammasome, in part by other means, lead to the induction of the production of IL-1β. In "early-onset of enterocolitis (IBD)", a functional IL-10 receptor is lacking. Therapeutically, above all, the IL-1 receptor antagonist anakinra is used. In case of TRAPS and PGA, TNF-antagonists (etanercept) may also be used; in FMF colchicine is first choice. As additional possible autoinflammatory syndromes, PFAPA syndrome (periodic fever with aphthous stomatitis, pharyngitis and adenitis), Schnitzler syndrome, Still's disease of adult and pediatric onset, Behçet disease, gout, chronic recurrent multifocal osteomyelitis (CRMO) and Crohn's disease also are mentioned.

  16. Historical aspects of rheumatic fever.

    Science.gov (United States)

    Steer, Andrew C

    2015-01-01

    Few diseases have experienced such a remarkable change in their epidemiology over the past century, without the influence of a vaccine, than rheumatic fever. Rheumatic fever has all but disappeared from industrialised countries after being a frequent problem in the 1940s and 1950s. That the disease still occurs at high incidence in resource limited settings and in Indigenous populations in industrialised countries, particularly in Australia and New Zealand, is an indication of the profound effect of socio-economic factors on the disease. Although there have been major changes in the epidemiology of rheumatic fever, diagnosis remains reliant on careful clinical judgement and management is remarkably similar to that 50 years ago. Over the past decade, increasing attention has been given to rheumatic fever and rheumatic heart disease as public health issues, including in Australia and particularly in New Zealand, as well as in selected low and middle income countries. Perhaps the greatest hope for public health control of rheumatic fever is the development of a vaccine against Streptococcus pyogenes, and there are encouraging initiatives in this area. However, an effective vaccine is some time away and in the meantime public health efforts need to focus on effective translation of the known evidence around primary and secondary prophylaxis into policy and practice.

  17. Periodic Fever: A Review on Clinical, Management and Guideline for Iranian Patients - Part I

    Science.gov (United States)

    Ahmadinejad, Zahra; Mansori, Sedigeh; Ziaee, Vahid; Alijani, Neda; Aghighi, Yahya; Parvaneh, Nima; Mordinejad, Mohammad-Hassan

    2014-01-01

    Periodic fever syndromes are a group of diseases characterized by episodes of fever with healthy intervals between febrile episodes. The first manifestation of these disorders are present in childhood and adolescence, but infrequently it may be presented in young and middle ages. Genetic base has been known for all types of periodic fever syndromes except periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA). Common periodic fever disorders are Familial Mediterranean fever (FMF) and PFAPA. In each patient with periodic fever, acquired infection with chronic and periodic nature should be ruled out. It depends on epidemiology of infectious diseases. Some of them such as Familial Mediterranean fever and PFAPA are common in Iran. In Iran and other Middle East countries, brucellosis, malaria and infectious mononucleosis should be considered in differential diagnosis of periodic fever disorders especially with fever and arthritis manifestation. In children, urinary tract infection may be presented as periodic disorder, urine analysis and culture is necessary in each child with periodic symptoms. Some malignancies such as leukemia and tumoral lesions should be excluded in patients with periodic syndrome and weight loss in any age. After excluding infection, malignancy and cyclic neutropenia, FMF and PFAPA are the most common periodic fever disorders. Similar to other countries, Hyper IgD, Chronic Infantile Neurologic Cutaneous and Articular, TRAPS and other auto-inflammatory syndromes are rare causes of periodic fever in Iranian system registry. In part 1 of this paper we reviewed the prevalence of FMF and PFAPA in Iran. In part 2, some uncommon auto-inflammatory disorders such as TRAPS, Hyper IgD sydrome and cryopyrin associated periodic syndromes will be reviewed. PMID:25793039

  18. Periodic Fever, Aphthous Stomatitis, Pharyngitis and Cervical Adenitis (PFAPA) Syndrome in Iranian Children First Report of Iranian Periodic Fever and Autoinflammatory Registry (IPFAIR).

    Science.gov (United States)

    Mehregan, Fatemeh Fereshteh; Ziaee, Vahid; Ahmadinejad, Zahra; Tahghighi, Fatemeh; Sabouni, Farah; Moradinejad, Mohamad-Hassan

    2014-10-01

    The periodic fever, aphthous stomatitis, pharyngitis and cervical adenitis (PFAPA) syndrome is a nonhereditary idiopathic febrile syndrome belonging to the group of autoinflammatory diseases. No longtime sequel was reported in this disease. Early diagnosis can lead physicians to treatment of this disorder with a short course steroid application and provide satisfaction of the patient's family. This study is a prospective review of patients diagnosed with PFAPA syndrome who were registered in Iranian Periodic Fever and Autoinflammatory Registry (IPFAIR) through periodic fever clinic in the Children's Medical Center, Pediatric Center of Excellence in Tehran, Iran from January 2013 to March 2014. One hundred thirty patients were registered in our databases. Twenty-one (16.1%) patients including 15 males and 6 females had PFAPA. Normal growth was seen in all patients. The median age at onset was 18 months. The mean duration of fever was 4 days and the mean duration of intervals between fever episodes 21 days. Along with fever, all patients had characteristic symptoms. All patients were asymptomatic between fever episodes. Steroid was used in all patients and causing immediate reduction by 84.61%. Two patients received both steroid and colchicine because of their clinical feature and positive laboratory tests for PFAPA and familial Mediterranean fever. No patient received biological therapy or a tonsillectomy. The long diagnostic delay of PFAPA gives cause to concern indicating a need for greater awareness of the disease so that the diagnosis may be made timely.

  19. KOWLEDGE, ATTITUDES AND BELIEFS CONCERNING FEVER IN KAZIM KARABEKIR A DISTRICT AREA OF UMRANIYE

    Directory of Open Access Journals (Sweden)

    Sebahat Dilek TORUN

    2007-02-01

    Full Text Available Fever is extremely common in population. People have been shown to have unrealistic fears of the harmful effects of fever and they generally see it as the main component of an illness. The objective of this study was to survey people about their kowledge, attitude and beliefs concerning fever. The study was conducted in Kazim Karabekir a district area of Umraniye. The data were collected by focus group discussion in 6 goups and 40 people. An education was given to participants after discussion to teach the use of thermometer and patient care with high fever. Most of the participants feel the need for decreasing the temparature of people with high fever. They define the harms of high fever as febrile convulsion, stroke and menengitis. They dont know the range of normal body temparature. They generally don’t use termometers, measure the fever by touching with hand. Consequently, it has been observed that participants consider high fever is dangerous. However their applications related to high fever are insufficient. [TAF Prev Med Bull. 2007; 6(1: 69-76

  20. Drivers for inappropriate fever management in children: a systematic review.

    Science.gov (United States)

    Kelly, M; McCarthy, S; O'Sullivan, R; Shiely, F; Larkin, P; Brenner, M; Sahm, L J

    2016-08-01

    Background Fever is one of the most common childhood symptoms and accounts for numerous consultations with healthcare practitioners. It causes much anxiety amongst parents as many struggle with managing a feverish child and find it difficult to assess fever severity. Over- and under-dosing of antipyretics has been reported. Aim of the review The aim of this review was to synthesise qualitative and quantitative evidence on the knowledge, attitudes and beliefs of parents regarding fever and febrile illness in children. Method A systematic search was conducted in ten bibliographic databases from database inception to June 2014. Citation lists of studies and consultation with experts were used as secondary sources to identify further relevant studies. Titles and abstracts were screened for inclusion according to pre-defined inclusion and exclusion criteria. Quantitative studies using a questionnaire were analysed using narrative synthesis. Qualitative studies with a semi-structured interview or focus group methodology were analysed thematically. Results Of the 1565 studies which were screened for inclusion in the review, the final review comprised of 14 studies (three qualitative and 11 quantitative). Three categories emerged from the narrative synthesis of quantitative studies: (i) parental practices; (ii) knowledge; (iii) expectations and information seeking. A further three analytical themes emerged from the qualitative studies: (i) control; (ii) impact on family; (iii) experiences. Conclusion Our review identifies the multifaceted nature of the factors which impact on how parents manage fever and febrile illness in children. A coherent approach to the management of fever and febrile illness needs to be implemented so a consistent message is communicated to parents. Healthcare professionals including pharmacists regularly advise parents on fever management. Information given to parents needs to be timely, consistent and accurate so that inappropriate fever

  1. A study of the outbreak of Chikungunya fever.

    Science.gov (United States)

    Patil, Supriya Satish; Patil, Satish R; Durgawale, P M; Patil, A G

    2013-06-01

    Chikungunya fever occurred in an epidemic form in the state of Maharashtra after a gap of about 32 years. Many cases with symptoms which were suggestive of Chikungunya fever were reported from the village Kasegaon, Dist Sangli, Maharashtra, India. Hence, this study was done to assess the magnitude of the outbreak and to identify the possible socio-environmental factors which are responsible for Chikungunya fever. This cross sectional study was carried out at Kasegaon by a team from the Krishna Institute of Medical Sciences, Karad, Maharashtra, in collaboration with the Primary Health Centre, Kasegaon, Distt. Sangli. The Chikungunya prevalence was 9.6%. There were 154 clinically suspected Chikungunya fever cases. Of these, 54.5% were males and 45.5% were females. About 72.7% of the cases were in the age range of 11-50 years, which is the active age group. The main symptoms were an acute onset of fever with joint pain (100%). Multiple joints were involved in (89.6%) cases. The mean duration of the fever was 3 days (range 1-10 days). About 40.3% people preferred to consult a government health facility. In the affected area, 83.1% people were aware of Chikungunya fever. Only few (1.1%) knew the vectors which were responsible for the Chikungunya transmission. Among the people in the affected area, 33.1% had knowledge on insecticide spraying, 23.2% had knowledge on the use of mosquito nets and repellents, 12.5% had knowledge on source reduction and 0.8% had knowledge on larvicides.

  2. STUDY OF ULTRASOUND FINDING IN DENGUE FEVER

    Directory of Open Access Journals (Sweden)

    Sunita Bajaj

    2016-10-01

    Full Text Available BACKGROUND Dengue fever (DF is a viral haemorrhagic fever causing severe morbidity and mortality in affected patients. The aim of the study is to describe the role of ultrasonography (USG in the assessment of patients with Dengue fever, and its complications and to prove ultrasound is useful in the diagnosis during an epidemic. MATERIALS AND METHODS It is a prospective study was conducted in 2016 comprising of 178 patients who were serologically positive for dengue, radiological investigations were conducted in all cases. RESULTS Out of 178 patients Males (N=117 are more effected subjects in the study. female: Male ratio is 1:2. Hepatomegaly 74.1% which is most common findings in study, 113 (63.4% had GB wall thickening 98 had ascites (55%, 32 had pleural effusion (17.9%. most commonly seen in the age group of 20-39 years. Hepatomegaly was the most common finding noted in 67 patients (37.6%, followed by GB wall thickening in 65 patients (36.1%. Hepatomegaly was more common in 0-19 is 56 patients with 31.4% years age group Ascites in >40 years age group (16.8%. Hepatomegaly was seen in most of the patients whose platelet count was <40,000. (94.7%. GB wall thickening (88.5% common findings seen in patients whose platelet count was <40,000. In patients with platelet count of 40,000-80,000, Ascites is most common finding (87.5%, followed by Splenomegaly (60.7%. In patients whose platelet count was 80,000-150,000, Ascites (50% was more common than Splenomegaly (45.8%. In three patients with platelet count more than 150,000, no sonological abnormality was detected. CONCLUSIONS Ultrasound findings of hepatic changes, GB wall oedema, splenomegaly, ascites and pleural effusion in patients presenting with signs and symptoms of Dengue fever during an epidemic are diagnostic. Contributing in the differential diagnosis with other causes of febrile disease.

  3. Effect of familial Mediterranean fever on sexual and reproductive health in women.

    Science.gov (United States)

    Karakaş Uğurlu, Görkem; Uğurlu, Mustafa; Erten, Şükran; Can, Serdar Süleyman; Ulusoy Kaymak, Semra; Çayköylü, Ali

    2017-04-18

    The aim of this study was to investigate the relationship between familial Mediterranean fever and female sexual dysfunction and premenstrual syndrome. This study included 36 patients with familial Mediterranean fever and 33 healthy volunteers. Familial Mediterranean fever was diagnosed according to the Tel Hashomer criteria and familial Mediterranean fever mutations were identified in all of the patients. The patients and healthy volunteers were compared in terms of anxiety, depression, sexual dysfunction, and premenstrual syndrome, and a model was created that describes the relationships among these variables. We found statistically significant differences between the groups in terms of anxiety, premenstrual syndrome, and Golombok Rust Inventory of Sexual Satisfaction frequency and vaginismus subscale scores. There was no difference in depression scores between the groups. Familial Mediterranean fever is a rheumatic disease that predisposes patients to sexual dysfunction and premenstrual syndrome, which emerges as direct and indirect psychological factors.

  4. Management of acute childhood fevers.

    Science.gov (United States)

    Teuten, Polly; Paul, Siba Prosad; Heaton, Paul Anthony

    2015-01-01

    Feverish illnesses commonly affect children and are the second most frequent reason for a child to be admitted to hospital. Most cases are viral in origin, usually with a good prognosis. Fever can be caused by severe and rapidly progressive illness which needs urgent referral to hospital for potentially life-saving treatment, and community practitioners must be able to identify such cases showing 'red flag'features. The fear of serious disease among parents and carers may result in 'fever phobia' leading to minor illnesses being managed inappropriately. Community practitioners are well placed to reassure and support families, and to provide education regarding the facts about fever, the appropriate use of antipyretic medication, how to avoid dehydration, and the beneficial role of immunisation in preventing infection.

  5. Rheumatic Fever Programme in Samoa.

    Science.gov (United States)

    Viali, Satupaitea; Saena, Puleiala; Futi, Vailogoua

    2011-02-11

    Rheumatic fever is very common in Samoa. The following paper describes the Rheumatic Fever Programme in Samoa and looks at the incidence of acute rheumatic fever (ARF) and rheumatic heart disease (RHD). The incidence of ARF has decreased to 30 per 100,000 in 2005, 12.8 per 100,000 in 2007, 7.3 per 100,000 in 2008, and 9.5 per 100,000 in 2009. The incidence of RHD has decreased to 40.2 per 100,000 in 2007, 34 per 100,000 in 2008, and 31.8 per 100,000 in 2009. Cardiac surgery in New Zealand is expensive, but is cheaper to perform in Samoa. RHD screening with echocardiogram at schools may be the best way to reduce the burden and suffering from RHD.

  6. Bilateral retinitis following typhoid fever

    OpenAIRE

    Prabhushanker, M.; Topiwalla, Tasneem T.; Ganesan, Geetha; Appandaraj, Sripal

    2017-01-01

    Background Post typhoid fever immune related reactions affecting the eye is a rare finding which can have various presentations in which typhoid retinopathy is not a well recognized sequelae. Case presentation Here we present a case of 59?year old male who presented with right eye sudden painless loss of vision 4?weeks after typhoid fever which was diagnosed and treated successfully. His BCVA was 2/60 in right eye and 6/6 in left eye. Fundus examination showed retinitis along with macular ser...

  7. Cutaneous manifestations of chikungunya fever.

    Science.gov (United States)

    Seetharam, K A; Sridevi, K; Vidyasagar, P

    2012-01-01

    Chikungunya fever, a re-emerging RNA viral infection produces different cutaneous manifestations in children compared to adults. 52 children with chikungunya fever, confirmed by positive IgM antibody test were seen during 2009-2010. Pigmentary lesions were common (27/52) followed by vesiculobullous lesions (16/52) and maculopapular lesions (14/52). Vesiculobullous lesions were most common in infants, although rarely reported in adults. Psoriasis was exacerbated in 4 children resulting in more severe forms. In 2 children, guttate psoriasis was observed for the first time.

  8. Crimean-Congo Hemorrhagic Fever (CCHF)

    Science.gov (United States)

    ... Cancel Submit Search The CDC Crimean-Congo Hemorrhagic Fever (CCHF) Note: Javascript is disabled or is not ... on Facebook Tweet Share Compartir Crimean-Congo hemorrhagic fever (CCHF) is caused by infection with a tick- ...

  9. Rocky Mountain Spotted Fever: Statistics and Epidemiology

    Science.gov (United States)

    ... The CDC Cancel Submit Search The CDC Rocky Mountain Spotted Fever (RMSF) Note: Javascript is disabled or ... please visit this page: About CDC.gov . Rocky Mountain Spotted Fever (RMSF) Symptoms, Diagnosis, and Treatment Statistics ...

  10. Hyperthermia and fever control in brain injury.

    Science.gov (United States)

    Badjatia, Neeraj

    2009-07-01

    Fever in the neurocritical care setting is common and has a negative impact on outcome of all disease types. Meta-analyses have demonstrated that fever at onset and in the acute setting after ischemic brain injury, intracerebral hemorrhage, and cardiac arrest has a negative impact on morbidity and mortality. Data support that the impact of fever is sustained for longer durations after subarachnoid hemorrhage and traumatic brain injury. Recent advances have made eliminating fever and maintaining normothermia feasible. However, there are no prospective randomized trials demonstrating the benefit of fever control in these patient populations, and important questions regarding indications and timing remain. The purpose of this review is to analyze the data surrounding the impact of fever across a range of neurologic injuries to better understand the optimal timing and duration of fever control. Prospective randomized trials are needed to determine whether the beneficial impact of secondary injury prevention is outweighed by the potential risks of prolonged fever control.

  11. Malignant catarrhal fever: understanding molecular diagnostics in context of epidemiology

    Science.gov (United States)

    Malignant catarrhal fever (MCF) is a frequently fatal disease, primarily of ruminants, caused by a group of gammaherpesviruses. Due to complexities of pathogenesis and epidemiology in various species which are either clinically-susceptible or reservoir hosts, veterinary clinicians face significant ...

  12. Childhood fever education in a military population: is education enough?

    Science.gov (United States)

    Steelman, J; Kotchmar, G S; Brehm, W T; Greenwall, K

    1999-12-01

    Parental knowledge of childhood fever and clinic and emergency room utilization were studied in a military pediatric clinic population to determine if intervention would improve parental understanding and management of childhood fever. Multiple choice tests evaluating childhood fever knowledge were given to control and intervention groups. Clinic and emergency room utilization were tracked for appropriateness of visits based on criteria used in previous similar studies. Initial test scores showed no difference between the two groups. Subsequent test scores revealed a difference between the two groups as reflected by improved test scores. Evaluation of clinic and emergency room utilization of the groups did not show an overall improvement except in one subgroup analyzed. Intervention improved parental knowledge; however, intervention did not translate into anticipated improvement in clinic and emergency room utilization patterns. Emphasis on education and preventative services are important in both civilian and military pediatric practice. Results of this study highlight the need to discuss and reinforce fever education as a topic in pediatric preventive health care visits.

  13. EpiReview: Typhoid fever, NSW, 2005-2011.

    Science.gov (United States)

    Gunaratnam, Praveena; Tobin, Sean; Seale, Holly; Musto, Jennie

    2013-11-01

    To examine trends in the incidence of typhoid fever in NSW to inform the development of prevention strategies. Typhoid fever case notification data for the period 2005-2011 were extracted from the NSW Notifiable Conditions Information Management System. Population incidence rates were calculated and analysed by demographic variables. There were 250 case notifications of typhoid fever in NSW from 2005 to 2011, of which 240 are likely to have been acquired overseas. Case notifications remained relatively stable over the review period with the highest rates in Western Sydney Local Health District (10.9 per 100,000 population). Two-thirds (66.4%) of all case notifications are likely to have been acquired in South Asia, and about half of overseas-acquired case notifications were most likely to have been associated with travel to visit friends and relatives. Hospitalisation was required for 79.6% of cases where hospitalisation status was known. Prior typhoid vaccination was reported in 7% of cases in 2010 and 2011 where vaccination status was known. While typhoid fever rates remain low in NSW, case notifications of this preventable infection continue to be reported, particularly in travellers visiting friends and relatives in South Asia. Further research to better understand barriers to the use of preventive measures may be useful in targeting typhoid fever prevention messages in high-risk groups, particularly South Asian communities in NSW.

  14. [Analysis of parental knowledge and care in childhood fever].

    Science.gov (United States)

    Pérez-Conesa, Maria-Cristina; Sánchez Pina, Inés; Ridao Manonellas, Saida; Tormo Esparza, Antoni; García Hernando, Verónica; López Fernández, Marta

    2017-03-11

    To describe the parental knowledge and care of fever in children under 2years. Relate this data with socio-demographic with characteristics. Cross-sectional and correlation multicenter study. Five teams of Primary Care in Barcelona. Parents of children under 2years attended to administer a vaccine included in the pediatric systematic calendar. A total of 311 subjects participated. The main variables are 9 items of knowledge and 8 of care or management of fever obtained with the adaptation of the questionnaire by Chiappini et al. (2012). 69.8% had a correct care/management of fever. 3.9% matched all items of knowledge. The knowledge score is lower in people with no education (p=0.03); higher in Europe and South America and lowest in Asia and Africa (Pfever care (P=.03). It is important to note that the correlation between the scores of knowledge and management is positive (rho=0.15, P=.008). A correct care of fever is observed despite the low knowledge. A good strategy to promote a correct care of febrile child is to do sanitary education with update information and adapted it to parents, focusing on the differences between ethnic groups because they seem to have inaccurate beliefs about fever. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  15. Status of paratyphoid fever vaccine research and development.

    Science.gov (United States)

    Martin, Laura B; Simon, Raphael; MacLennan, Calman A; Tennant, Sharon M; Sahastrabuddhe, Sushant; Khan, M Imran

    2016-06-01

    Salmonella enterica serovars Typhi and Paratyphi (S. Paratyphi) A and B cause enteric fever in humans. Of the paratyphoid group, S. Paratyphi A is the most common serovar. In 2000, there were an estimated 5.4 million cases of S. Paratyphi A worldwide. More recently paratyphoid fever has accounted for an increasing fraction of all cases of enteric fever. Although vaccines for typhoid fever have been developed and in use for decades, vaccines for paratyphoid fever have not yet been licensed. Several S. Paratyphi A vaccines, however, are in development and based on either whole cell live-attenuated strains or repeating units of the lipopolysaccharide O-antigen (O:2) conjugated to different protein carriers. An O-specific polysaccharide (O:2) of S. Paratyphi A conjugated to tetanus toxoid (O:2-TT), for example, has been determined to be safe and immunogenic after one dose in Phase I and Phase II trials. Two other conjugated vaccine candidates linked to diphtheria toxin and a live-attenuated oral vaccine candidate are currently in preclinical development. As promising vaccine candidates are advanced along the development pipeline, an adequate supply of vaccines will need to be ensured to meet growing demand, particularly in the most affected countries.

  16. Simultaneous Onset of Chickenpox and Scarlet Fever: a Case Report

    Directory of Open Access Journals (Sweden)

    M Karimi

    2012-05-01

    Full Text Available Introduction: Chickenpox is a contagious febrile illness with rash that is caused by varicella zoster virus. Most children up to age 15 are infected with the virus. Scarlet fever is caused by erythrogenic toxin of streptococcus group A and usually causes skin reactions such as fine red and often itchy papules on the trunk and extremities as well as skin redness, especially on the groin and forearm. Case: Patient is a 3-year-old girl that two days after chickenpox while she had active lesions of the chickenpox, was infected with scarlet fever. Skin lesions at different stages along with the clinical symptoms confirmed the diagnosis of chickenpox. Chickenpox is a febrile illness, more contagious and associated with the rash, which rarely has been reported with scarlet fever. Macular lesions spreading all over the body especially the trunk, with strawberry red tongue and exudative lesions of tonsils with good response to penicillin confirmed the complication of scarlet fever following chickenpox. Rarely scarlet fever is a complication of chickenpox and symptoms of both conditions may be seen simultaneously. Considering that diagnosis of both diseases are based on clinical findings, so physicians should start the appropriate treatment if they have clinical suspicion.

  17. Overview of Classical Swine Fever (Hog Cholera, Classical Swine fever)

    Science.gov (United States)

    Classical swine fever is a contagious often fatal disease of pigs clinically characterized by high body temperature, lethargy, yellowish diarrhea, vomits and purple skin discoloration of ears, lower abdomen and legs. It was first described in the early 19th century in the USA. Later, a condition i...

  18. Hemorrhagic Fever with Renal Syndrome (Korean Hemorrhagic Fever)

    Science.gov (United States)

    1989-07-31

    Meningo- Fever, chills, headache, encepha- stiff neck, myalgia, litis conjunctival infection, back pain, dysuria, facial palsy (died 6 day) 3. Isolation of... Central Africa (23-26) and more recently in Taiwan, the Philippines, Malaysia, Singapore, Hong Kong, Fiji, Hawaii, Argentine, Uruguay and Paraguay

  19. [The nitroblue tetrazolium test in scarlet fever (author's transl)].

    Science.gov (United States)

    Trojan, I; Weippl, G

    1975-04-18

    The nitroblue tetrazolium (NBT) test was originally used to diagnose chronic granulomatous disease in childhood. Now it is applied in the diagnosis of acute bacterial infectious diseases, too. The NBT reduction of neutrophils was tested in 27 children with scarlet fever using the modified technique described by K i m et al. The tests were performed in 24 patients between the second and fourth day of illness, before starting antibiotic treatment. In accordance with the results obtained by Humbert et al. in a series of patients with various infectious diseases, 83% of the investigated children showed NBT values of between 41% and 95% (mean value 72%). The percentage of NBT-positive cells was likewise raised in cases of recurrent scarlet fever. Children with scarlet fever complications had highly elevated NBT-reduction values. The control group, consisting of children without infectious diseases, showed values of between 28% and 66% (mean value 33%).

  20. A timely reminder--rheumatic fever.

    Science.gov (United States)

    Lilic, Nikola; Kumar, Priyanka

    2013-04-19

    Rheumatic fever is a disease diagnosed using the Jones criteria. The Jones criteria were designed using data from areas with a low prevalence of rheumatic fever. In New Zealand there is a high prevalence of rheumatic fever amongst Maori and Pacific peoples. A case is presented where a child of Samoan ethnicity is diagnosed and treated for rheumatic fever without fulfilling the Jones criteria. Evidence supporting the broadening of the diagnostic criteria in high prevalence areas is highlighted.

  1. A Case of Olanzapine-Induced Fever

    Science.gov (United States)

    Yang, Cho-Hsiang; Chen, Ying-Yeh

    2017-01-01

    Olanzapine, a frequently used second-generation antipsychotic, has rarely been implicated as a cause of drug-induced fever in the absence of neuroleptic malignant syndrome. We describe a patient who developed isolated fever following olanzapine monotherapy, which subsided after discontinuation of olanzapine. Blockade of dopaminergic receptors and elevated cytokines concentration are possible mechanisms of fever development during treatment with olanzapine. This case calls for attention to olanzapine-induced fever in clinical practice. PMID:28138204

  2. Frequency of typhoid fever and its association with seasonal variations in Taxila, Pakistan

    Directory of Open Access Journals (Sweden)

    Naeem Bukhari

    2016-08-01

    Full Text Available Objective: To analyse seropositivity rates of salmonella with seasonal variations in the population of Taxila and the surrounding rural areas. Methods: The study was conducted among 760 suspected patients with symptoms of fever, headache, nausea and decreased white blood cells count screened for the typhoid fever. Blood samples collected from the suspected patients were tested for seropositivity by slide agglutination (Widal test and Immunochromatographic test, i.e. Typhidot. Results: From overall 760 suspected patients of typhoid fever only 192 (25.26% samples were positive for Widal and Typhidot test. The peak seropositivity rates were identified during the months of April–June, while decreased cases were observed from January to March. Age wise distribution of typhoid fever reflected that age groups of 10–15 years and 25–35 years were at higher risks of developing enteric fever with respect to age groups of 5–10 years and 61–70 years, respectively. On gender basis evaluation, females (24.49% were slightly at low risks of developing typhoid fever than males (25.9%. Conclusions: The present study highlights a higher burden of typhoid fever in Taxila and the surrounding areas population that directly reflects the poor hygienic condition and contamination of drinking water. The frequency of typhoid fever fluctuates with seasonal variations as higher rates found during the summer as compared to winter season.

  3. Parental knowledge and perceptions of fever in children and fever management practices: differences between parents of children with and without a history of febrile seizures.

    Science.gov (United States)

    Sakai, Rie; Niijima, Shinichi; Marui, Eiji

    2009-04-01

    The aim of this study was to compare maternal knowledge and perceptions of fever, fever management practices, and information sources of mothers of children with and without a history of febrile seizures. A questionnaire was used to survey mothers of children who visited health departments for a routine 18-month-old well baby check-up. A total of 386 responses were analyzed. More mothers of children with a history of febrile seizures than mothers of children without it stated that high fever caused febrile seizures and antipyretics prevented it. Fewer mothers of children with a history of febrile seizures than mothers in the other group thought that high fever caused brain damage and antipyretics prevented the disease from worsening and warmed the child's body during fever episode. Many mothers in both groups stated that they considered physicians to be their primary information source. Spouse and own parents were named as information sources among mothers of children with a history of febrile seizures, whereas books and the Internet were named in the other group. Mothers of children with a history of febrile seizures demonstrated a higher rate of accuracy in their knowledge of fever than those in the other group. Mothers of children with a history of febrile seizures used personal communication, whereas those in the other group relied on mass communication for health information. Providing accurate information to family members is essential to provide mothers with both accurate information and emotional support.

  4. Rocky Mountain Spotted Fever (For Parents)

    Science.gov (United States)

    ... Feeding Your 1- to 2-Year-Old Rocky Mountain Spotted Fever KidsHealth > For Parents > Rocky Mountain Spotted Fever Print A A A What's in ... en español La rickettsiosis maculosa About RMSF Rocky Mountain spotted fever (RMSF) is a bacterial infection that's ...

  5. First Outbreak of Dengue Hemorrhagic Fever, Bangladesh

    OpenAIRE

    Rahman, Mahbubur; Rahman, Khalilur; Siddque, A. K.; Shoma, Shereen; A. H. M. Kamal; Ali, K.S.; Nisaluk, Ananda; Breiman, Robert F

    2002-01-01

    During the first countrywide outbreak of dengue hemorrhagic fever in Bangladesh, we conducted surveillance for dengue at a hospital in Dhaka. Of 176 patients, primarily adults, found positive for dengue, 60.2% had dengue fever, 39.2% dengue hemorrhagic fever, and 0.6% dengue shock syndrome. The Dengue virus 3 serotype was detected in eight patients.

  6. Geriatric Fever Score: a new decision rule for geriatric care.

    Directory of Open Access Journals (Sweden)

    Min-Hsien Chung

    Full Text Available Evaluating geriatric patients with fever is time-consuming and challenging. We investigated independent mortality predictors of geriatric patients with fever and developed a prediction rule for emergency care, critical care, and geriatric care physicians to classify patients into mortality risk and disposition groups.Consecutive geriatric patients (≥65 years old visiting the emergency department (ED of a university-affiliated medical center between June 1 and July 21, 2010, were enrolled when they met the criteria of fever: a tympanic temperature ≥37.2°C or a baseline temperature elevated ≥1.3°C. Thirty-day mortality was the primary endpoint. Internal validation with bootstrap re-sampling was done.Three hundred thirty geriatric patients were enrolled. We found three independent mortality predictors: Leukocytosis (WBC >12,000 cells/mm3, Severe coma (GCS ≤ 8, and Thrombocytopenia (platelets <150 10(3/mm3 (LST. After assigning weights to each predictor, we developed a Geriatric Fever Score that stratifies patients into two mortality-risk and disposition groups: low (4.0% (95% CI: 2.3-6.9%: a general ward or treatment in the ED then discharge and high (30.3% (95% CI: 17.4-47.3%: consider the intensive care unit. The area under the curve for the rule was 0.73.We found that the Geriatric Fever Score is a simple and rapid rule for predicting 30-day mortality and classifying mortality risk and disposition in geriatric patients with fever, although external validation should be performed to confirm its usefulness in other clinical settings. It might help preserve medical resources for patients in greater need.

  7. Identification of Ctenocephalides felis fleas as a host of Rickettsia felis, the agent of a spotted fever rickettsiosis in Yucatań, Mexico.

    Science.gov (United States)

    Zavala-Velázquez, J E; Zavala-Castro, J E; Vado-Solís, I; Ruiz-Sosa, J A; Moron, C G; Bouyer, D H; Walker, D H

    2002-01-01

    In search for the vector of the recently recognized spotted fever rickettsiosis of the Yucatán, ticks, fleas, and lice were collected from vegetation and dogs in localities where seropositive persons had been found. The arthropods were examined by polymerase chain reaction (PCR) using primers for the genus-specific 17-kDa protein gene followed by restriction fragment length polymorphism (RFLP) and DNA sequencing. Eleven (20%) of 54 pools of Ctenocephalides felis fleas contained DNA of Rickettsia felis. None of 219 Amblyomma cajennense, 474 Rhiphicephalus sanguineus, 258 Boophilus sp. ticks, and 33 Poliplax species lice contained DNA of Rickettsia. The identity of the rickettsial DNA was confirmed as R. felis by PCR/RFLP for the citrate synthase and outer membrane protein A genes and by DNA sequencing. The results indicate that the host of R. felis in Yucatán is C. felis and suggest that the spotted fever rickettsiosis that has infected >5% of the population of the Yucatán and can present as a dengue-like illness is likely to be caused by R. felis.

  8. Typhoid Fever In Children

    African Journals Online (AJOL)

    Prof Ezechukwu

    2012-06-29

    Jun 29, 2012 ... study carried out in a Nigerian. Teaching ... common among the age group five to nine years ... dardization, inter laboratory variation and high false positive and ... symptoms and / or signs at presentation, social class based on ...

  9. Radiological observation in typhoid fever

    Energy Technology Data Exchange (ETDEWEB)

    Lim, K. Y.; Park, H. Y.; Kim, J. D.; Rhee, H. S. [Presbyterian Medical Center, Jeonju (Korea, Republic of)

    1985-12-15

    Radiographic findings in plain abdominal films, chest PA and liver scanning are considered to be ancillary diagnostic methods for uncomplicated typhoid fever and a valuable method for detection of complication such as intestinal perforation. 189 cases of clinically proven typhoid fever from Mar. 1973 to Feb. 1979 in this Hospital were reviewed and radiographic findings were analyzed carefully. The results are as follows: 1. Most (73.6%) cases were between 20 and 40 years of age. 2. Three of the most common radiographic findings were as follows: 1) Localized paralytic ileus in RLQ or diffuse paralytic ileus (96.3%). 2) Hepatomegaly (56.5%). 3) Splenomegaly (49.7%). 3. In cases of typhoid fever with intestinal perforation there were additional significant findings such as free air under diaphragm (85%), free fluid in peritoneal cavity (90%) and air fluid levels in RLQ (80%). 4. The most frequent chest x-ray finding was elevation of diaphragm (11.1%). 5. 8 cases of complicated typhoid fever which eventually came to operation were diagnosed only by radiographic method.

  10. Abdominal Complications of Typhoid Fever

    OpenAIRE

    Ketan Vagholkar; Jimmy Mirani; Urvashi Jain; Madhavan Iyengar; Rahul Kumar Chavan

    2015-01-01

    The natural history of typhoid fever poses both a diagnostic and a therapeutic challenge. Awareness of the clinical features of the primary presentation and of the complications are pivotal to early diagnosis. Typically, aggressive supportive care is all that is needed. However abdominal complications do occur and proper surgical care is required to lower morbidity and mortality.

  11. Nature Inspired Hay Fever Therapy

    Institute of Scientific and Technical Information of China (English)

    Andrei P.Sommer; Dan Zhu

    2008-01-01

    The survival oriented adaptation of evolved biosystems to variations in their environment is a selective optimization process. Recognizing the optimised end product and its functionality is the classical arena of bionic engineering. In a primordial world, however, the molecular organization and functions of prebiotic systems were solely defined by formative processes in their physical and chemical environment, for instance, the interplay between interracial water layers on surfaces and solar light. The formative potential of the interplay between light (laser light) and interfacial water layers on surfaces was recently exploited in the formation of supercubane carbon nanocrystals. In evolved biosystems the formative potential of interracial water layers can still be activated by light. Here we report a case of hay fever, which was successfully treated in the course of a facial reju-venation program starting in November 2007. Targeting primarily interfacial water layers on elastin fibres in the wrinkled areas, we presumably also activated mast cells in the nasal mucosa, reported to progressively decrease in the nasal mucosa of the rabbit, when frequently irradiated. Hay fever is induced by the release of mediators, especially histamine, a process associated with the degranulation of mast cells. Decrease in mast cells numbers implies a decrease in the release of histamine. To the best of our knowledge this is the first report on the treatment of hay fever with visible light. This approach was inspired by bionic thinking, and could help ameliorating the condition of millions of people suffering from hay fever world wide.

  12. Cardiac Manifestation in Dengue Fever.

    Science.gov (United States)

    Arora, Mohit; Patil, Rekha S

    2016-07-01

    To study the cardiac manifestations of the dengue fever. This one year descriptive study was undertaken at KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belgaum under the Department of Medicine. A total of 120 patients with either dengue IgM or IgM and IgG were studied. The assessment of cardiac manifestations was done based on electrocardiogram, 2D echocardiography and cardiac enzymes. Of the 120 patients, 85 (70.83%) were males and the male to female ratio was 2.4:1. The mean age of the patients was 33.02 ± 12.71 years. The commonest clinical presentation was myalgia (97.5%) followed by fever (92.5%). On clinical examination 33.33% of the patients had petecheia and only 9 patients having active bleeding manifestation at the time of presentation. A raised CK-MB and Troponin I was observed in 33.3% and 26.7% patients ECG findings revealed normal rhythm among 95% with 15.8% of them having an abnormal heart rate. Rhythm disturbance was noted in 5% of the patients with AV block being the most common (66.67%). Cardiac manifestation in the form of myocarditis was observed in 37.50% of the patients with a positive correlation with the severity of the dengue fever defined as by W.H.O. criteria. Patients with dengue fever are at high risk of developing myocarditis and rhythm disturbance and therefore require a close cardiac monitoring.

  13. Sandfly Fever Sicilian Virus, Algeria

    Science.gov (United States)

    Izri, Arezki; Temmam, Sarah; Moureau, Grégory; Hamrioui, Boussad; de Lamballerie, Xavier

    2008-01-01

    To determine whether sandfly fever Sicilian virus (SFSV) is present in Algeria, we tested sandflies for phlebovirus RNA. A sequence closely related to that of SFSV was detected in a Phlebotomus ariasi sandfly. Of 60 human serum samples, 3 contained immunoglobulin G against SFSV. These data suggest SFSV is present in Algeria. PMID:18439364

  14. Fever in Infants and Children

    Science.gov (United States)

    ... with a high fever?YesNoDoes it hurt or burn when your child urinates and does he or she or have ... CareMild cases of croup can be treated at home. Make sure your child gets plenty of rest and lots of fluids. ...

  15. Absorption fever characteristics due to percutaneous renal biopsy-related hematoma.

    Science.gov (United States)

    Hu, Tingyang; Liu, Qingquan; Xu, Qin; Liu, Hui; Feng, Yan; Qiu, Wenhui; Huang, Fei; Lv, Yongman

    2016-09-01

    This study aims to describe the unique characteristics of absorption fever in patients with a hematoma after percutaneous renal biopsy (PRB) and distinguish it from secondary infection of hematoma.We retrospectively studied 2639 percutaneous renal biopsies of native kidneys. We compared the clinical characteristics between 2 groups: complication group (gross hematuria and/or perirenal hematoma) and no complication group. The axillary temperature of patients with a hematoma who presented with fever was measured at 06:00, 10:00, 14:00, and 18:00. The onset and duration of fever and the highest body temperature were recorded. Thereafter, we described the time distribution of absorption fever and obtained the curve of fever pattern.Of 2639 patients, PRB complications were observed in 154 (5.8%) patients. Perirenal hematoma was the most common complication, which occurred in 118 (4.5%) of biopsies, including 74 small hematoma cases (thickness ≤3 cm) and 44 large hematoma cases (thickness >3 cm). Major complications were observed in only 6 (0.2%) cases resulting from a large hematoma. Of 118 patients with a perirenal hematoma, absorption fever was observed in 48 cases. Furthermore, large hematomas had a 5.23-fold higher risk for absorption fever than the small ones.Blood pressure, renal insufficiency, and prothrombin time could be risk factors for complications. Fever is common in patients with hematoma because of renal biopsy and is usually noninfectious. Evaluation of patients with post-biopsy fever is necessary to identify any obvious infection sources. If no focus is identified, empiric antibiotic therapy should not be initiated nor should prophylactic antibiotics be extended for prolonged durations. Absorption fevers will resolve in time without specific therapeutic interventions.

  16. Childhood fever management program for Korean pediatric nurses: A comparison between blended and face-to-face learning method.

    Science.gov (United States)

    Jeong, Yong Sun; Kim, Jin Sun

    2014-01-01

    A blended learning can be a useful learning strategy to improve the quality of fever and fever management education for pediatric nurses. This study compared the effects of a blended and face-to-face learning program on pediatric nurses' childhood fever management, using theory of planned behavior. A nonequivalent control group pretest-posttest design was used. A fever management education program using blended learning (combining face-to-face and online learning components) was offered to 30 pediatric nurses, and 29 pediatric nurses received face-to-face education. Learning outcomes did not significantly differ between the two groups. However, learners' satisfaction was higher for the blended learning program than the face-to-face learning program. A blended learning pediatric fever management program was as effective as a traditional face-to-face learning program. Therefore, a blended learning pediatric fever management-learning program could be a useful and flexible learning method for pediatric nurses.

  17. Acute rheumatic fever and rheumatic heart disease among children--American Samoa, 2011-2012.

    Science.gov (United States)

    Beaudoin, Amanda; Edison, Laura; Introcaso, Camille E; Goh, Lucy; Marrone, James; Mejia, Amelita; Van Beneden, Chris

    2015-05-29

    Acute rheumatic fever is a nonsuppurative, immune-mediated consequence of group A streptococcal pharyngitis (strep throat). Recurrent or severe acute rheumatic fever can cause permanent cardiac valve damage and rheumatic heart disease, which increases the risk for cardiac conditions (e.g., infective endocarditis, stroke, and congestive heart failure). Antibiotics can prevent acute rheumatic fever if administered no more than 9 days after symptom onset. Long-term benzathine penicillin G (BPG) injections are effective in preventing recurrent acute rheumatic fever attacks and are recommended to be administered every 3-4 weeks for 10 years or until age 21 years to children who receive a diagnosis of acute rheumatic fever. During August 2013, in response to anecdotal reports of increasing rates of acute rheumatic fever and rheumatic heart disease, CDC collaborated with the American Samoa Department of Health and the Lyndon B. Johnson Tropical Medical Center (the only hospital in American Samoa) to quantify the number of cases of pediatric acute rheumatic fever and rheumatic heart disease in American Samoa and to assess the potential roles of missed pharyngitis diagnosis, lack of timely prophylaxis prescription, and compliance with prescribed BPG prophylaxis. Using data from medical records, acute rheumatic fever incidence was calculated as 1.1 and 1.5 cases per 1,000 children aged ≤18 years in 2011 and 2012, respectively; 49% of those with acute rheumatic fever subsequently received a diagnosis of rheumatic heart disease. Noncompliance with recommended prophylaxis with BPG after physician-diagnosed acute rheumatic fever was noted for 22 (34%) of 65 patients. Rheumatic heart disease point prevalence was 3.2 cases per 1,000 children in August 2013. Establishment of a coordinated acute rheumatic fever and rheumatic heart disease control program in American Samoa, likely would improve diagnosis, treatment, and patient compliance with BPG prophylaxis.

  18. Fever of unknown origin: a clinical approach.

    Science.gov (United States)

    Cunha, Burke A; Lortholary, Olivier; Cunha, Cheston B

    2015-10-01

    Fevers of unknown origin remain one of the most difficult diagnostic challenges in medicine. Because fever of unknown origin may be caused by over 200 malignant/neoplastic, infectious, rheumatic/inflammatory, and miscellaneous disorders, clinicians often order non-clue-based imaging and specific testing early in the fever of unknown origin work-up, which may be inefficient/misleading. Unlike most other fever-of-unknown-origin reviews, this article presents a clinical approach. Characteristic history and physical examination findings together with key nonspecific test abnormalities are the basis for a focused clue-directed fever of unknown origin work-up. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. Adult-onset acute rheumatic fever.

    Science.gov (United States)

    Nakashima, Dainari; Ueda, Kohei; Tsukuda, Kyozo; Utsu, Noriaki; Kohki, Shimazu; Fushimi, Hiroaki; Miyakoshi, Kazuho

    2012-01-01

    A 62-year-old man was hospitalized for acute rheumatic fever. He had previously suffered from rheumatic fever at 15 years of age. The rheumatic fever was complicated by carditis, which caused valve disease that required surgical treatment. The incidence of rheumatic fever has decreased in most developed countries with improvements in sanitary conditions. The low incidence of this disease makes a timely and accurate diagnosis difficult. Due to the fact that both the first occurrence and recurrence of acute rheumatic fever can occur in the elderly and adults, this potential disease should not be overlooked when making a differential diagnosis.

  20. Evaluation of fever in the immediate postoperative period in patients who underwent total joint arthroplasty.

    Science.gov (United States)

    Athanassious, Christian; Samad, Adil; Avery, Anthony; Cohen, Jason; Chalnick, David

    2011-12-01

    Forty percent to 50% of patients may experience an immediate postoperative fever. Research suggests that these are of aseptic cause due to inflammatory mediators. This is a retrospective analysis of fevers in total hip arthroplasty (THA) and total knee arthroplasty (TKA) patients from 2006 to 2008. Thirty-six percent of THA and 31% of TKA patients developed a fever, with most developing a maximum temperature on postoperative day (POD) 2. The maximum mean temperature between the THA and TKA group was not significantly different. Fevers in the immediate postoperative period are a normal variant in patients undergoing THA or TKA. Urinalysis, urine culture and sensitivity, and chest x-ray are not required during this period because most of these fevers stem from aseptic causes. Copyright © 2011 Elsevier Inc. All rights reserved.

  1. Effectiveness of Simulation-Based Education on Childhood Fever Management by Taiwanese Parents.

    Science.gov (United States)

    Chang, Li-Chuan; Lee, Ping-Ing; Guo, Nai-Wen; Huang, Mei-Chih

    2016-12-01

    Childhood fever is a common symptom managed by parents at home. Most parents do not know the definition of fever, its effect, or its management. To establish simulation-based education for parents and evaluate its effectiveness for fever management at home are essential for nursing care. This study assesses the long-term effects of simulation-based education on information, motivation, behavioral skills, and behaviors related to parental fever management in Taiwan. Cluster random sampling was used to recruit parents having children aged from 3 months to 5 years who were attending kindergartens in Kaohsiung, Taiwan. A total of 160 parents were randomly assigned into experimental (EP) and control (CP) groups equally. Parents in the EP group received simulation-based education with fever education brochures, while the CP group received only the brochure. Data on parental fever information, motivation, behavioral skills, and management behaviors were collected before the 1(st) day, on the 1(st) day (except management behaviors), at the 6-month, and at the 12-month marks post-training with a self-developed instrument based on the information-motivation-behavioral skills model. The results of a generalized estimating equation analysis indicated that the information, motivation, behavioral skills, and management behaviors of all participants had improved at the post-test assessment, with the EP group showing significantly better improvement than the CP group. This study supports that simulation-based education effectively enhances fever management of parents for a long period of time. Simulation-based education, compared to using the brochure, was a better strategy for improving parental information, motivation, behavioral skills, and behaviors regarding fever management. We suggest that providing community-based education on fever with scenario simulation is needed to increase parental competence for child care. Copyright © 2016. Published by Elsevier B.V.

  2. What would PCR assessment change in the management of fevers in a malaria endemic area? A school-based study in Benin in children with and without fever

    Directory of Open Access Journals (Sweden)

    Faucher Jean-François

    2010-08-01

    Full Text Available Abstract Background A recent school-based study in Benin showed that applying a policy of anti-malarial prescriptions restricted to parasitologically-confirmed cases on the management of fever is safe and feasible. Additional PCR data were analysed in order to touch patho-physiological issues, such as the usefulness of PCR in the management of malaria in an endemic area or the triggering of a malaria attack in children with submicroscopic malaria. Methods PCR data were prospectively collected in the setting of an exposed (with fever/non exposed (without fever study design. All children had a negative malaria rapid diagnostic test (RDT at baseline, were followed up to day 14 and did not receive drugs with anti-malarial activity. The index group was defined by children with fever at baseline and the control group by children without fever at baseline. Children with submicroscopic malaria in these two groups were defined by a positive PCR at baseline. Results PCR was positive in 66 (27% children of the index group and in 104 (44% children of the control group respectively. The only significant factor positively related to PCR positivity at baseline was the clinical status (control group. When definition of malaria attacks included PCR results, no difference of malaria incidence was observed between the index and control groups, neither in the whole cohort, nor in children with submicroscopic malaria. The rate of undiagnosed malaria at baseline was estimated to 3.7% at baseline in the index group. Conclusions Treating all children with fever and a positive PCR would have led to a significant increase of anti-malarial consumption, with few benefits in terms of clinical events. Non malarial fevers do not or do not frequently trigger malaria attacks in children with submicroscopic malaria.

  3. [Clinical aspects of viral hemorrhagic fever].

    Science.gov (United States)

    Saijo, Masayuki

    2005-12-01

    Viral hemorrhagic fever (VHF) is defined as virus infections that usually cause pyrexia and hemorrhagic symptoms with multiple organ failure. VHF includes following viral infections: Ebola hemorrhagic fever (EHF), Marburg hemorrhagic fever (MHF), Crimean-Congo hemorrhagic fever (CCHF) and Lassa fever. In particular, the causative agents of EHF, MHF, CCHF, and Lassa fever are Ebola, Marburg, CCHF, Lassa viruses, respectively, and regarded as biosafety level-4 pathogens because of their high virulence to humans. Recently, relatively large outbreaks of EHF and MHF have occurred in Africa, and areas of EHF- and MHF-outbreaks seem to be expanding. Although outbreaks of VHF have not been reported in Japan, there is a possibility that the deadly hemorrhagic fever viruses would be introduced to Japan in future. Therefore, preparedness for possible future outbreaks of VHF is necessary in areas without VHF outbreaks.

  4. Clinical genetic testing of periodic fever syndromes.

    Science.gov (United States)

    Marcuzzi, Annalisa; Piscianz, Elisa; Kleiner, Giulio; Tommasini, Alberto; Severini, Giovanni Maria; Monasta, Lorenzo; Crovella, Sergio

    2013-01-01

    Periodic fever syndromes (PFSs) are a wide group of autoinflammatory diseases. Due to some clinical overlap between different PFSs, differential diagnosis can be a difficult challenge. Nowadays, there are no universally agreed recommendations for most PFSs, and near half of patients may remain without a genetic diagnosis even after performing multiple-gene analyses. Molecular analysis of periodic fevers' causative genes can improve patient quality of life by providing early and accurate diagnosis and allowing the administration of appropriate treatment. In this paper we focus our discussion on effective usefulness of genetic diagnosis of PFSs. The aim of this paper is to establish how much can the diagnostic system improve, in order to increase the success of PFS diagnosis. The mayor expectation in the near future will be addressed to the so-called next generation sequencing approach. Although the application of bioinformatics to high-throughput genetic analysis could allow the identification of complex genotypes, the complexity of this definition will hardly result in a clear contribution for the physician. In our opinion, however, to obtain the best from this new development a rule should always be kept well in mind: use genetics only to answer specific clinical questions.

  5. Population Screening for Chronic Q-Fever Seven Years after a Major Outbreak.

    Directory of Open Access Journals (Sweden)

    Gabriëlla Morroy

    Full Text Available From 2007 through 2010, the Netherlands experienced a large Q-fever epidemic, with 4,107 notifications. The most serious complication of Q-fever is chronic Q-fever.In 2014, we contacted all 2,161 adult inhabitants of the first village in the Netherlands affected by the Q-fever epidemic and offered to test for antibodies against Coxiella burnetii using immunofluorescence assay (IFA to screen for chronic infections and assess whether large-scale population screening elsewhere is warranted.Of the 1,517 participants, 33.8% were IFA-positive. Six IFA-positive participants had an IgG phase I titer ≥1:512. Two of these six participants were previously diagnosed with chronic Q-fever. Chronic infection was diagnosed in one of the other four participants after clinical examination.Seven years after the initial outbreak, seroprevalence remains high, but the yield of screening the general population for chronic Q-fever is low. A policy of screening known high-risk groups for chronic Q-fever in outbreak areas directly following an outbreak might be more efficient than population screening. A cost-effectiveness analysis should also be performed before initiating a population screening program for chronic Q-fever.

  6. Clinico-epidemiologicalfeatures of dengue fever in Saudi Arabia

    Institute of Scientific and Technical Information of China (English)

    Abdel-Hady El-Gilany; Abdelaziz Eldeib; Sabri Hammad

    2010-01-01

    Objective: To highlight some clinical and epidemiological features of dengue fever.Methods:All patients who were admitted to hospitals in Holly Mecca City, Saudi Arabia and were confirmed as dengue fever (DF) or dengue hemorrhagic fever (DHF) were included in this study. The data were collected from patient files and through direct interview with patients or their relatives. Cases were followed through their hospital stay. Routine laboratory investigations were done and diagnosis was confirmed by PCR.Results: Most of cases admitted in stable condition (94.37%) and only one case (1.41%) died. Dengue-1 and 3 types were the prevalent dengue viruses and cases in age group 16-44 were the most frequent (70.40%). The most common symptoms was fever reported from all cases followed by headache (74.60%), myalgia and anorexia (67.60%), back pain (59.20%) and chills (54.90%). DF represented (60.57%) of the cases while DHF represented (39.43%). About half of cases had underground water tanks for human use, 5.60% had over house roof water tanks and 43.70% had both types, 16.90% of these tanks were uncovered. Approximately 70.00% of cases reported presence of small collection of water nearby houses and 46.80% reported the presence of mosquitoes within their houses.Conclusions: Most dengue fever cases might be endogenous in origin due to prevalence of mosquitoes and their breeding places within the houses and in nearby localities. Control of mosquitoes and their breeding places will contribute to prevention of dengue fever.

  7. Fever of unknown origin (FUO) in a renal transplant recipient due to drug fever from sirolimus.

    Science.gov (United States)

    Sharif, Sairah; Kong, May W; Drakakis, James; Cunha, Burke A

    2016-08-01

    A variety of medications may cause drug fever. Drug fevers may persist for days to weeks until diagnosis is considered. The diagnosis of drug fever is confirmed when there is resolution of fever within 3 days after the medication is discontinued. Only rarely do undiagnosed drug fevers persist for over 3 weeks to meet fever of unknown origin (FUO) criteria. FUOs due to drug fever are uncommon, and drug fevers due to immunosuppressive drugs are very rare. This is a case of a 58-year-old female renal transplant recipient who presented with FUO that remained undiagnosed for over 8 weeks. We believe this is the first reported case of an FUO due to drug fever from sirolimus in a renal transplant recipient.

  8. Guidelines for the genetic diagnosis of hereditary recurrent fevers

    DEFF Research Database (Denmark)

    Shinar, Y; Obici, L; Aksentijevich, I

    2012-01-01

    Hereditary recurrent fevers (HRFs) are a group of monogenic autoinflammatory diseases characterised by recurrent bouts of fever and serosal inflammation that are caused by pathogenic variants in genes important for the regulation of innate immunity. Discovery of the molecular defects responsible ...... and 19 September 2011 to ratify the draft and obtain a final consensus document. An agreed set of best practice guidelines was proposed for genetic diagnostic testing of HRFs, for reporting the genetic results and for defining their clinical significance.......Hereditary recurrent fevers (HRFs) are a group of monogenic autoinflammatory diseases characterised by recurrent bouts of fever and serosal inflammation that are caused by pathogenic variants in genes important for the regulation of innate immunity. Discovery of the molecular defects responsible...... for these diseases has initiated genetic diagnostics in many countries around the world, including the Middle East, Europe, USA, Japan and Australia. However, diverse testing methods and reporting practices are employed and there is a clear need for consensus guidelines for HRF genetic testing. Draft guidelines were...

  9. An outbreak of scarlet fever in a primary school.

    Science.gov (United States)

    Lamden, K H

    2011-04-01

    Scarlet fever, due to infection with an erythrogenic toxin-producing Group A streptococcus, is an uncommon and generally mild illness, although serious sequelae do occur. In March 2009, 57 of the 126 (45%) pupils in a primary school in Lancashire, UK developed scarlet fever over a 4-week period. Infection was transmitted via direct contact between pupils, particularly among the youngest pupils. A significant degree of transmission also occurred between siblings. The median number of days absent from school was 3 (range 1-10 days). No children were hospitalised. Control measures, including hygiene advice to the school and exclusion of pupils for 24h while initiating penicillin treatment, were ineffective. The outbreak occurred against a background of an unusually high incidence of invasive Group A streptococcal infection. While there are national guidelines for the control of invasive disease, none exist for the control of scarlet fever outbreaks. This prolonged outbreak of scarlet fever highlights the need for an evidence based approach to outbreak management.

  10. Investigation and control of malaria and typhoid fever in construction site by a construction group in Nigeria%某建设集团尼日利亚项目部建设工地疟疾和伤寒疫情的调查与处置

    Institute of Scientific and Technical Information of China (English)

    贾玉新; 刘旭红; 何建; 李治平; 吴照

    2016-01-01

    Objective Through malaria and typhoid fever outbreak investigation and control in foreign construction project site in Nigeria, experience and guidance were provided for the prevention and control of infectious diseases under the similar situations. Methods Procedures included field visits, retrospective investigation, etiology microscopy of Plasmodium falciparum, blood culture of typhoid fever cases in June, 2013. Results Among the 74 persons on the construction site, 3 was infected by malaria, and 4 by malaria and typhoid, 26 carrying Salmonella typhi, including the 3 chefs. Under the guidance of the advisory group, malaria cases were treated by standard protocols. Cases of typhoid fever and pathogen carriers were isolated and treated. Patients with malaria and typhoid fever as well as other health issues were dispatched back to China for further medical care. Conclusion Elimination of mosquitoes and breeding sources, strengthening personal protection, avoidance of mosquito bites were effective important measures to prevent malaria. It may need further study in Nigeria.%目的:通过对某建设集团尼日利亚项目部建设工地疟疾、伤寒疫情的调查与处置,为涉外建设项目传染病疫情的预防控制提供经验,尤其是对疟疾、伤寒疫情的处置提供指导。方法2013年6月采用现场走访和回顾性调查等方法进行流行病学调查。采用疟疾实验室病原学镜检疟原虫、伤寒实验室血培养等方法确诊病例。结果建设工地74人中,患疟疾3例,同时患有疟疾和伤寒的4例,携带伤寒杆菌者26例,其中包括食堂仅有的3名厨师。在工作组专家的指导和帮助下,对疟疾患者进行规范治疗,对伤寒患者及伤寒杆菌携带者进行隔离和针对性治疗,对患有疟疾或伤寒伴有其他基础性疾病的工人接回国内进行规范性治疗。结论消灭蚊虫、清除蚊虫孳生地、加强个人防护和避免蚊虫叮咬是预防疟

  11. Nuclease Tudor-SN Is Involved in Tick dsRNA-Mediated RNA Interference and Feeding but Not in Defense against Flaviviral or Anaplasma phagocytophilum Rickettsial Infection.

    Directory of Open Access Journals (Sweden)

    Nieves Ayllón

    Full Text Available Tudor staphylococcal nuclease (Tudor-SN and Argonaute (Ago are conserved components of the basic RNA interference (RNAi machinery with a variety of functions including immune response and gene regulation. The RNAi machinery has been characterized in tick vectors of human and animal diseases but information is not available on the role of Tudor-SN in tick RNAi and other cellular processes. Our hypothesis is that tick Tudor-SN is part of the RNAi machinery and may be involved in innate immune response and other cellular processes. To address this hypothesis, Ixodes scapularis and I. ricinus ticks and/or cell lines were used to annotate and characterize the role of Tudor-SN in dsRNA-mediated RNAi, immune response to infection with the rickettsia Anaplasma phagocytophilum and the flaviviruses TBEV or LGTV and tick feeding. The results showed that Tudor-SN is conserved in ticks and involved in dsRNA-mediated RNAi and tick feeding but not in defense against infection with the examined viral and rickettsial pathogens. The effect of Tudor-SN gene knockdown on tick feeding could be due to down-regulation of genes that are required for protein processing and blood digestion through a mechanism that may involve selective degradation of dsRNAs enriched in G:U pairs that form as a result of adenosine-to-inosine RNA editing. These results demonstrated that Tudor-SN plays a role in tick RNAi pathway and feeding but no strong evidence for a role in innate immune responses to pathogen infection was found.

  12. Latex agglutination test (LAT) for the diagnosis of typhoid fever.

    Science.gov (United States)

    Sahni, Gopal Shankar

    2013-06-01

    The efficacy of latex agglutination test in the rapid diagnosis of typhoid fever was studied and the result compared with that of blood culture. This study included 80 children suffering from typhoid fever, among which 40 were confirmed by blood culture isolation and 40 had possible typhoid fever based on high Widal's titre (a four-fold rise in the titre of antibody to typhi "O" and "H" antigen was considered as a positive Widal's test result). Eighty children, 40 with febrile illness confirmed to be other than typhoid and 40 normal healthy children were used as negative controls. The various groups were: (i) Study group ie, group I had 40 children confirmed by culture isolation of Salmonella typhi(confirmed typhoid cases). (ii) Control groups ie, (a) group II with 40 febrile controls selected from paediatrics ward where cause other than S typhi has been established, (b) group III with 40 afebrile healthy controls that were siblings of the children admitted in paediatric ward for any reason with no history of fever and TAB vaccination in the last one year, and (c) group IV with 40 children with high Widal's titre in paired sera sample. Widal's test with paired sera with a one week interval between collections were done in all 40 patients. Latex aggtutination test which could detect 900 ng/ml of antigen as observed in checker board titration, was positive in all 40 children from group I who had positive blood culture and in 30 children from group IV who had culture negative and had high Widal's titre positive. Latex agglutination test was positive in 4 children in group II and none in group III. Using blood culture positive cases as true positive and children in groups II and III as true negative, the test had a sensitivity of 100% and specificity of 96%. Latex agglutination test was found to be significantly sensitive (100%) and specific (96%) and could detect 75% more cases in group IV (possible typhoid cases). Thus latex agglutination test can be used for rapid

  13. Bilateral retinitis following typhoid fever.

    Science.gov (United States)

    Prabhushanker, M; Topiwalla, Tasneem T; Ganesan, Geetha; Appandaraj, Sripal

    2017-01-01

    Post typhoid fever immune related reactions affecting the eye is a rare finding which can have various presentations in which typhoid retinopathy is not a well recognized sequelae. Here we present a case of 59 year old male who presented with right eye sudden painless loss of vision 4 weeks after typhoid fever which was diagnosed and treated successfully. His BCVA was 2/60 in right eye and 6/6 in left eye. Fundus examination showed retinitis along with macular serous detachment in right eye and retinitis in left eye. Significant improvement in BCVA in right eye was observed after treatment with oral steroid with resolving retinitis lesions. Diagnosis of post typhoid immune mediated retinitis was made with good resolution following treatment. Immune mediated retinitis is a rare sequelae to typhoid infection which can be successfully treated with systemic steroids with good resolution of the lesions.

  14. Familial Mediterranean fever: current perspectives

    Science.gov (United States)

    Sönmez, Hafize Emine; Batu, Ezgi Deniz; Özen, Seza

    2016-01-01

    Familial Mediterranean fever (FMF) is the most frequent monogenic autoinflammatory disease, and it is characterized by recurrent attacks of fever and polyserositis. The disease is associated with mutations in the MEFV gene encoding pyrin, which causes exaggerated inflammatory response through uncontrolled production of interleukin 1. The major long-term complication of FMF is amyloidosis. Colchicine remains the principle therapy, and the aim of treatment is to prevent acute attacks and the consequences of chronic inflammation. With the evolution in the concepts about the etiopathogenesis and genetics of the disease, we have understood that FMF is more complicated than an ordinary autosomal recessive monogenic disorder. Recently, recommendation sets have been generated for interpretation of genetic testing and genetic diagnosis of FMF. Here, we have reviewed the current perspectives in FMF in light of recent recommendations. PMID:27051312

  15. Pathogenesis of arenavirus hemorrhagic fevers.

    Science.gov (United States)

    Moraz, Marie-Laurence; Kunz, Stefan

    2011-01-01

    Viral hemorrhagic fevers (VHFs) caused by arenaviruses belong to the most devastating emerging human diseases and represent serious public health problems. Arenavirus VHFs in humans are acute diseases characterized by fever and, in severe cases, different degrees of hemorrhages associated with a shock syndrome in the terminal stage. Over the past years, much has been learned about the pathogenesis of arenaviruses at the cellular level, in particular their ability to subvert the host cell's innate antiviral defenses. Clinical studies and novel animal models have provided important new information about the interaction of hemorrhagic arenaviruses with the host's adaptive immune system, in particular virus-induced immunosuppression, and have provided the first hints towards an understanding of the terminal hemorrhagic shock syndrome. The scope of this article is to review our current knowledge on arenavirus VHF pathogenesis with an emphasis on recent developments.

  16. Fever, febrile seizures and epilepsy.

    Science.gov (United States)

    Dubé, Céline M; Brewster, Amy L; Richichi, Cristina; Zha, Qinqin; Baram, Tallie Z

    2007-10-01

    Seizures induced by fever (febrile seizures) are the most common type of pathological brain activity in infants and children. These febrile seizures and their potential contribution to the mechanisms of limbic (temporal lobe) epilepsy have been a topic of major clinical and scientific interest. Key questions include the mechanisms by which fever generates seizures, the effects of long febrile seizures on neuronal function and the potential contribution of these seizures to epilepsy. This review builds on recent advances derived from animal models and summarizes our current knowledge of the mechanisms underlying febrile seizures and of changes in neuronal gene expression and function that facilitate the enduring effects of prolonged febrile seizures on neuronal and network excitability. The review also discusses the relevance of these findings to the general mechanisms of epileptogenesis during development and points out gaps in our knowledge, including the relationship of animal models to human febrile seizures and epilepsy.

  17. Familial Mediterranean Fever and Hypercoagulability

    Science.gov (United States)

    Tayer-Shifman, Oshrat E.; Ben-Chetrit, Eldad

    2011-01-01

    Familial Mediterranean fever (FMF) is an autosomal recessive hereditary disease which is characterized by recurrent attacks of fever and peritonitis, pleuritis, arthritis, or erysipelas-like skin disease. As such, FMF is a prototype of autoinflammatory diseases where genetic changes lead to acute inflammatory episodes. Systemic inflammation – in general - may increase procoagulant factors, and decrease natural anticoagulants and fibrinolytic activity. Therefore, it is anticipated to see more thrombotic events among FMF patients compared with healthy subjects. However, reviewing the current available literature and based upon our personal experience, thrombotic events related purely to FMF are very rare. Possible explanation for this discrepancy is that along with the procoagulant activity during FMF acute attacks, anticoagulant and fibrinolytic changes are also taking place. Colchicine which is the treatment of choice in FMF may also play a role in reducing inflammation thereby decreasing hypercoagulability. PMID:21713077

  18. African swine fever : transboundary diseases

    Directory of Open Access Journals (Sweden)

    M-L. Penrith

    2009-09-01

    Full Text Available African swine fever (ASF is a devastating haemorrhagic fever of pigs that causes up to 100 % mortality, for which there is no vaccine. It is caused by a unique DNA virus that is maintained in an ancient cycle between warthogs and argasid ticks, making it the only known DNA arbovirus. ASF has a high potential for transboundary spread, and has twice been transported from Africa to other continents - Europe and subsequently the Caribbean and Brazil (1957, 1959 and the Caucasus (2007. It is also a devastating constraint for pig production in Africa. Research at Onderstepoort Veterinary Institute has made and is making important contributions to knowledge of this disease, focusing on the cycle in warthogs and tampans and transmission from that cycle to domestic pigs, resistance to its effects in domestic pigs, and the molecular genetic characterisation and epidemiology of the virus.

  19. Unusual Presentation of Dengue Fever

    Science.gov (United States)

    Aslam, Moaz; Aleem, Numra A.; Zahid, Mohammad F.; Rahman, Arshalooz J.

    2016-01-01

    Dengue fever (DF) is an acute febrile illness that follows a self-limiting course. However, some patients suffer from complications, including myocarditis, due to the involvement of other organs. A child presented at the Aga Khan University Hospital in Karachi, Pakistan, in June 2013 with a high-grade fever, malaise and epigastric pain radiating to the chest. Positive DF antigen and immunoglobulin M assays confirmed the diagnosis of DF. Persistent bradycardia with low blood pressure led to further cardiac investigations which showed a decreased ejection fraction and raised serum cardiac enzymes, indicating myocardial damage. With supportive care and use of inotropes, the spontaneous normalisation of cardiac enzyme levels and ejection fraction was observed. The child was discharged five days after admission. This case highlights the importance of identifying myocarditis in DF patients suffering from cardiac symptoms that are not explained by other potential aetiologies. Awareness, early suspicion and supportive care are essential to ensure favourable outcomes. PMID:26909198

  20. Mucocutaneous manifestations of Chikungunya fever

    Directory of Open Access Journals (Sweden)

    Bandyopadhyay Debabrata

    2010-01-01

    Full Text Available Chikungunya fever (CF is an arboviral acute febrile illness transmitted by the bite of infected Aedes mosquitoes. After a quiescence of more than three decades, CF has recently re-emerged as a major public health problem of global scale. CF is characterized by an acute onset of high fever associated with a severe disabling arthritis often accompanied by prominent mucocutaneous manifestations. The disease is usually self-limiting, but the joint symptoms and some of the cutaneous features may persist after the defervescence. A wide range of mucocutaneous changes has been described to occur in association with CF during the current epidemic. Besides a morbilliform erythema, hyperpigmentation, xerosis, excoriated papules, aphthous-like ulcers, vesiculobullous and lichenoid eruptions, and exacerbation of pre-existing or quiescent dermatoses had been observed frequently. These unusual features may help in the clinical differential diagnosis of acute viral exanthems mimicking CF.

  1. Imported chikungunya fever in Madrid.

    Science.gov (United States)

    Richi Alberti, Patricia; Steiner, Martina; Illera Martín, Óscar; Alcocer Amores, Patricia; Cobo Ibáñez, Tatiana; Muñoz Fernández, Santiago

    2016-01-01

    Chikungunya Fever is a mosquito-transmitted viral disease that causes fever, rash and musculoskeletal complaints. The latest may persist for several months, or even years or developed a relapsing course, that deserve an adequate treatment. Due to the large outbreak declared in the Caribbean in 2013, imported cases of Chikungunya as well as the risk of autochthonous transmission in case of available vectors have increased in non-endemic countries, like Spain. We described four cases of Chikungunya treated in our clinic. Copyright © 2015 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

  2. Prolonged fever after Infliximab infusion

    Institute of Scientific and Technical Information of China (English)

    Jennifer; Katz; Michael; Frank

    2012-01-01

    Pharmacologic management for ulcerative colitis (UC) has recently been expanded to include antitumor necrosis factor (TNF) therapy for severe disease. Infliximab, a chimeric monoclonal antibody directed again TNF α was first tested in patients with Crohn’s disease. In addition to serious infections, malignancy, drug induced lupus and other autoimmune diseases, serum sickness-like reactions, neurological disease, and infusion reactions further complicate the use of Infliximab. We report a case of prolonged fever after Infliximab infusion to treat steroid refractory UC.

  3. Azathioprine-induced fever in autoimmune hepatitis

    Science.gov (United States)

    Khoury, Tawfik; Ollech, Jacob E; Chen, Shmuel; Mizrahi, Meir; Shalit, Meir

    2013-01-01

    Underdiagnosis of drug-induced fever leads to extensive investigation and prolongation of hospitalization, and may lead to multiple unnecessary invasive procedures and a wrong diagnosis. Azathioprine is a widely used immunosuppressive drug. We report a case of a 53-year-old female patient diagnosed with autoimmune hepatitis treated with azathioprine, who presented to the emergency room with a 6-wk history of fever and chills without other associated symptoms. Since the patient’s fever was of unknown origin, she was hospitalized. All treatment was stopped and an extensive workup to explore the source of fever and chills was performed. Results of chest X-ray, viral, urine, and blood cultures, autoimmune serology, transthoracic and transesophageal echocardiography, and abdominal ultrasound revealed no source of infection. A rechallenge test of azathioprine was performed and the fever and chills returned within a few hours. Azathioprine was established as the definite cause following rechallenge. Fever as an adverse drug reaction is often unrecognized. Azathioprine has been reported to cause drug-induced fever in patients with inflammatory bowel disease, rheumatoid arthritis, and sarcoidosis. To the best of our knowledge there have been no previous reports documenting azathioprine-induced fever in patients with autoimmune hepatitis. The occurrence of fever following the readministration of azathioprine suggests the diagnosis of drug-induced fever, particularly after the exclusion of other causes. A careful rechallenge is recommended to confirm the diagnosis. PMID:23840156

  4. Why Fever Phobia Is Still Common?

    Science.gov (United States)

    Gunduz, Suzan; Usak, Esma; Koksal, Tulin; Canbal, Metin

    2016-01-01

    Background Fever is a reliable sign of illness, but it also evokes fear and anxiety. It is not the fever itself but the fear of possible complications and accompanying symptoms that is important for pediatricians and parents. Objectives We aimed to investigate maternal understanding of fever, its potential consequences, and impacts on the treatment of children. Patients and Methods A questionnaire was use to explore the attitudes, knowledge, and practices of mothers of 861 children brought to four medical centers in different regions of Turkey in 2012, with fever being the chief complaint. All the children were aged 3 months - 15 years. Results Among the 861 mothers, 92.2% favored antipyretics for fever, either alone or in addition to external cooling measures. Most favored paracetamol or ibuprofen. In this study, the appropriate use of antipyretics was 75.2%, which was higher than that reported in the literature. In common with previous reports, seizures and brain damage were perceived as the most frightening and harmful effects of fever. All the mothers expressed concerns about fever, but they were most common among the highly educated or those with one child. Conclusions Fever phobia remains common, not only among low socioeconomic status mothers but also among those of high socioeconomic status. Healthcare providers should take fever phobia into account and provide correct information to caregivers about fever at all visits. PMID:27781110

  5. Familial Mediterranean fever: current perspectives

    Directory of Open Access Journals (Sweden)

    Sönmez HE

    2016-03-01

    Full Text Available Hafize Emine Sönmez,* Ezgi Deniz Batu,* Seza ÖzenDepartment of Pediatrics, Division of Rheumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey *These authors contributed equally to this workAbstract: Familial Mediterranean fever (FMF is the most frequent monogenic autoinflammatory disease, and it is characterized by recurrent attacks of fever and polyserositis. The disease is associated with mutations in the MEFV gene encoding pyrin, which causes exaggerated inflammatory response through uncontrolled production of interleukin 1. The major long-term complication of FMF is amyloidosis. Colchicine remains the principle therapy, and the aim of treatment is to prevent acute attacks and the consequences of chronic inflammation. With the evolution in the concepts about the etiopathogenesis and genetics of the disease, we have understood that FMF is more complicated than an ordinary autosomal recessive monogenic disorder. Recently, recommendation sets have been generated for interpretation of genetic testing and genetic diagnosis of FMF. Here, we have reviewed the current perspectives in FMF in light of recent recommendations.Keywords: familial Meditarranean fever, recommendation, child

  6. Rapid diagnostic tests for typhoid and paratyphoid (enteric) fever

    Science.gov (United States)

    Wijedoru, Lalith; Mallett, Sue; Parry, Christopher M

    2017-01-01

    Background Differentiating both typhoid (Salmonella Typhi) and paratyphoid (Salmonella Paratyphi A) infection from other causes of fever in endemic areas is a diagnostic challenge. Although commercial point-of-care rapid diagnostic tests (RDTs) for enteric fever are available as alternatives to the current reference standard test of blood or bone marrow culture, or to the widely used Widal Test, their diagnostic accuracy is unclear. If accurate, they could potentially replace blood culture as the World Health Organization (WHO)-recommended main diagnostic test for enteric fever. Objectives To assess the diagnostic accuracy of commercially available rapid diagnostic tests (RDTs) and prototypes for detecting Salmonella Typhi or Paratyphi A infection in symptomatic persons living in endemic areas. Search methods We searched the Cochrane Infectious Diseases Group Specialized Register, MEDLINE, Embase, Science Citation Index, IndMED, African Index Medicus, LILACS, ClinicalTrials.gov, and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) up to 4 March 2016. We manually searched WHO reports, and papers from international conferences on Salmonella infections. We also contacted test manufacturers to identify studies. Selection criteria We included diagnostic accuracy studies of enteric fever RDTs in patients with fever or with symptoms suggestive of enteric fever living in endemic areas. We classified the reference standard used as either Grade 1 (result from a blood culture and a bone marrow culture) or Grade 2 (result from blood culture and blood polymerase chain reaction, or from blood culture alone). Data collection and analysis Two review authors independently extracted the test result data. We used a modified QUADAS-2 extraction form to assess methodological quality. We performed a meta-analysis when there were sufficient studies for the test and heterogeneity was reasonable. Main results Thirty-seven studies met the inclusion

  7. The prevalence of celiac disease among patients with familial mediterranean Fever.

    Science.gov (United States)

    Işikay, Sedat; Işikay, Nurgül; Kocamaz, Halil

    2015-01-01

    Familial Mediterranean Fever and celiac disease are both related to auto-inflammation and/or auto-immunity and they share some common clinical features such as abdominal pain, diarrhea, bloating and flatulence. Objectives We aimed to determine the association of these two diseases, if present. Totally 112 patients diagnosed with Familial Mediterranean Fever and 32 cases as healthy control were included in the study. All participants were examined for the evidence of celiac disease, with serum tissue transglutaminase IgA levels (tTG IgA). Totally 144 cases, 112 with Familial Mediterranean Fever and 32 healthy control cases were included in the study. tTG IgA positivity was determined in three cases with Familial Mediterranean Fever and in one case in control group. In that aspect there was no significant difference regarding the tTG IgA positivity between groups (P=0.81). Duodenum biopsy was performed to the tTG IgA positive cases and revealed Marsh Type 3b in two Familial Mediterranean Fever cases and Marsh Type 3c in the other one while the biopsy results were of the only tTG IgA positive case in control group was Marsh Type 3b. In HLA evaluation of the celiac cases; HLA DQ2 was present in two celiac cases of the Familial Mediterranean Fever group and in the only celiac case of the control group while HLA DQ8 was present in one celiac case of the Familial Mediterranean Fever group. We did not determine an association of Familial Mediterranean Fever with celiac disease. Larger studies with subgroup analysis are warranted to determine the relationship of these two diseases.

  8. THE PREVALENCE OF CELIAC DISEASE AMONG PATIENTS WITH FAMILIAL MEDITERRANEAN FEVER

    Directory of Open Access Journals (Sweden)

    Sedat IŞIKAY

    2015-03-01

    Full Text Available Background Familial Mediterranean Fever and celiac disease are both related to auto-inflammation and/or auto-immunity and they share some common clinical features such as abdominal pain, diarrhea, bloating and flatulence. Objectives We aimed to determine the association of these two diseases, if present. Methods Totally 112 patients diagnosed with Familial Mediterranean Fever and 32 cases as healthy control were included in the study. All participants were examined for the evidence of celiac disease, with serum tissue transglutaminase IgA levels (tTG IgA. Results Totally 144 cases, 112 with Familial Mediterranean Fever and 32 healthy control cases were included in the study. tTG IgA positivity was determined in three cases with Familial Mediterranean Fever and in one case in control group. In that aspect there was no significant difference regarding the tTG IgA positivity between groups (P=0.81. Duodenum biopsy was performed to the tTG IgA positive cases and revealed Marsh Type 3b in two Familial Mediterranean Fever cases and Marsh Type 3c in the other one while the biopsy results were of the only tTG IgA positive case in control group was Marsh Type 3b. In HLA evaluation of the celiac cases; HLA DQ2 was present in two celiac cases of the Familial Mediterranean Fever group and in the only celiac case of the control group while HLA DQ8 was present in one celiac case of the Familial Mediterranean Fever group. Conclusions We did not determine an association of Familial Mediterranean Fever with celiac disease. Larger studies with subgroup analysis are warranted to determine the relationship of these two diseases.

  9. Fever as a seizure precipitant factor in Panayiotopoulos syndrome: a clinical and genetic study.

    Science.gov (United States)

    Cordelli, Duccio Maria; Aldrovandi, Anna; Gentile, Valentina; Garone, Caterina; Conti, Sara; Aceti, Arianna; Gennaro, Elena; Zara, Federico; Franzoni, Emilio

    2012-03-01

    To examine fever as a precipitating factor for focal seizures in patients with Panayiotopoulos syndrome (PS) and evaluate the role of SCN1A in PS patients with seizures triggered by fever. From January 2000 to June 2008, we identified patients referred for seizures who fulfilled the criteria of PS. Patients were divided into two groups, according to the presence (group A) or the absence (group B) of seizures triggered by fever. Electroclinical features of the two groups were compared. In addition, an analysis of SCN1A in patients of group A was performed. Thirty patients fulfilled the inclusion criteria. Eleven patients (36%) had at least one focal autonomic seizure triggered by fever (group A). In group A, 7/11 patients (63.5%) had the first focal autonomic seizure during a febrile illness. Two of these 7 patients were misdiagnosed at the onset of PS. The median age at the onset of PS was slightly lower in group A than in group B (p=.050). Moreover, patients in group A more frequently had a positive familial history of febrile seizures (FS) (p=.047). No mutations of SCN1A were found in any of the 10 patients screened. Fever is a common trigger for focal autonomic seizures in PS. Knowing that an autonomic manifestation during fever can be an epileptic seizure could facilitate diagnosis and prevent unnecessary investigations and erroneous treatments. Moreover, our data show that SCN1A gene does not contribute significantly to susceptibility to autonomic seizures during fever in patients with PS. Copyright © 2011 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  10. AN EPIDEMIOLOGICAL STUDY, CLINICOPATHOLOGICAL CORRELATION AND MANAGEMENT OF DENGUE FEVER

    Directory of Open Access Journals (Sweden)

    Nisha

    2013-10-01

    Full Text Available ABSTRACT: BACKGROUND: Dengue fever is an arthropod borne viral syndrome. OBJ ECTIVE: This study evaluated the newer signs and symptoms, to come to a bedside diagnosis of dengue fever and to predict the prognosis on the basis of clinical features and investigations. METHODS: This was a prospective study and included children aged u pto 15 years, admitted in the pediatric ward over 2 year period. Dengue like fever was defined according to WHO guidelines and then newer signs and symptoms and lab investigations were looked for,and treated symptomatically according to WHO guidelines. R ESULTS: Most of the children included were in the age group of 6 - 12 years with mean age being 5.3 years. Male to female ratio was 1.3:1 . Maximum patients were seen in winter with peak in October. Out of 90 children 13.3 % of DF , 48.89 % DHF, 37.78% DSS. The newer clinical features were found to were Pruritus (80%on recovery ,retro orbital pain(35%,Anorexia 68% ,Sore throat 30% , Fever(100%, Scrotal oedema (10%, Loose stools(20%, Cardiomyopathy (10%, Encephalopathy (1%, Menorrhagia(20%. One child had presented with Autism /ADHD on followup. Mortality rate 8.8% and all belonged to DSS group. Poor prognostic factors for death were vomiting, tachypnea ,convulsions, fluid collection in lungs, abdomen ,altered sensorium, convulsions , raised SGPT and s econdary infections.Fluid therapy (Oral / IV was used in all Platelets and blood transfusion was given in 20% and 13.3 % respectively. Ionotropes were used for DSS cases. CONCLUSIONS: The timely appropriate identification and timely management of Dengue fever go a long way in reducing mortality in dengue

  11. Typhoid fever: case report and literature review.

    Science.gov (United States)

    Sanhueza Palma, Natalia Carolina; Farías Molina, Solange; Calzadilla Riveras, Jeannette; Hermoso, Amalia

    2016-06-21

    Typhoid fever remains a major health problem worldwide, in contrast to Chile, where this disease is an isolated finding. Clinical presentation is varied, mainly presenting with fever, malaise, abdominal discomfort, and nonspecific symptoms often confused with other causes of febrile syndrome. We report a six-year-old, male patient presenting with fever of two weeks associated with gastrointestinal symptoms, malaise, hepatomegaly and elevated liver enzymes. Differential diagnoses were considered and a Widal reaction and two blood cultures were requested; both came back positive, confirming the diagnosis of typhoid fever caused by Salmonella typhi. Prior to diagnosis confirmation, empirical treatment was initiated with ceftriaxone and metronidazole, with partial response; then drug therapy was adjusted according to ciprofloxacin susceptibility testing with a favorable clinical response. We discuss diagnostic methods and treatment of enteric fever with special emphasis on typhoid fever.

  12. Prevention of lassa Fever in Nigeria.

    Science.gov (United States)

    Inegbenebor, Ute; Okosun, John; Inegbenebor, Josephine

    2010-01-01

    Although specific treatment is available for Lassa fever, early diagnosis is still difficult in most Nigerian primary and secondary health centers. This study was carried out to compare the case-fatality rates of Lassa fever and other medical diseases commonly seen in adult medical wards, to determine the community habits that make Lassa fever endemic in Edo Central District of Nigeria, with the aim of prescribing preventive measures for its control in Nigeria. The records of 908 inpatients in the adult medical wards of Irrua Specialist Teaching Hospital, Irrua and responses from respondents interviewed by trained interviewers on their knowledge, attitudes and practices pertaining to Lassa fever were used for this study. The case-fatality rate of Lassa fever in this center was 28%. Cultural factors and habits were found to favor endemicity of Lassa fever in Edo Central District of Nigeria. Preventive measures were prescribed for families and communities.

  13. Fever of unknown origin in returning travellers.

    Science.gov (United States)

    Korzeniewski, Krzysztof; Gaweł, Bartłomiej; Krankowska, Dagny; Wasilczuk, Katarzyna

    2015-01-01

    The aim of the article is to discuss issues associated with the occurrence of febrile illnesses in leisure and business travellers, with a particular emphasis on fevers of unknown origin (FUO). FUO, apart from diarrhoeas, respiratory tract infections and skin lesions, are one of the most common health problems in travellers to tropical and subtropical countries. FUO are manifestations of various diseases, typically of infectious or invasive aetiology. In one out of 3 cases, the cause of a fever in travellers returning from the hot climate zone is malaria, and therefore diagnostic tests should first aim at ruling out this specific disease entity. Other illnesses with persistent fever include dengue, enteric fever, viral hepatitis A, bacterial diarrhoeas and rickettsioses. Fever may also occur in travellers suffering from diseases of non-tropical origin, e.g. cosmopolitan respiratory tract or urinary tract infections, also, fever may coexist with other illnesses or injuries (skin rashes, bites, burns).

  14. Vaccination for typhoid fever in sub-Saharan Africa.

    Science.gov (United States)

    Slayton, Rachel B; Date, Kashmira A; Mintz, Eric D

    2013-04-01

    Emerging data on the epidemiologic, clinical and microbiologic aspects of typhoid fever in sub-Saharan Africa call for new strategies and new resources to bring the regional epidemic under control. Areas with endemic disease at rates approaching those in south Asia have been identified; large, prolonged and severe outbreaks are occurring more frequently; and resistance to antimicrobial agents, including fluoroquinolones is increasing. Surveillance for typhoid fever is hampered by the lack of laboratory resources for rapid diagnosis, culture confirmation and antimicrobial susceptibility testing. Nonetheless, in 2010, typhoid fever was estimated to cause 725 incident cases and 7 deaths per 100,000 person years in sub-Saharan Africa. Efforts for prevention and outbreak control are challenged by limited access to safe drinking water and sanitation and by a lack of resources to initiate typhoid immunization. A comprehensive approach to typhoid fever prevention including laboratory and epidemiologic capacity building, investments in water, sanitation and hygiene and reconsideration of the role of currently available vaccines could significantly reduce the disease burden. Targeted vaccination using currently available typhoid vaccines should be considered as a short- to intermediate-term risk reduction strategy for high-risk groups across sub-Saharan Africa.

  15. Autoinflammatory syndromes behind the scenes of recurrent fevers in children.

    Science.gov (United States)

    Rigante, Donato

    2009-08-01

    Many children experience recurrent fevers with no easily identifiable source and only a careful follow-up helps in the early identification of other presenting symptoms of other defined conditions which require medical intervention. Autoinflammatory syndromes are rare childhood-onset disorders of the innate immunity in which recurrent flares of fever and inflammation affecting skin, joints, the gastrointestinal tube, or serous membranes are the most striking signs, without any evidence of autoantibody production or underlying infections. Among the pediatric conditions belonging to this group we can consider hereditary recurrent fevers (familial Mediterranean fever, mevalonate kinase deficiency syndrome, tumor necrosis factor receptor-associated periodic syndrome, cryopyrin-associated periodic syndromes), pyogenic disorders (PAPA syndrome, CRMO syndrome, Majeed syndrome), immune-mediated granulomatous diseases (Blau syndrome, Crohn's disease), and idiopathic febrile syndromes (systemic-onset juvenile idiopathic arthritis, PFAPA syndrome, Behçet syndrome). Their genetic background has only been partially elucidated and advances in their molecular pathogenesis are shedding new light on the innate immune system, whilst more and more diseases are being reconsidered at a pathogenetic level and included in this new chapter of postgenomic medicine. The diagnosis of most autoinflammatory syndromes relies on clinical history, demonstration of an increased acute-phase response during inflammatory attacks, and, possibly, genetic confirmation, which is still elusive especially for idiopathic febrile syndromes. This astonishing progress in the awareness and knowledge of autoinflammatory syndromes has anticipated the actual possibilities of medical intervention and rationalized treatment with targeted biologic agents.

  16. Hyper-IgD syndrome and hereditary periodic fever syndromes

    Directory of Open Access Journals (Sweden)

    L. Vicentini

    2011-09-01

    Full Text Available Hereditary periodic fever syndromes are a group of systemic disorders characterized by recurrent attacks of systemic inflammation (autoinflammation without infectious or autoimmune cause. The hyper-IgD syndrome (HIDS is a rare autosomal recessive inflammatory disorder characterized by recurrent fever, increased serum IgD (normal value < 100 U/ml and generalized inflammation (lymphadenopathy, arthralgias/arthritis, abdominal complaints, skin rash, and headache. The attacks persist during the entire life although frequency and severity tend to diminish with age. HIDS is caused by specific mutations in the gene encoding mevalonate kinase, resulting in depressed enzymatic activity. At present the therapy for the syndrome is only supportive. Other than HIDS, other hereditary systemic inflammatory disorders have been described: the Familial Mediterranean Fever, the tumour necrosis factor receptor associated periodic syndrome (TRAPS, a disease related to the mutations of one of the TNF receptors, the Familial Cold Urticaria and the Muckle-Wells syndrome. The differential diagnosis with other causes of periodic fever is crucial for assessing appropriate management and treatment.

  17. relapsing fever, a disappearing cause of fever and maternal death in ...

    African Journals Online (AJOL)

    2013-04-01

    Apr 1, 2013 ... Objective: To study the incidence of tick borne relapsing fever (TBRF) during the last. 50 years ... fever was a disease of major worldwide importance, affecting ... of Diseases (ICD) of the World Health Organization. Reporting ...

  18. The role of viral agents in aetiopathogenesis of acute rheumatic fever.

    Science.gov (United States)

    Olgunturk, Rana; Okur, Ilyas; Cirak, Meltem Y; Oguz, Ayse Deniz; Akalin, Nursel; Turet, Sevgi; Tunaoglu, Sedef

    2011-01-01

    The reason why abnormal immune response exists in acute rheumatic fever is not exactly explained. The influence of co-pathogens like certain viruses were mentioned regarding the initiation of the immunological reaction in acute rheumatic fever patients by several authors since 1970. This study was designed to find the role or effect of some viral infections in the development of rheumatic fever. In this study, 47 cases with acute rheumatic fever (acute rheumatic arthritis, acute rheumatic carditis, and chorea), 20 cases with chronic rheumatic fever, 20 cases with streptococcal pharyngitis, and 20 healthy age- and gender-matched control cases were involved. Serological and molecular tests were made including hepatitis B virus, hepatitis C virus, rubella virus, herpes simplex virus (HSV group 1), and Epstein-Barr virus (EBV). HBsAg, rubella IgM and EBV IgM positivity were not seen in any of patients with rheumatic fever. Although antiHBs seropositivity was higher in the control group, it was not statistically significant (p > 0.05). There was no difference in rubella IgG, HSV IgM seropositivity, either (p > 0.05). EBV DNA was searched by the polymerase chain reaction technique; due to the latent nature of the virus, no significant difference was found between the control group and the other groups (p > 0.05). In this study, no positive correlation could be found to support the synergism theories regarding the streptoccocus infection and viral infections in the development of acute rheumatic fever. Only EBV DNA positivity was found in all acute rheumatic fever cases but not in the control group may lead to further studies with larger series of patients.

  19. [Postoperative fever in orthopedic and urologic surgery].

    Science.gov (United States)

    Saavedra, Federico; Myburg, Cristina; Lanfranconi, Marisa B; Urtasun, Martin; De Oca, Luis Montes; Silberman, Andres; Lambierto, Alberto; Gnocchi, Cesar A

    2008-01-01

    Post-operative fever incidence varies widely. In clean and clean-contaminated surgery the non-infectious fever is more frequent than the infectious fever. We performed a prospective study including 303 patients who underwent orthopedic and urologic elective surgery. The aims of our study were to investigate the incidence of post-operative fever, its etiology, the relationship between time of onset and the etiology, and the usefulness of extensive fever work-up to determine post-operative infection. The incidence of post-operative fever was 14% (42/303) of which 81% (34/42) was noninfectious and 19% (8/42) was infectious. The etiology of the fever in the first 48 hours after surgery was always non-infectious (p fever work-up was performed in patients who presented fever only after the initial 48 hours of surgery with normal physical examination (n = 19) consisting of chest x-ray, blood (2) and urine cultures. The chest x-ray was normal in all the patients, the urine cultures were positive in four cases (21%, IC 95%: 6-45) and the blood cultures in only one case (5%, IC 95%: 0.1-26). Seven patients had post-operative infections without fever as a clinical sign. The most frequently observed etiology of post-operative fever was non-infectious, related to the normal inflammatory host response to surgery. Based on the present results, the extensive fever work-up performed to investigate post-operative infection does not seem to be a useful tool. The diagnosis of post-operative infection was based on clinical follow up and the correct interpretation of the patient's symptoms and signs.

  20. Fever of Unknown Origin: An Unusual Case

    OpenAIRE

    Bansal, R. A.; Hayman, G. R.; Bansal, A. S.

    2011-01-01

    Recurrent episodic fever of unknown origin (FUO) arising from tumour of the gastrointestinal tract is rare. We report an otherwise healthy 62-year-old man with recurrent circumscribed bouts of fever and raised CRP for 3 years who has remained well and fever-free 2 years after the removal of a well-differentiated adenocarcinoma of the colon. Occult colonic neoplasm should be considered and sought when routine investigations for FUO are negative.

  1. Advanced heart block in acute rheumatic fever.

    Science.gov (United States)

    Hubail, Zakariya; Ebrahim, Ishaq M

    2016-04-01

    First degree heart block is considered a minor criterion for the diagnosis of this condition. The cases presented here demonstrate that higher degrees of heart block do occur in rheumatic fever. Children presenting with acquired heart block should be worked-up for rheumatic fever. Likewise, it is imperative to serially follow the electrocardiogram in patients already diagnosed with acute rheumatic fever, as the conduction abnormalities can change during the course of the disease.

  2. Advanced heart block in acute rheumatic fever

    OpenAIRE

    2015-01-01

    First degree heart block is considered a minor criterion for the diagnosis of this condition. The cases presented here demonstrate that higher degrees of heart block do occur in rheumatic fever. Children presenting with acquired heart block should be worked-up for rheumatic fever. Likewise, it is imperative to serially follow the electrocardiogram in patients already diagnosed with acute rheumatic fever, as the conduction abnormalities can change during the course of the disease.

  3. [Differential diagnosis in fever of unknown origin].

    Science.gov (United States)

    Huppertz, H-I

    2006-11-01

    Fever is one of the most frequent and important symptoms in pediatrics. Most cases are caused by self-limiting viral or easily treatable bacterial infections. If after 5-7 days no cause of the ongoing fever has been found, the condition is termed fever of unknown origin, a working diagnosis which often poses a diagnostic challenge. The ultimate cause may be an infectious disease, a chronic inflammatory disorder, a malignancy, or another rare disease. The cause may also remain obscure or the fever can finally disappear. Here we elaborate the diagnostic work-up and symptomatic treatment.

  4. Preliminary consultation on preferred product characteristics of benzathine penicillin G for secondary prophylaxis of rheumatic fever.

    Science.gov (United States)

    Wyber, Rosemary; Boyd, Ben J; Colquhoun, Samantha; Currie, Bart J; Engel, Mark; Kado, Joseph; Karthikeyan, Ganesan; Sullivan, Mark; Saxena, Anita; Sheel, Meru; Steer, Andrew; Mucumbitsi, Joseph; Zühlke, Liesl; Carapetis, Jonathan

    2016-10-01

    Rheumatic fever is caused by an abnormal immune reaction to group A streptococcal infection. Secondary prophylaxis with antibiotics is recommended for people after their initial episode of rheumatic fever to prevent recurrent group A streptococcal infections, recurrences of rheumatic fever and progression to rheumatic heart disease. This secondary prophylaxis must be maintained for at least a decade after the last episode of rheumatic fever. Benzathine penicillin G is the first line antibiotic for secondary prophylaxis, delivered intramuscularly every 2 to 4 weeks. However, adherence to recommended secondary prophylaxis regimens is a global challenge. This paper outlines a consultation with global experts in rheumatic heart disease on the characteristics of benzathine penicillin G formulations which could be changed to improve adherence with secondary prophylaxis. Characteristics included dose interval, pain, administration mechanism, cold chain independence and cost. A sample target product profile for reformulated benzathine penicillin G is presented.

  5. Anaphylaxis vulnerable groups

    African Journals Online (AJOL)

    Ehab

    Professor of Pediatric Allergy and Immunology, Ain Shams University, Cairo, Egypt. Age groups ... fever, emotional stress, travel or other disruption of routine ... Anaphylaxis following immunization is a rare event ... estimated.15,16 An estimate of 1 per 100 000 after. MMR ... pregnancy include low back pain, uterine cramps,.

  6. A族β溶血性链球菌与猩红热的相关研究%Relation between Beta-Haemolytic Group A Streptococcus Isolate and Scarlet Fever

    Institute of Scientific and Technical Information of China (English)

    梁云梅; 杨永弘

    2009-01-01

    A族β溶血性链球菌(beta-haemolytic group A Streptococcus isolate,GAS)又称为酿脓链球菌(Streptococcus pyogenes),是一种常见的致病性化脓性革兰阳性球菌,猩红热是由GAS引起的儿童常见呼吸道传染病.近年来,随着严重侵袭性GAS感染在欧美一些国家再次增多,猩红热在一些国家中的发病率也在升高.简要介绍GAS的分型、超抗原及耐药与猩红热之间的关系.

  7. TRAINING PROGRAM FOR NURSING STAFF REGARDING VIRAL HEMORRHAGIC FEVERS IN A MILITARY HOSPITAL.

    Science.gov (United States)

    El-Bahnasawy, Mamdouh M; Megahed, Laila Abdel-Mawla; Saleh, Halla Ahmed Abdullah; Abdelfattah, Magda Abdelhamid; Morsy, Tosson Aly

    2015-08-01

    Viral hemorrhagic fevers (VHFs) refer to a group of illnesses caused by several distinct families of viruses. In general, the term "viral hemorrhagic fever" is used to describe a severe multisystem syndrome (multisystem in that multiple organ systems in the bpdy are affected). Characteristically, the overall vascular system is damaged, and the body's ability to regulate itself is impaired. These symptoms are often accompanied by hemorrhage (bleeding); however, the bleeding is it rarely life-threatening. While some types of hemorrhagic fever viruses can cause relatively mild illnesses, many of these viruses cause severe, life-threatening disease. The selected disaster diseases for this study included: 1-Crimean-Congo hemorrhagic Fever, 2-Dengue Fever, 3-Ebola Fever, 4-Hem-orrhagic Fever with renal syndrome (HFRS), 5-Hantavirus Pulmonary Syndrome, 6-Lassa Fever, 7-Marburg Fever, 8-Rift Valley Fever and 9-Yellow Fever. The educational training program was given over ten sessions to a group of Staff Nurses. The results showed that the program succeeded in enhancing nurse' knowledge, awareness, responsibility, and obligations toward patients with the Viral Hemorrhagic Fevers The results showed a significant impact of training sessions illuminated in the follow-up test on the knowledge score of nurses in all types of diseases except for the Congo hemorrhagic fever, while, statistical significance varied in some diseases in the study when it comes to the comparison between pretest and post-test. All results confirmed on the positive impact of the training program in enhancing the knowledge of nurses toward VHFs patients and their relevant. There was a significant positive impact of the training sessions on changing the attitude of nurses toward patients with VHFs. This result was confirmed on the collective level since the total scores on tests revealed significant positive impact of the study on changing the attitude of nurses toward relevant patients. The relationship

  8. Incidence of fever in labor and risk of neonatal sepsis.

    Science.gov (United States)

    Towers, Craig V; Yates, Angela; Zite, Nikki; Smith, Casey; Chernicky, Lindsey; Howard, Bobby

    2017-06-01

    The current recommendation regarding the management of a term newborn delivered of a mother with an intrapartum fever or a diagnosis of clinical chorioamnionitis is that the neonate should have baseline laboratory work drawn along with blood cultures and be universally treated with antibiotics until culture results return. These guidelines report that the rate of intrapartum fever is about 3%; however, a few large studies suggest that the rate is higher at about 7%. We sought to prospectively evaluate the rate of fever during labor in a large number of deliveries and determine the rate of early-onset neonatal sepsis in newborns delivered from mothers with an intrapartum fever compared with newborns delivered from mothers without intrapartum fever. This was a prospective cohort study of all temperatures obtained in women in labor from Jan. 1, 2011, through June 30, 2014. Every patient with a fever of ≥38°C at ≥36 weeks' gestation was evaluated for gestational age, parity, spontaneous or induced labor, group B streptococcus status, regional anesthesia, mode of delivery, treatment with intrapartum antibiotics, and whether a clinical diagnosis of chorioamnionitis was made by the managing physician. Neonates were assessed for blood culture results, neonatal intensive care unit admission, length of stay, and any major newborn complications. Statistical analysis involved χ(2), Fisher exact, and Student t test. A total of 412 patients (6.8%; 95% confidence interval, 6.2-7.5%) developed a fever in 6057 deliveries at ≥36 weeks' gestation. No cases of maternal sepsis occurred. Of the 417 newborns (5 sets of twins), only 1 (0.24%; 95% confidence interval, 0.01-1.3%) developed early-onset neonatal sepsis with a positive blood culture for Escherichia coli. There were 4 cases (0.07%; 95% confidence interval, 0.02-0.18%) of early-onset neonatal sepsis in the 5697 newborns (52 sets of twins) delivered from mothers who were not febrile and this difference was not significant

  9. Increased levels of circulating Annexin A5 in Familial Mediterranean fever

    OpenAIRE

    Hovhannisyan Lilit P; Mkrtchyan Gohar M; Boyajyan Anna S; Hovsepyan Tigran J

    2010-01-01

    Abstract Background Familial Mediterranean fever is a genetic autoinflammatory disease most commonly affecting the ethnic groups originating from around the Mediterranean Sea. Apoptosis plays an important role in down-regulation of the inflammatory response by reducing the lifespan of activated immunocompetent cells. Thus, increased apoptosis may be associated with pathogenesis of familial Mediterranean fever. Methods In the present study we determined the serum levels of apoptotic marker, An...

  10. Fever of Unknown Origin in Children: Optimization of Diagnostic Search (Part II

    Directory of Open Access Journals (Sweden)

    B.A. Bezkaravayny

    2014-07-01

    Full Text Available In the second part of the article according to the previously developed scheme we continued description of the most common in pediatric practice systemic inflammatory connective tissue diseases and diseases of the so-called mixed group, which initially may be undiagnosed and masked as fever of unknown origin. We suggested a phased approach in the implementation of the diagnostic search in fever of unknown origin.

  11. Hepatitis, gallbladder hydrops, splenomegaly, and ascites in a child with scarlet fever.

    Science.gov (United States)

    Wang, Li Yueh; Young, Ton-Ho

    2012-11-01

    We report a case of scarlet fever associated with hepatitis, gallbladder hydrops, splenomegaly, and ascites in a 15-year-old girl. The girl presented with fever and skin rash. Leukocyte, liver enzyme, and serum C-reactive protein concentrations were elevated. Ultrasonography revealed marked gallbladder wall thickening, diffuse liver parenchymal disease with moderate splenomegaly, and moderate ascites throughout the abdominal and pelvic cavities. Blood cultures for group A β-hemolytic streptococci were negative. Complete recovery was facilitated with antibiotic treatment.

  12. Describing the Breakbone Fever: IDODEN, an Ontology for Dengue Fever

    Science.gov (United States)

    Mitraka, Elvira; Topalis, Pantelis; Dritsou, Vicky; Dialynas, Emmanuel; Louis, Christos

    2015-01-01

    Background Ontologies represent powerful tools in information technology because they enhance interoperability and facilitate, among other things, the construction of optimized search engines. To address the need to expand the toolbox available for the control and prevention of vector-borne diseases we embarked on the construction of specific ontologies. We present here IDODEN, an ontology that describes dengue fever, one of the globally most important diseases that are transmitted by mosquitoes. Methodology/Principal Findings We constructed IDODEN using open source software, and modeled it on IDOMAL, the malaria ontology developed previously. IDODEN covers all aspects of dengue fever, such as disease biology, epidemiology and clinical features. Moreover, it covers all facets of dengue entomology. IDODEN, which is freely available, can now be used for the annotation of dengue-related data and, in addition to its use for modeling, it can be utilized for the construction of other dedicated IT tools such as decision support systems. Conclusions/Significance The availability of the dengue ontology will enable databases hosting dengue-associated data and decision-support systems for that disease to perform most efficiently and to link their own data to those stored in other independent repositories, in an architecture- and software-independent manner. PMID:25646954

  13. Dengue fever and dengue haemorrhagic fever in adolescents and adults.

    Science.gov (United States)

    Tantawichien, Terapong

    2012-05-01

    Dengue fever (DF) is endemic in tropical and subtropical zones and the prevalence is increasing across South-east Asia, Africa, the Western Pacific and the Americas. In recent years, the spread of unplanned urbanisation, with associated substandard housing, overcrowding and deterioration in water, sewage and waste management systems, has created ideal conditions for increased transmission of the dengue virus in tropical urban centres. While dengue infection has traditionally been considered a paediatric disease, the age distribution of dengue has been rising and more cases have been observed in adolescents and adults. Furthermore, the development of tourism in the tropics has led to an increase in the number of tourists who become infected, most of whom are adults. Symptoms and risk factors for dengue haemorrhagic fever (DHF) and severe dengue differ between children and adults, with co-morbidities and incidence in more elderly patients associated with greater risk of mortality. Treatment options for DF and DHF in adults, as for children, centre round fluid replacement (either orally or intravenously, depending on severity) and antipyretics. Further data are needed on the optimal treatment of adult patients.

  14. Increased levels of circulating Annexin A5 in Familial Mediterranean fever

    Directory of Open Access Journals (Sweden)

    Hovhannisyan Lilit P

    2010-11-01

    Full Text Available Abstract Background Familial Mediterranean fever is a genetic autoinflammatory disease most commonly affecting the ethnic groups originating from around the Mediterranean Sea. Apoptosis plays an important role in down-regulation of the inflammatory response by reducing the lifespan of activated immunocompetent cells. Thus, increased apoptosis may be associated with pathogenesis of familial Mediterranean fever. Methods In the present study we determined the serum levels of apoptotic marker, Annexin A5, in familial Mediterranean fever patients, within an attack and attack-free, in comparison to healthy subjects and assessed the influence of colchicine treatment on this parameter. In addition, in all study subjects serum levels of C-reactive protein and interleukine-1β, and the total leukocyte count were also determined. Results Our results demonstrated that pathogenesis of familial Mediterranean fever is characterized by the increased levels of circulating Annexin A5, which is higher in patients within the attack and which associate with the increased levels of C-reactive protein and interleukine-1β and total leukocyte count. Conclusions The results obtained indicate elevated rates of apoptosis of subpopulations of leukocytes involved in autoinflammation and recurrent episodes of fever in familial Mediterranean fever. It was also revealed that regular colchicine treatment sufficiently decreases the rate of apoptosis in familial Mediterranean fever patients by affecting the intensity of autoinflammatory reactions.

  15. Periodic fever in MVK deficiency: a patient initially diagnosed with incomplete Kawasaki disease.

    Science.gov (United States)

    Thors, Valtyr S; Vastert, Sebastiaan J; Wulffraat, Nico; van Royen, Annet; Frenkel, Joost; de Sain-van der Velden, Monique; de Koning, Tom J

    2014-02-01

    Mevalonate kinase deficiency (MKD) is a rare autosomal recessive disorder causing 1 of 2 phenotypes, hyperimmunoglobulin D syndrome and mevalonic aciduria, presenting with recurrent fever episodes, often starting in infancy, and sometimes evoked by stress or vaccinations. This autoinflammatory disease is caused by mutations encoding the mevalonate kinase (MVK) gene and is classified in the group of periodic fever syndromes. There is often a considerable delay in the diagnosis among pediatric patients with recurrent episodes of fever. We present a case of an 8-week-old girl with fever of unknown origin and a marked systemic inflammatory response. After excluding infections, a tentative diagnosis of incomplete Kawasaki syndrome was made, based on the finding of dilated coronary arteries on cardiac ultrasound and fever, and she was treated accordingly. However, the episodes of fever recurred, and alternative diagnoses were considered, which eventually led to the finding of increased excretion of mevalonic acid in urine. The diagnosis of MKD was confirmed by mutation analysis of the MVK gene. This case shows that the initial presentation of MKD can be indistinguishable from incomplete Kawasaki syndrome. When fever recurs in Kawasaki syndrome, other (auto-)inflammatory diseases must be ruled out to avoid inappropriate diagnostic procedures, ineffective interventions, and treatment delay.

  16. Fever-Induced Brugada Syndrome

    Directory of Open Access Journals (Sweden)

    Sandhya Manohar MD

    2015-03-01

    Full Text Available Brugada syndrome is increasingly recognized as a cause of sudden cardiac death. Many of these patients do not get diagnosed due its dynamic and often hidden nature. We have come a long way in understanding the disease process, and its electrophysiology appears to be intimately linked with sodium channel mutations or disorders. The cardiac rhythm in these patients can deteriorate into fatal ventricular arrhythmias. This makes it important for the clinician to be aware of the conditions in which arrhythmogenicity of Brugada syndrome is revealed or even potentiated. We present such an instance where our patient’s Brugada syndrome was unmasked by fever.

  17. Fever Through a Jaundiced Eye

    Directory of Open Access Journals (Sweden)

    Christina C. Kennelly MD

    2014-04-01

    Full Text Available Pyogenic liver abscess (PLA is an important clinical entity to consider in a patient with fever and abdominal pain. Previously, the condition was difficult to diagnose and treat, but with the introduction of widely available and reliable imaging techniques, its diagnosis has become more straightforward. Although uncommon, PLA should especially be considered in the differential diagnosis for patients with specific predisposing conditions such as underlying biliary tract disease, whether as a result of chronic inflammatory disease or malignancy. The introduction of percutaneous drainage has revolutionized the management of PLA, and thus, this disease has become largely correctable.

  18. Safety and immunogenicity of combined rabies and typhoid fever immunization.

    Science.gov (United States)

    Fritzell, C; Rollin, P E; Touir, M; Sureau, P; Teulieres, L

    1992-01-01

    The prevalence of rabies and typhoid fever in many developing countries poses a serious health hazard to travellers. The development of a combined immunization schedule would be advantageous. A study was performed on 104 adult volunteers using purified Vero cell rabies vaccine and Typhim Vi, a purified capsular polysaccharide, either separately or in combination. No significant difference was observed in immunogenicity or tolerance between the two groups. A 3-year follow-up study is planned.

  19. [EBOLA HEMORRHAGIC FEVER: DIAGNOSTICS, ETIOTROPIC AND PATHOGENETIC THERAPY, PREVENTION].

    Science.gov (United States)

    Zhdanov, K V; Zakharenko, S M; Kovalenko, A N; Semenov, A V; Fisun, A Ya

    2015-01-01

    The data on diagnostics, etiotropic and pathogenetic therapy, prevention of Ebola hemorrhagic fever are presented including diagnostic algorithms for different clinical situations. Fundamentals of pathogenetic therapy are described. Various groups of medications used for antiviral therapy of conditions caused by Ebola virus are characterized. Experimental drugs at different stages of clinical studies are considered along with candidate vaccines being developed for the prevention of the disease.

  20. Caregivers' perceptions of childhood fever in Ilorin, North-Central ...

    African Journals Online (AJOL)

    Caregivers' perceptions of childhood fever in Ilorin, North-Central Nigeria. ... The aim was to determine knowledge and attitudes of parents regarding fever in their ... at all contacts with the healthcare system on fever, and its management.

  1. Study of infection by Rickettsiae of the spotted fever group in humans and ticks in an urban park located in the City of Londrina, State of Paraná, Brazil Estudo da infecção por Rickettsias do grupo da febre maculosa em humanos e carrapatos de um parque urbano na Cidade de Londrina, Estado do Paraná

    Directory of Open Access Journals (Sweden)

    Roberta Santos Toledo

    2011-06-01

    Full Text Available INTRODUCTION: Spotted fevers are emerging zoonoses caused by Rickettsia species in the spotted fever group (SFG. Rickettsia rickettsii is the main etiologic agent of Brazilian spotted fever (BSF and it is transmitted by Amblyomma spp. ticks. METHODS: The study aimed to investigate SFG rickettsiae in the Arthur Thomas Municipal Park in Londrina, PR, by collecting free-living ticks and ticks from capybaras and blood samples from personnel working in these areas. Samples from A. dubitatum and A. cajennense were submitted for PCR in pools to analyze the Rickettsia spp. gltA (citrate synthase gene. RESULTS: All the pools analyzed were negative. Human sera were tested by indirect immunofluorescence assay with R. rickettsii and R. parkeri as antigens. Among the 34 sera analyzed, seven (20.6% were reactive for R. rickettsii: four of these had endpoint titers equal to 64, 2 titers were 128 and 1 titer was 256. None of the samples were reactive for R. parkeri. An epidemiological questionnaire was applied to the park staff, but no statistically significant associations were identified. CONCLUSIONS: The serological studies suggest the presence of Rickettsiae related to SFG that could be infecting the human population studied; however, analysis of the ticks collected was unable to determine which species may be involved in transmission to humans.INTRODUÇÃO: A febre maculosa é uma zoonose emergente causada por espécies de Rickettsia do grupo febre maculosa (GFM. Rickettsia rickettsii é o principal agente etiológico da febre maculosa brasileira (FMB e é transmitida por Amblyomma spp. MÉTODOS: Com o objetivo de obter informações sobre GFM Rickettsiae no Parque Municipal Arthur Thomas em Londrina, PR, carrapatos de vida livre e de capivaras foram coletados, assim como amostras de sangue das pessoas que trabalham no parque. A. dubitatum e A. cajennense foram submetidos à PCR em pools para analises de Rickettsia spp. gltA (citrate synthase gene

  2. Concurrent outbreaks of Chikungunya and Dengue fever in Kandy, Sri Lanka, 2006-07: a comparative analysis of clinical and laboratory features.

    Science.gov (United States)

    Kularatne, S A M; Gihan, M C; Weerasinghe, S C; Gunasena, S

    2009-07-01

    To compare the clinical and laboratory features of confirmed cases of Chikungunya and Dengue fever; to validate the clinical diagnosis based on serology. Cases with a clinical diagnosis of Chikungunya and Dengue fever were recruited for seroconfirmation during a concurrent epidemic in 2006-07, at the General Hospital, Peradeniya, Sri Lanka. Of 54 patients with fever, serology confirmed 21 with Chikungunya infection, 20 with Dengue infection, and three co-infections, with sensitivity of the clinical diagnosis of 92% for Chikungunya fever and 95% for Dengue fever. The mean age of patients with Chikungunya fever was 45 years (range 21-74 years), and patients with Dengue fever was 30 years (range 15-63 years) (p = 0.005). Sixteen (70%) of Chikungunya fever patients were females, while 15 (71%) of those with Dengue fever were males (p = 0.007). Arthralgia was common to both groups (p = 0.155), while headache and a bleeding tendency were observed more in patients with Dengue fever. Twelve (57%) Chikungunya cases had acute arthritis compared with none in the Dengue group (p = 0.001), lasting mean 6 days (range 1-14 days). They developed chronic arthritic disability (range 1-6 months). Leucopenia was common to both Chikungunya and Dengue fever patients. However, thrombocytopenia was more pronounced in the Dengue patients (mean (SD) platelet count 75 (34)x10(9)/l) than in the Chikungunya patients (117 (70)x10(9)/l) (p = 0.001). In the Chikungunya group there was a positive correlation between duration of the illness and the platelet count (r = 0.181, p = 0.194), but the Dengue group showed a negative correlation (r = -0.309, pDengue fever are similar. Arthritis is the pathognomonic sign in patients with Chikungunya fever.

  3. Daily hay fever forecast in the Netherlands. Radio broadcasting of the expected influence of the weather or subjective complaints of hay fever sufferers.

    Science.gov (United States)

    Spieksma, F T

    1980-10-01

    The literature on local pollen counts and their significance for hay fever is reviewed and a system for forecasting hay fever is described. Such forecasts have been broadcast by radio in The Netherlands since 1977. The hay fever forecast takes the form of a prognosis (in terms of three grades) of the influence of the expected whether situation on tomorrow's course of the subjective complaints of hay fever sufferers. It is not a forecast of the pollen count. When the subjective complaints of about 150 hay fever patients were used as reference for evaluation, the forecasts proved to have been correct in 72, 85, and 88% of the cases in 1977, 1978, and 1979, respectively. The practical usefulness and the limitations of the system are briefly discussed, with emphasis on the principle that not the local pollen count but the weather should be taken as the main determinative factor for the expected subjective experiences in a group of hay fever sufferers in a certain region.

  4. Long chain fatty acid (Lcfa) abnormalities in hyper Igd syndrome (Hids) and Familial Mediterranean Fever (Fmf): new insight into heritable periodic fevers.

    Science.gov (United States)

    Simon, Anna; Drenth, Joost P H; Matern, Dietrich; Goetzman, Eric S; Hager, Elizabeth J; Gibson, K Michael

    2013-03-01

    To examine essential fatty acids (EFAs) in hyper-IgD syndrome (HIDS) and Familial Mediterranean Fever (FMF). EFAs were determined in sera derived from an archival, cross-sectional group of HIDS/FMF patients, stratified for presence and absence of fever. Control populations included healthy afebrile adults, and individuals with non-periodic fever (septic shock). EFAs were quantified using isotope dilution gas chromatography-mass spectrometry and data analyzed employing a Kruskal-Wallis non-parametric ANOVA with Dunn's post-hoc test. Sera samples derived from HIDS patients showed significantly decreased C20, C26, phytanic and pristanic acids during febrile crises that normalized in the afebrile state, and a significantly increased afebrile C22_4ω6 level that normalized with fever. Samples derived from FMF patients revealed increased ω-oxidized LCFAs as compared to controls, and the trend was for these same species to be increased in comparison to febrile, but not afebrile, HIDS patients. Individuals with non-periodic fever demonstrated global decreases in C10-C24 fatty acids, both saturated and unsaturated, accompanied by an elevated triene/tetraene ratio. Our results suggest that different mechanisms are active in hereditary periodic fever syndromes that appear unrelated to fever, including depletion of very long chain fatty acids (VLCFAs) in febrile HIDS patients and increased ω-oxidized LCFAs in patients with FMF. These findings underscore new roles for EFAs in the potential production of inflammatory species in patients with hereditary periodic fever. Copyright © 2013 Elsevier Inc. All rights reserved.

  5. [Q fever: a cause of fever of unknown origin in Switzerland].

    Science.gov (United States)

    Fischer, L; Garin, N; Péter, O; Praz, G

    2012-10-10

    We describe two cases of Q fever in previously healthy women presenting with fever of unknown origin. The diagnosis was made after several days of investigations. Symptoms and signs of acute or chronic Coxiella burnetii infection are protean and non-specific. Q fever should be included in the differential diagnosis of fever of unknown origin and appropriate serologic studies should be done. We review the clinical presentation of Q fever. Use of serology for the diagnosis and the follow-up is discussed.

  6. Fever

    Science.gov (United States)

    ... child is overdressed or in a hot place. Febrile seizures do occur in some children. Most febrile seizures are over quickly and do not mean your ... the flu - what to ask your doctor - child Febrile seizures - what to ask your doctor When your baby ...

  7. Fever

    Science.gov (United States)

    ... 1, use an oral rehydration solution such as Pedialyte. These solutions contain water and salts proportioned to replenish fluids and electrolytes. Pedialyte ice pops also are available. Rest. You need ...

  8. A model of dengue fever

    Directory of Open Access Journals (Sweden)

    Boutayeb A

    2003-02-01

    Full Text Available Abstract Background Dengue is a disease which is now endemic in more than 100 countries of Africa, America, Asia and the Western Pacific. It is transmitted to the man by mosquitoes (Aedes and exists in two forms: Dengue Fever and Dengue Haemorrhagic Fever. The disease can be contracted by one of the four different viruses. Moreover, immunity is acquired only to the serotype contracted and a contact with a second serotype becomes more dangerous. Methods The present paper deals with a succession of two epidemics caused by two different viruses. The dynamics of the disease is studied by a compartmental model involving ordinary differential equations for the human and the mosquito populations. Results Stability of the equilibrium points is given and a simulation is carried out with different values of the parameters. The epidemic dynamics is discussed and illustration is given by figures for different values of the parameters. Conclusion The proposed model allows for better understanding of the disease dynamics. Environment and vaccination strategies are discussed especially in the case of the succession of two epidemics with two different viruses.

  9. Rheumatic fever in New Zealand.

    Science.gov (United States)

    Webb, Rachel; Wilson, Nigel

    2013-03-01

    Acute rheumatic fever and its sequel rheumatic heart disease remain major unsolved problems in New Zealand, causing significant morbidity and premature death. The disease burden affects predominantly indigenous Māori and Pacific Island children and young adults. In the past decade these ethnic disparities are even widening. Secondary prophylaxis using 28-day intramuscular penicillin has been the mainstay of disease control. In the greater Auckland region, audit shows community nurse-led penicillin delivery rates of 95% and recurrence rates of less than 5%. The true penicillin failure rate of 0.07 per 100 patient years supports 4 weekly penicillin rather than more frequent dose regimens. Landmark primary prevention research has been undertaken supporting sore throat primary prevention programmes in regions with very high rheumatic fever rates. Echocardiographic screening found 2.4% previously undiagnosed rheumatic heart disease in socially disadvantaged children. Combined with secondary prevention, echocardiography screening has the potential to reduce the prevalence of severe rheumatic heart disease.

  10. FAMILIAL MEDITERRANEAN FEVER AND HYPERCOAGULABILITY

    Directory of Open Access Journals (Sweden)

    Oshrat E. Tayer-Shifman

    2011-05-01

    Full Text Available Familial Mediterranean fever (FMF is an autosomal recessive hereditary disease which is characterized by recurrent attacks of fever and peritonitis, pleuritis, arthritis, or erysipelas-like skin disease. As such, FMF is a prototype of autoinflammatory diseases where genetic changes lead to acute inflammatory episodes. Systemic inflammation – in general - may increase procoagulant factors, and decrease natural anticoagulants and fibrinolytic activity. Therefore, it is anticipated to see more thrombotic events among FMF patients compared with healthy subjects. However, reviewing the current available literature and based upon our personal experience, thrombotic events related purely to FMF are very rare. Possible explanation for this discrepancy is that along with the procoagulant activity during FMF acute attacks, anticoagulant and fibrinolytic changes are also taking place. Furthermore, it may well be that during the acute attack of FMF the procoagulant factors are consumed or used for the purpose of inflammation so that nothing is left for their role in the coagulation pathway. Colchicine may also play a role in reducing inflammation thereby decreasing hypercoagulabilty

  11. Infections After Renal Transplant in Recipients With Familial Mediterranean Fever: A Life-Threatening Issue.

    Science.gov (United States)

    Tatar, Erhan; Karatas, Murat; Aykas, Ahmet; Okut, Gokalp; Bozkaya, Giray; Uslu, Adam

    2017-02-01

    We evaluated long-term results and infections requiring hospitalization in kidney transplant patients with Familial Mediterranean Fever (associated amyloidosis-type). We retrospectively reviewed medical records of patients with familial Mediterranean fever with at least 1-year posttransplant follow-up. Kidney transplant recipients with primary glomerulonephritis and equivalent demography, immunity status, and follow-up comprised the control group. In 32 patients with familial Mediterranean fever versus 25 control patients (mean follow-up 82 ± 57 vs 79 ± 54 mo; P = .82), average serum creatinine values were 1.7 ± 0.9 versus 1.5 ± 1.0 mg/dL (P = .41) at discharge, 1.4 ± 0.4 versus 1.3 ± 0.5 mg/dL (P = .44) at 1 year, 1.4 ± 0.6 versus 1.3 ± 0.5 mg/dL (P = .63) at 3 years, and 2.0 ± 1.5 versus 2.1 ± 1.5 mg/dL (P = .92) at last follow-up. Groups were not statistically different regarding average inpatient and number of hospitalizations due to infections at 1 year; however, at last follow-up, 26 patients with familial Mediterranean fever (81%) had 8.6 average admissions and 13 control patients (52%) had 2.8 average admissions (P = .02, P familial Mediterranean fever and 28% and 55.5% of control patients (P familial Mediterranean fever patients (18.7%) and 2 control patients (8%) died (P = .23). Although renal transplant patients with associated amyloidosis-type familial Mediterranean fever and those with glomerulonephritis have similar rejection and/or graft loss rates, hospital admissions due to infection and increased mortality are more common in the familial Mediterranean fever group, with immunosuppression drug withdrawal.

  12. Association of Mean Platelet Volume with Severity, Serology & Treatment Outcome in Dengue Fever: Prognostic Utility.

    Science.gov (United States)

    Sharma, Kritika; Yadav, Ajay

    2015-11-01

    Dengue is the most rapidly spreading mosquito-borne viral disease in the world. Dengue fever (DF) with its severe manifestations such as dengue haemorrhagic fever (DHF) and dengue shock syndrome (DSS) has emerged as a major public health problem of international concern. Thrombocytopenia and bleeding are common complications of dengue fever, hence besides platelet counts, there is a need to assess the role of mean platelet volume. Studying association of mean platelet volume (MPV) with severity, serology & treatment outcome to assess its prognostic utility, which can be of great help in limiting morbidity & mortality associated with dengue fever. The present study was conducted in Central Pathology Lab of SMS Medical College & Hospital, Jaipur, Rajasthan from the period of March 2013 till October 2013. Blood samples were collected from 200 patients with NS 1 Antigen positivity experiencing febrile illness, clinically consistent with dengue infection. Evaluation of platelet counts, MPV, IgM and IgG antibodies was done in all these cases. Categorical data were presented as numbers (percent) and were compared among groups using Chi-square test. Groups compared for demographic data were presented as mean and standard deviation and were compared using student t-test, ANOVA and Post-Hoc Test, Tukey Test using SPSS, version 20 for Windows. A total of 200 Dengue fever cases were studied. Out of which, 68% cases were of DF, 23% DHF & 9% DSS i.e. classical dengue fever was most common presentation. Maximum (44%) cases were in age group of 15-24 years. Fever was the presenting complaint in all cases (100%). 98% cases of dengue had thrombocytopenia. MPV showed no significant correlation with severity, serology & treatment outcome, thus excluding its role in dengue cases. Mean platelet volume is not important as prognostic parameter in dengue fever.

  13. Biomarkers of fever: from bench to bedside

    NARCIS (Netherlands)

    M. Limper (Maarten)

    2014-01-01

    markdownabstract__Abstract__ This thesis aims to study biomarkers in inflammation and infection, with a special focus on the distinction between infectious and non-infectious fever. The thesis consists of three parts, part I being this introduction, in which the concept of fever in infectious and n

  14. Chronic Q fever in The Netherlands

    NARCIS (Netherlands)

    Kampschreur, L.M.

    2013-01-01

    From 2007-2010, during the recent Q fever epidemic in the Netherlands, over 4000 cases of acute Q fever were registered, which is an underestimation of the total amount of Coxiella burnetii infections due to a high amount of asymptomatic primary infections. In the literature it is stated that 1-5% o

  15. The immune response in Q fever

    NARCIS (Netherlands)

    Schoffelen, T.

    2015-01-01

    Q fever is an infection caused by the bacterium Coxiella burnetii. A large outbreak of Q fever occurred in the Netherlands between 2007 and 2010, in which infected goats and sheep were the source of human infections. In some people, so-called ‘chronic Q fever’ develops, which mainly manifests as end

  16. Classical Swine Fever Virus-Rluc Replicons

    DEFF Research Database (Denmark)

    Risager, Peter Christian; Belsham, Graham J.; Rasmussen, Thomas Bruun

    Classical swine fever virus (CSFV) is the etiologic agent of the severe porcine disease, classical swine fever. Unraveling the molecular determinants of efficient replication is crucial for gaining proper knowledge of the pathogenic traits of this virus. Monitoring the replication competence within...

  17. Unexpected Rift Valley fever outbreak, northern Mauritania.

    Science.gov (United States)

    El Mamy, Ahmed B O; Baba, Mohamed Ould; Barry, Yahya; Isselmou, Katia; Dia, Mamadou L; El Kory, Mohamed O B; Diop, Mariam; Lo, Modou Moustapha; Thiongane, Yaya; Bengoumi, Mohammed; Puech, Lilian; Plee, Ludovic; Claes, Filip; de La Rocque, Stephane; Doumbia, Baba

    2011-10-01

    During September-October 2010, an unprecedented outbreak of Rift Valley fever was reported in the northern Sahelian region of Mauritania after exceptionally heavy rainfall. Camels probably played a central role in the local amplification of the virus. We describe the main clinical signs (hemorrhagic fever, icterus, and nervous symptoms) observed during the outbreak.

  18. Rift Valley fever outbreak, southern Mauritania, 2012.

    Science.gov (United States)

    Sow, Abdourahmane; Faye, Ousmane; Ba, Yamar; Ba, Hampathé; Diallo, Diawo; Faye, Oumar; Loucoubar, Cheikh; Boushab, Mohamed; Barry, Yahya; Diallo, Mawlouth; Sall, Amadou Alpha

    2014-02-01

    After a period of heavy rainfall, an outbreak of Rift Valley fever occurred in southern Mauritania during September-November 2012. A total of 41 human cases were confirmed, including 13 deaths, and 12 Rift Valley fever virus strains were isolated. Moudjeria and Temchecket Departments were the most affected areas.

  19. Rocky Mountain spotted fever in children.

    Science.gov (United States)

    Woods, Charles R

    2013-04-01

    Rocky Mountain spotted fever is typically undifferentiated from many other infections in the first few days of illness. Treatment should not be delayed pending confirmation of infection when Rocky Mountain spotted fever is suspected. Doxycycline is the drug of choice even for infants and children less than 8 years old.

  20. [Familial Mediterranean fever: not to be missed

    NARCIS (Netherlands)

    Frenkel, J.; Bemelman, F.J.; Potter van Loon, B.J.; Simon, A.

    2013-01-01

    Familial Mediterranean fever (FMF) is common among Turkish and Moroccan migrants. We describe three patients with FMF. A 3-year-old girl with recurrent fever and abdominal pain who was diagnosed early with FMF and treated effectively with colchicine. An adolescent girl who required interleukin

  1. Valley Fever (Coccidioidomycosis) Risk and Prevention

    Science.gov (United States)

    ... fungal spores. The following are some common-sense methods that may be helpful to avoid getting Valley fever. It’s important to know that although these steps are recommended, they haven’t been proven to prevent Valley fever. ... information about respirators. Stay inside during dust storms and ...

  2. Dengue hemorrhagic fever complicated by pancreatitis

    Directory of Open Access Journals (Sweden)

    Guido Ricardo Gonzalez Fontal

    2011-10-01

    Full Text Available Acute pancreatitis is an atypical complication of dengue fever and is rarely described. We are reporting a case of dengue hemorrhagic fever complicated by acute pancreatitis in a patient with history of diabetes mellitus type 1 and end stage renal disease on hemodialysis.

  3. Ask Dr. Sue: "Children and Fevers."

    Science.gov (United States)

    Aronson, Susan S.

    1989-01-01

    Considers aspects of children's fevers. Answers questions concerning: (1) the temperature at which a fever is infectious; (2) the point at which a feverish child in care should be sent home; (3) the length of time a parent should wait before returning the child to day care; and (4) the way to take a child's temperature. (RJC)

  4. [Diagnostic approach to fever of unknown origin

    NARCIS (Netherlands)

    Bleeker-Rovers, C.P.; Meer, J.W.M. van der

    2008-01-01

    Nowadays, fever of unknown origin (FUO) is generally defined as a fever higher than 38-3 degrees C lasting for a period of at least three weeks, in which no definitive diagnosis has been made after a number of obligatory tests. A diagnostic algorithm is proposed in which history taking, physical

  5. Bickerstaff's brainstem encephalitis associated with typhoid fever.

    OpenAIRE

    Wali, G M

    1991-01-01

    A 14 year old boy developed the syndrome of Bickerstaff's brainstem encephalitis during the course of bacteriologically proved typhoid fever. The clinical course and the results of various neurological investigations are detailed. This report adds a further manifestation to the published neuropsychiatric complications of typhoid fever.

  6. The immune response in Q fever

    NARCIS (Netherlands)

    Schoffelen, T.

    2015-01-01

    Q fever is an infection caused by the bacterium Coxiella burnetii. A large outbreak of Q fever occurred in the Netherlands between 2007 and 2010, in which infected goats and sheep were the source of human infections. In some people, so-called ‘chronic Q fever’ develops, which mainly manifests as

  7. Chronic Q fever in The Netherlands

    NARCIS (Netherlands)

    Kampschreur, L.M.

    2013-01-01

    From 2007-2010, during the recent Q fever epidemic in the Netherlands, over 4000 cases of acute Q fever were registered, which is an underestimation of the total amount of Coxiella burnetii infections due to a high amount of asymptomatic primary infections. In the literature it is stated that 1-5%

  8. Comparisons of predictors for typhoid and paratyphoid fever in Kolkata, India

    Directory of Open Access Journals (Sweden)

    Deen Jacqueline L

    2007-10-01

    Full Text Available Abstract Background: Exposure of the individual to contaminated food or water correlates closely with the risk for enteric fever. Since public health interventions such as water improvement or vaccination campaigns are implemented for groups of individuals we were interested whether risk factors not only for the individual but for households, neighbourhoods and larger areas can be recognised? Methods: We conducted a large enteric fever surveillance study and analyzed factors which correlate with enteric fever on an individual level and factors associated with high and low risk areas with enteric fever incidence. Individual level data were linked to a population based geographic information systems. Individual and household level variables were fitted in Generalized Estimating Equations (GEE with the logit link function to take into account the likelihood that household factors correlated within household members. Results: Over a 12-month period 80 typhoid fever cases and 47 paratyphoid fever cases were detected among 56,946 residents in two bustees (slums of Kolkata, India. The incidence of paratyphoid fever was lower (0.8/1000/year, and the mean age of paratyphoid patients was older (17.1 years than for typhoid fever (incidence 1.4/1000/year, mean age 14.7 years. Residents in areas with a high risk for typhoid fever had lower literacy rates and economic status, bigger household size, and resided closer to waterbodies and study treatment centers than residents in low risk areas. Conclusion: There was a close correlation between the characteristics detected based on individual cases and characteristics associated with high incidence areas. Because the comparison of risk factors of populations living in high versus low risk areas is statistically very powerful this methodology holds promise to detect risk factors associated with diseases using geographic information systems.

  9. Fever of unknown origin; Re-evaluation of sup 67 Ga scintigraphy in detecting causes of fever

    Energy Technology Data Exchange (ETDEWEB)

    Misaki, Takashi; Matsui, Akira; Tanaka, Fumiko; Okuno, Yoshishige; Mitsumori, Michihide; Torizuka, Tatsurou; Dokoh, Shigeharu; Hayakawa, Katsumi; Shimbo, Shin-ichirou (Kyoto City Hospital (Japan))

    1990-06-01

    Gallium-67 scintigraphy is a commonly performed imaging modality in deteting pyrogenic lesions in cases of long-standing inexplainable fever. To re-evaluate the significance of gallium imaging in such cases, a retrospective review was made of 56 scans performed in febrile patients in whom sufficient clinical and laboratory findings were obtained. Gallium scans were true positive in 30 patients, false positive in 3, true negative in 19, and false negative in 4. In the group of true positive, local inflammatory lesions were detected in 23 patients with a final diagnosis of lung tuberculosis, urinary tract infection, and inflammatory joint disease. Abnormal gallium accumulation, as shown in the other 7 patients, provided clues to the diagnosis of generalized disorders, such as hematological malignancies (n=3), systemic autoimmune diseases (n=3), and severe infectious mononucleosis (n=one). In the group of false positive, gallium imaging revealed intestinal excretion of gallium in 2 patients and physiological pulmonary hilar accumulation in one. In the true negative group of 19 patients, fever of unknown origin was resolved spontaneously in 12 patients, and with antibiotics and corticosteroids in 2 and 5 patients, respectively. Four patients having false negative scans were finally diagnosed as having urinary tract infection (n=2), bacterial meningitis (n=one), and polyarteritis (n=one). Gallium imaging would remain the technique of choice in searching for origin of unknown fever. It may also be useful for early diagnosis of systemic disease, as well as focal inflammation. (N.K.).

  10. Typhoid fever: the experience of last decade

    Directory of Open Access Journals (Sweden)

    A. N. Kovalenko

    2009-01-01

    Full Text Available This article is about analyses of diagnostics and treatment of the modern typhoid fever. In the past typhoid fever was critical and lifethreatening inflectional disease. But nowadays thanks to using of chloramphenicol and other antimicrobial preparations, typhoid fever is serious but well curable disease. In the second part of the 20th century the number of typhoid fever cases has decreased. As a result a new generation of physicians, who has never come across this disease, appeared. Nowadays typhoid fever is still actual for practical public health in Russia. There are two causes: first, there is a risk of delivery of infections with tourists and immigrants. Second, the small number of physicians, who possess well knowledge of clinical features and modern therapy.

  11. Viral haemorrhagic fevers in healthcare settings.

    Science.gov (United States)

    Ftika, L; Maltezou, H C

    2013-03-01

    Viral haemorrhagic fevers (VHFs) typically manifest as rapidly progressing acute febrile syndromes with profound haemorrhagic manifestations and very high fatality rates. VHFs that have the potential for human-to-human transmission and onset of large nosocomial outbreaks include Crimean-Congo haemorrhagic fever, Ebola haemorrhagic fever, Marburg haemorrhagic fever and Lassa fever. Nosocomial outbreaks of VHFs are increasingly reported nowadays, which likely reflects the dynamics of emergence of VHFs. Such outbreaks are associated with an enormous impact in terms of human lives and costs for the management of cases, contact tracing and containment. Surveillance, diagnostic capacity, infection control and the overall preparedness level for management of a hospital-based VHF event are very limited in most endemic countries. Diagnostic capacities for VHFs should increase in the field and become affordable. Availability of appropriate protective equipment and education of healthcare workers about safe clinical practices and infection control is the mainstay for the prevention of nosocomial spread of VHFs.

  12. Familial Mediterranean Fever: An Unusual Case Presentation.

    Science.gov (United States)

    Soora, Raksha; Nicandri, Katrina

    2015-12-01

    Familial Mediterranean Fever is a heritable illness typically characterized by recurrent fevers and serositis. Triggers of this illness include many things, such as cold or stress. This case describes a teenager who initially presented to the gynecologist office because of recurrent fevers with menses. Because she only had symptoms with menses, was healthy between attacks, and met the Livneh criteria, treatment with colchicine and combined oral contraceptive pills was initiated, with improvement of her symptoms. There are multiple etiologies for febrile illness during menses, and one should consider familial Mediterranean fever as a possible cause of cyclic fevers. Copyright © 2015 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  13. Educational Fever and South Korean Higher Education

    Directory of Open Access Journals (Sweden)

    Jeong-Kyu Lee

    2006-05-01

    Full Text Available This paper examines the influence of educational fever on the development of the Republic of Korea education and economy in the context of the cultural history of this country. In order to examine this study, the author explains the concept of educational fever and discusses the relation between Confucianism and education zeal. Educational fever and human capitalization in South Korean higher education are analyzed from a comparative viewpoint. The study evaluates the effects and problems of education fever this country’s current higher education, and it concludes that Koreans’ educational fever has been a core factor by which to achieve the development of the national economy as well as the rapid expansion of higher education.

  14. The geographical distribution of Q fever.

    Science.gov (United States)

    KAPLAN, M M; BERTAGNA, P

    1955-01-01

    The results of a WHO-assisted survey of the distribution of Q fever in 32 countries and an analysis of reports published to date indicate that Q fever exists in 51 countries on five continents. Q-fever infection was most often reported in man and the domestic ruminants, such as cattle, sheep, and goats.The disease was found to exist in most countries where investigations were carried out. Notable exceptions were Ireland, the Netherlands, New Zealand, Poland, and the Scandinavian countries. With the exception of Poland, where the results were inconclusive, all these countries import relatively few domestic ruminants-the most important animal reservoirs of human Q-fever infection. It seems, therefore, that the traffic of infected ruminants may be one of the most important, if not the most important, means for the geographical spread of Q fever. The importance, if any, of ticks associated with such traffic needs to be defined.

  15. Fever management: Evidence vs current practice.

    Science.gov (United States)

    El-Radhi, A Sahib Mehdi

    2012-12-08

    Fever is a very common complaint in children and is the single most common non-trauma-related reason for a visit to the emergency department. Parents are concerned about fever and it's potential complications. The biological value of fever (i.e., whether it is beneficial or harmful) is disputed and it is being vigorously treated with the belief of preventing complications such as brain injury and febrile seizures. The practice of alternating antipyretics has become widespread at home and on paediatric wards without supporting scientific evidence. There is still a significant contrast between the current concept and practice, and the scientific evidence. Why is that the case in such a common complaint like fever The article will discuss the significant contrast between the current concepts and practice of fever management on one hand, and the scientific evidence against such concepts and practice.

  16. Milk fever control principles: a review

    DEFF Research Database (Denmark)

    Thilsing-Hansen, T; Jørgensen, R J; Østergaard, S

    2002-01-01

    Three main preventive principles against milk fever were evaluated in this literature review, and the efficacy of each principle was estimated from the results of controlled investigations. Oral calcium drenching around calving apparently has a mean efficacy of 50%-60% in terms of milk fever...... prevention as well as prevention of milk fever relapse after intravenous treatment with calcium solutions. However, some drenches have been shown to cause lesions in the forestomacs. When using the DCAD (dietary cation-anion difference) principle, feeding rations with a negative DCAD (measured as (Na + K......)-(Cl + S)) significantly reduce the milk fever incidence. Calculating the relative risk (RR) of developing milk fever from controlled experiments results in a mean RR between 0.19 and 0.35 when rations with a negative versus positive DCAD are compared. The main drawback from the DCAD principle...

  17. Rat Bite Fever Resembling Rheumatoid Arthritis

    Directory of Open Access Journals (Sweden)

    Ripa Akter

    2016-01-01

    Full Text Available Rat bite fever is rare in Western countries. It can be very difficult to diagnose as blood cultures are typically negative and a history of rodent exposure is often missed. Unless a high index of suspicion is maintained, the associated polyarthritis can be mistaken for rheumatoid arthritis. We report a case of culture-positive rat bite fever in a 46-year-old female presenting with fever and polyarthritis. The clinical presentation mimicked rheumatoid arthritis. Infection was complicated by discitis, a rare manifestation. We discuss the diagnosis and management of this rare zoonotic infection. We also review nine reported cases of rat bite fever, all of which had an initial presumptive diagnosis of a rheumatological disorder. Rat bite fever is a potentially curable infection but can have a lethal course if left untreated.

  18. Fever after percutaneous nephrolithotomy: contributing factors.

    Science.gov (United States)

    Sharifi Aghdas, Farzaneh; Akhavizadegan, Hamed; Aryanpoor, Aryan; Inanloo, Hassan; Karbakhsh, Mojgan

    2006-08-01

    The exact mechanism of fever and urosepsis after percutaneous procedures has not been established. This research studied the frequency of fever after percutaneous nephrolithotomy (PCNL) and the contributing factors. In a cross-sectional study, from September 2003 to March 2004, all 217 patients with nephrolithiasis treated with PCNL at the Labbafinegad Specialized Urology Center were studied. Data were collected before, during, and after surgery. The frequency of fever after PCNL was 25.8% (n=56) although in 62.2% of the cases (n=135), no prophylactic antibiotics had been administered. The mean durations of hospitalization in patients with and without fever were 5.4+/-2.3 and 3.4+/-1.7 days, respectively (p=0.001). Significant correlations were observed between fever and female sex (p=0.005), positive urine culture (p=0.02), and nephrostomy tube insertion (p=0.041). Other variables did not prove to be significant. In logistic regression analysis, female sex and nephrostomy tube insertion were independently related to post-operative fever. Although a considerable proportion of our patients had not received prophylactic antibiotics, the rate of fever after PCNL was no higher than is reported in the literature. Use of only a short course of antibiotics before surgery for staghorn stones did not result in a higher rate of fever. Female sex created a higher risk for fever, probably because of the greater propensity to urinary tract infection. The significant relation of a nephrostomy tube to fever could be attributed to its role as a foreign body or to use in more complicated cases.

  19. STUDY OF SERUM AMINOTRANSFERASE LEVELS IN DENGUE FEVER

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    Jnaneshwari

    2014-03-01

    Full Text Available BACKGROUND: The involvement of liver in dengue fever is not uncommon as reported in literature since 1970. Liver and nervous system involvement simultaneously predicts poor outcome in dengue fever. Atypical manifestations include liver involvement with elevation of enzymes, central nervous involvement (encephalopathy and cardiac alterations (myocarditis. Liver involvement in dengue fever is manifested by the elevation of transaminases representing reactive hepatitis, due to direct attack of virus itself or the use of hepatotoxic drugs. OBJECTIVE OF THE STUDY: Study of serum aminotransferase levels in dengue fever. METHODOLOGY: In this descriptive, cross sectional study, all patients who presented to the Department of medicine with dengue IgM positive were included. Study period of 24 months from July 2010-June 2012, patients attending to M.S. Ramaiah medical college were included (n=166. RESULTS: 166 patients reactive for dengue virus specific IgM antibody were studied. As per WHO classification, 137 (82.5% patients were classified as dengue fever, 20 (12% as dengue hemorrhagic fever, and 9 (5.4% as dengue shock syndrome. Mean age of dengue infection patients was 35.71 ±12.9 (SD years, with male to female ratio nearly equal. Hepatic dysfunction is very common in all forms of dengue infection, with AST rising significantly more than ALT. Serum aminotransferase levels appear to have a directly proportional correlation with grading of dengue infection. Hyperbilirubinemia, elevated transaminases, hypoproteinemia, hypoalbuminemia and deranged coagulation profile were seen in higher frequency in DHF and DSS group as compared to classical DF group. AST and ALT were significantly higher in patients with secondary infection (IgM & IgG positive as compared to primary infection (IgM positive. CONCLUSION: Serum aminotransferase levels are significantly raised in all forms of dengue infection and it directly correlates with severity of infection. Serum

  20. Arthritis and adult respiratory distress syndrome: unusual presentations of typhoid fever.

    Science.gov (United States)

    Dhakad, Urmila; Das, Siddharth K; Srivastva, Durgesh; Nolkha, Nilesh

    2014-10-21

    A middle-aged woman presented with fever of 1-month duration along with bilateral knee joint pain, swelling and difficulty in walking for 2 weeks. The patient's Typhidot test was positive for IgM antibodies. Her Widal test was negative, and blood culture and synovial fluid culture were sterile. She was started on ceftriaxone, to which her fever initially responded. However, after 4 days of treatment her disease course was complicated by relapse of fever and acute respiratory distress syndrome (ARDS). This settled with respiratory support and addition of azithromycin. Following recovery from ARDS and fever, her persistent knee arthritis responded to intra-articular methyl prednisolone instillation. 2014 BMJ Publishing Group Ltd.

  1. Acute Rheumatic Fever: An Evidence-Based Approach To Diagnosis And Initial Management.

    Science.gov (United States)

    Khanna, Kajal; Liu, Deborah R

    2016-08-01

    Acute rheumatic fever is an inflammatory reaction involving the joints, heart, and nervous system that occurs after a group A streptococcal infection. It typically presents as a febrile illness with clinical manifestations that could include arthritis, carditis, skin lesions, or abnormal movements. Of these, the cardiac manifestations of acute rheumatic fever are most concerning, as children may present in acute heart failure and may go on to develop valvular insufficiency or stenosis. Because this is a rare presentation to emergency departments in developed countries, it is crucial for clinicians to keep a broad differential when presented with clinical presentations suspicious for acute rheumatic fever. This issue focuses on the clinical evaluation and treatment of patients with acute rheumatic fever by offering a thorough review of the literature on diagnosis and recommendations on appropriate treatment.

  2. Clinical Etiologies of Fever of Unknown Origin in 500 Cases.

    Science.gov (United States)

    Jun-Cai, T U; Ping, Zhou; Xiao-Juan, L I; Ying, Sun; Hui-Yuan, S I; Chun-Wei, Wang; Shou-Lei, Han; Fei-Yun, Zhu

    2015-06-01

    To investigate the distribution and change of the causes of fever of unknown origin(FUO). The clinical data of 500 inpatients with FUO in our center between December 2003 and June 2014 were retrospectively analyzed. The diagnostic methods,etiologies,and their possible relationship with age,sex,fever duration,and period. Of these 500 FUO patients,452(90.4%)were confirmed to be with fever caused by conditions including infectious diseases [(n=231,46.2%;e.g.tuberculosis(32.9%,76/231)],connective tissue diseases(CTD)(n=99,19.8%),neoplasms(n=58,11.6%),miscellaneous causes(n=64,12.8%). The causes were not identified in 48 cases(9.6%).The proportion of CTD in female patients was significantly higher than that in male patients(26.3% vs. 14.5%,P=0.025),whereas the proportion of neoplasms in male patients was significantly higher than that in female patients(14.5% vs. 8.0%,P=0.001). Infectious diseases was the most common cause in all age groups,CTD ranked the second in the 21-39-year group and 40-59-year group,and neoplasm was the second most coomon cause in the over 60 year group. Thus,the distribution of FUO etiologies significantly differed in different age groups(χ(2)=43.10,P=0.000). The duration of fever in patients with neoplasms [60(28,90)d] was longer than that in patients with infectious diseases [28(21,42)d,Z=-4.168,P=0.000] or CTD [30(21,60)d,Z=-2.406,P=0.016)]. Compared with the level in 2003-2008,the proportion of CTD significantly increased in 2009-2014(13.7% vs. 23.8%,χ(2)=8.598,P=0.003),along with the dicrease of the proportions of infectious diseases,neoplasms and miscellaneous diseases were decreased(all P>0.05). Infectious diseases(in particular,tuberculosis)remains the major cause of FUO. CTD and neoplasms also play important roles in the development of FUO. The distributions of the FUO etiologies have certain differences in terms of age,sex,duration of fever,and period.

  3. Association Between Keratoconus and Familial Mediterranean Fever in Turkey.

    Science.gov (United States)

    Kosker, Mustafa; Arslan, Nese; Alp, Muhammed Yunus; Ozisler, Cem; Acar, Mutlu; Dogan, Aysun Sanal; Yesilyurt, Ahmet; Gurdal, Canan

    2016-01-01

    To evaluate the association between familial Mediterranean fever (FMF) and keratoconus (KC). This retrospective case-control study was performed to compare the prevalence of KC in patients with FMF with the corresponding prevalence in control patients without FMF referred to Genetic Diagnostic Center at Diskapi Yildirim Beyazit Training and Research Hospital from June 2012 to June 2015. We included all 100 patients with FMF. Each FMF-affected patient was matched to 3 controls. None of the patients in the control group (0%, 0/300) had KC, whereas 4 of 100 patients with FMF (4%) had KC (P Mediterranean fever (MEFV) gene mutations, particularly in homozygous mutations of the MEFV gene, may be a predisposing factor in the development of KC.

  4. Periprosthetic breast abscess caused by Streptococcus pyogenes after scarlet fever.

    Science.gov (United States)

    Persichetti, Paolo; Langella, Marika; Marangi, Giovanni Francesco; Vulcano, Ettore; Gherardi, Giovanni; Dicuonzo, Giordano

    2008-01-01

    We present a case of a 32-year-old white women, affected by breast cancer and treated with mastectomy, who underwent immediate breast reconstruction with a tissue expander. She presented a periprosthetic infection from Streptococcus pyogenes (group A streptococcus, GAS) after scarlet fever. S. pyogenes may be responsible for suppurative complications of the respiratory system and a variety of metastatic foci of infection such as suppurative arthritic, endocarditis, meningitis, or brain abscess. Even though, in the literature, several cases and types of infection associated with breast implantation have been described, to our knowledge this is the first case report of periprosthetic infection after scarlet fever. Signs, symptoms, diagnosis, and treatment of GAS infection that occurred 2 months after the surgery are discussed.

  5. Workload and management of childhood fever at general practice out-of-hours care: an observational cohort study.

    Science.gov (United States)

    de Bont, Eefje G P M; Lepot, Julie M M; Hendrix, Dagmar A S; Loonen, Nicole; Guldemond-Hecker, Yvonne; Dinant, Geert-Jan; Cals, Jochen W L

    2015-05-19

    Even though childhood fever is mostly self-limiting, children with fever constitute a considerable workload in primary care. Little is known about the number of contacts and management during general practitioners' (GPs) out-of-hours care. We investigated all fever related telephone contacts, consultations, antibiotic prescriptions and paediatric referrals of children during GP out-of-hours care within 1 year. Observational cohort study. We performed an observational cohort study at a large Dutch GP out-of-hours service. Children (parents contacted the GP out-of-hours service for a fever related illness in 2012 were included. Number of contacts and consultations, antibiotic prescription rates and paediatric referral rates. We observed an average of 14.6 fever related contacts for children per day at GP out-of-hours services, with peaks during winter months. Of 17,170 contacts in 2012, 5343 (31.1%) were fever related and 70.0% resulted in a GP consultation. One in four consultations resulted in an antibiotic prescription. Prescriptions increased by age and referrals to secondary care decreased by age (pparents (89.5%) contacted the out-of-hours service only once during a fever episode (89.5%) and 7.6% of children were referred to secondary care. This study shows that childhood fever does account for a large workload at GP out-of-hours services. One in three contacts is fever related and 70% of those febrile children are called in to be assessed by a GP. One in four consultations for childhood fever results in antibiotic prescribing and most consultations are managed in primary care without referral. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  6. SECONDARY BACTERIAL INFECTION IN ADULT PATIENTS WITH PROLONGED AND SEVERE DENGUE FEVER

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    Anil Kumar

    2016-05-01

    Full Text Available INTRODUCTION Generally, in dengue shock syndrome antibiotics are not advised. But unrecognised bacterial infection is likely to contribute to morbidity and mortality, probably because of increased vascular permeability. OBJECTIVES To assess the incidence of secondary bacterial infection in adult patients with prolonged and severe dengue fever. METHODS A prospective study was conducted recruiting patients with confirmed acute dengue infection who had prolonged fever (>5 days. Prior to institution of antibiotic therapy, two sets of blood cultures were taken from patients. Demographic, clinical, haematological and biochemical parameters were recorded. Severity of fever & associated symptoms assessed. Ultrasonography done to find out development of ascites and pleural effusions. RESULTS Sixty patients (60.0% males with a mean age of 33.5 years (SD 12.1 were studied. The average duration of fever was 6.9 days (SD 1.6. Fifteen patients (25% had bacterial isolates in their blood cultures; Staphylococcus aureus (n=3, coliforms (n=7, pseudomonas (n=2 and 3 had mixed growths. The culture positive group had severe body aches and joints paint at admission and high grade fever, third space fluid accumulation and significant drop in platelets compared to culture-negative group. CONCLUSIONS A quarter of dengue patients with prolonged fever had a bacterial isolate. Culture-positive patients appeared more ill with body aches and had higher degrees of fever during the course of the illness. Increased vascular permeability may predispose to bacterial seepage into blood. Although white cell count is not helpful in detecting bacteraemia in dengue fever, low platelet count and severe symptoms at presentation may be helpful.

  7. Antibody response to 17D yellow fever vaccine in Ghanaian infants.

    Science.gov (United States)

    Osei-Kwasi, M; Dunyo, S K; Koram, K A; Afari, E A; Odoom, J K; Nkrumah, F K

    2001-01-01

    To assess the seroresponses to yellow fever vaccination at 6 and 9 months of age; assess any possible adverse effects of immunization with the 17D yellow fever vaccine in infants, particularly at 6 months of age. Four hundred and twenty infants who had completed BCG, OPV and DPT immunizations were randomized to receive yellow fever immunization at either 6 or 9 months. A single dose of 0.5 ml of the reconstituted vaccine was administered to each infant by subcutaneous injection. To determine the yellow fever antibody levels of the infants, each donated 1 ml whole blood prior to immunization and 3 months post-immunization. Each serum sample was titred on Vero cells against the vaccine virus. The most common adverse reactions reported were fever, cough, diarrhoea and mild reactions at the inoculation site. The incidences of adverse reactions were not statistically different in both groups. None of the pre-immunization sera in both age groups had detectable yellow fever antibodies. Infants immunized at 6 months recorded seroconversion of 98.6% and those immunized at 9 months recorded 98% seroconversion. The GMT of their antibodies were 158.5 and 129.8, respectively. The results indicate that seroresponses to yellow fever immunization at 6 and 9 months as determined by seroconversion and GMTs of antibodies are similar. The findings of good seroresponses at 6 months without significant adverse effects would suggest that the 17D yellow fever vaccine could be recommended for use in children at 6 months in outbreak situations or in high risk endemic areas.

  8. Detection of fever in children emergency care: comparisons of tactile and rectal temperatures in Nigerian children

    Directory of Open Access Journals (Sweden)

    Okafor Olubukola O

    2010-04-01

    Full Text Available Abstract Background Clinical thermometry is the objective method for temperature measurements but tactile assessment of fever at home is usually the basis for seeking medical attention especially where the cost and level of literacy preclude the use of thermometers. This study was carried out to determine the reliability of tactile perception of fever by caregivers, nurses and house physicians in comparison to rectal thermometry and also the use of commonly practiced surface of the hand in the care of ill children. All caregivers of children aged 6 to 59 months who presented to the emergency department were approached consecutively at the triage stage but 182 children participated. Each child had tactile assessment of fever using palmar and dorsal surfaces of the hand by the caregivers, House Physicians and Nursing Officers. Rectal temperature was also measured and read independently by nurses and house physicians. Comparisons were made between tactile assessments and thermometer readings using a cut-off for fever, 38.0°C and above. Findings The caregivers' perception of fever had a sensitivity, specificity, positive predictive value (PPV and negative predictive value (NPV of 95%, 23%, 66% and 73%, respectively compared with 93%, 26%, 67% and 69%, respectively for nursing officers. Irrespective of the groups studied, 77.1% of 336 assessors opined that the dorsal surface of the hand was more sensitive in tactile assessment of temperature and the frequently used site for assessment of fever were the head (35.6% and neck (33.3%. Tactile assessment of temperature over-detected fever in ≥ 24% of cases among the three groups of assessors. Conclusions The present study suggests that tactile assessment of temperature may over estimate the prevalence of fever, it does not detect some cases and the need for objective measurement of temperature is emphasised in paediatric emergency care.

  9. Clinical Efficacy of Azithromycin in Typhoid and Paratyphoid Fever in Children

    Directory of Open Access Journals (Sweden)

    Md Atiqul Islam

    2015-01-01

    Full Text Available Background: Azithromycin sensitivity cannot precisely identify the strains of typhoid and paratyphoid fever for successful treatment. Most of the studies show that azithromycin is highly effective in uncomplicated typhoid fever. Very few studies have been carried out in Bangladesh to see the effectiveness and sensitivity of azithromycin in children with uncomplicated typhoid fever. Objective: To assess the clinical response of azithromycin in uncomplicated typhoid fever. Materials and Methods: This randomized clinical trial was conducted in Dhaka Shishu (children Hospital from January to December 2009. Children between 2–12 years of age with characteristic clinical presentation of uncomplicated typhoid fever with positive blood culture for S. typhi or S. paratyphi were included in this study. Patients were treated with oral azithromycin 20 mg/kg/day for 7 days in one group and intravenous ceftriaxone 100 mg/kg/day in another group. Effectiveness and sensitivity pattern were documented and compared. Results: Fifty patients were allocated randomly with azithromycin and 48 with ceftriaxone. Twenty two percent of the subjects were below 5 years and 78% above 5 years. Average time of defervescence was 4.44 ± 1.25 days in azithromycin group and 4.38 ± 1.21 days in ceftriaxone group. Response to treatment in both groups was excellent: 94% in azithromycin and 97.9% in ceftriaxone groups. The occurrence of complication was very low in both groups. Eighteen percent showed resistance to azithromycin and 2.1% to ceftriaxone. In azithromycin sensitive group 97.6% showed improvement and in resistant group 77.8% showed improvement. A good percentage of patients who were resistant to azithromycin showed clinical improvement following treatment with this drug. Conclusion: Current study recommends that azithromycin is effective in the treatment of enteric fever in children. The study also shows that some patients resistant to azithromycin showed clinical

  10. Rapid diagnostic tests for typhoid and paratyphoid (enteric) fever.

    Science.gov (United States)

    Wijedoru, Lalith; Mallett, Sue; Parry, Christopher M

    2017-05-26

    Differentiating both typhoid (Salmonella Typhi) and paratyphoid (Salmonella Paratyphi A) infection from other causes of fever in endemic areas is a diagnostic challenge. Although commercial point-of-care rapid diagnostic tests (RDTs) for enteric fever are available as alternatives to the current reference standard test of blood or bone marrow culture, or to the widely used Widal Test, their diagnostic accuracy is unclear. If accurate, they could potentially replace blood culture as the World Health Organization (WHO)-recommended main diagnostic test for enteric fever. To assess the diagnostic accuracy of commercially available rapid diagnostic tests (RDTs) and prototypes for detecting Salmonella Typhi or Paratyphi A infection in symptomatic persons living in endemic areas. We searched the Cochrane Infectious Diseases Group Specialized Register, MEDLINE, Embase, Science Citation Index, IndMED, African Index Medicus, LILACS, ClinicalTrials.gov, and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) up to 4 March 2016. We manually searched WHO reports, and papers from international conferences on Salmonella infections. We also contacted test manufacturers to identify studies. We included diagnostic accuracy studies of enteric fever RDTs in patients with fever or with symptoms suggestive of enteric fever living in endemic areas. We classified the reference standard used as either Grade 1 (result from a blood culture and a bone marrow culture) or Grade 2 (result from blood culture and blood polymerase chain reaction, or from blood culture alone). Two review authors independently extracted the test result data. We used a modified QUADAS-2 extraction form to assess methodological quality. We performed a meta-analysis when there were sufficient studies for the test and heterogeneity was reasonable. Thirty-seven studies met the inclusion criteria and included a total of 5080 participants (range 50 to 1732). Enteric fever prevalence

  11. Study on the relationship between M protein gene-types and superantigen genes of Group A Streptococcus pyogenes strains isolated from scarlet fever patients in Beijing%北京市猩红热患者 A 组链球菌 M 蛋白基因型别与超抗原基因特征的相关性研究

    Institute of Scientific and Technical Information of China (English)

    吴双胜; 赵佳琛; 王全意; 杨鹏; 彭晓旻; 马春娜; 张代涛; 卢桂兰; 潘阳; 崔淑娟; 石伟先; 刘医萌

    2015-01-01

    目的:分析2012年5月至2013年7月北京市猩红热患者A组链球菌(G A S )超抗原基因特征及其与M蛋白基因(emm基因)型别的相关性。方法采集猩红热患者标本进行GAS分离鉴定,并应用PCR方法检测 emm基因和超抗原基因(speA、speB、speC、speF、speG、speH、speI、speJ、speL、speK、speM、ssa和smeZ)。应用卡方检验比较率和构成比。结果2012年5月至2013年7月分离到的423株GAS菌株进行超抗原基因检测,结果显示 speB、speC、speF、speG、smeZ和ssa的检出率较高,分别达97.6%、99.8%、98.3%、99.8%、94.1%和88.4%,其次为 speH(54.6%)、speI(53.4%)、speA(45.2%)和 speJ(43.5%),而 speK(2.4%)、speL(1.4%)和 speM(1.7%)的检出率较低。GAS菌株主要 emm型别为emm12型(59.5%)和emm1型(37.4%)。 emm12型携带 speH和speI基因的比例高达84.8%和84.0%,而 emm1型仅为4.0%和3.4%;emm12型携带 speA 和speJ基因的比例仅为17.3%和14.8%,而 emm1型为95.3%和94.6%。emm12型与emm1型菌株之间携带基因谱的差异有统计学意义(P<0.05)。结论2012年至2013年,北京市GAS菌株流行型别以 emm1和 emm12型为主,且emm型别与超抗原基因谱之间存在相关关系。%Objective To explore the relationship between superantigen and M protein gene (emm)-types genes of Group A Streptococcus pyogenes (GAS) isolated from patients with scarlet fever in Beijing from May 2012 to July 2013 .Methods GAS was isolated from specimens of patients with scarlet fever . Superantigen genes (speA ,speB ,speC ,speF ,speG ,speH ,speI ,speJ ,speL ,speK ,speM ,ssa ,and smeZ) ,and emm gene were amplified by polymerase chain reaction .Rate and proportion were compared by chi-square test .Results Of the 423 GAS strains isolated from patients with scarlet fever from 2012 to 2013 ,most of the isolates

  12. Acute rheumatic fever and rheumatic heart disease.

    Science.gov (United States)

    Carapetis, Jonathan R; Beaton, Andrea; Cunningham, Madeleine W; Guilherme, Luiza; Karthikeyan, Ganesan; Mayosi, Bongani M; Sable, Craig; Steer, Andrew; Wilson, Nigel; Wyber, Rosemary; Zühlke, Liesl

    2016-01-14

    Acute rheumatic fever (ARF) is the result of an autoimmune response to pharyngitis caused by infection with group A Streptococcus. The long-term damage to cardiac valves caused by ARF, which can result from a single severe episode or from multiple recurrent episodes of the illness, is known as rheumatic heart disease (RHD) and is a notable cause of morbidity and mortality in resource-poor settings around the world. Although our understanding of disease pathogenesis has advanced in recent years, this has not led to dramatic improvements in diagnostic approaches, which are still reliant on clinical features using the Jones Criteria, or treatment practices. Indeed, penicillin has been the mainstay of treatment for decades and there is no other treatment that has been proven to alter the likelihood or the severity of RHD after an episode of ARF. Recent advances - including the use of echocardiographic diagnosis in those with ARF and in screening for early detection of RHD, progress in developing group A streptococcal vaccines and an increased focus on the lived experience of those with RHD and the need to improve quality of life - give cause for optimism that progress will be made in coming years against this neglected disease that affects populations around the world, but is a particular issue for those living in poverty.

  13. Brugada syndrome unmasked by fever.

    Science.gov (United States)

    Grogan, Scott P; Cube, Regino P; Edwards, John A

    2011-08-01

    Brugada syndrome (BS) is a cardiac rhythm disturbance that predisposes patients to sudden cardiac death. Brugada is classically described with specific electrocardiographic (EKG) findings of ST elevation and right bundle branch block in precordial leads and is an often unrecognized contributor to sudden cardiac death. We present a case of BS with cyclic EKG findings in a febrile 20-year-old active duty, Vietnamese male who presented following a witnessed syncopal event. His classic findings of Brugada pattern on EKG demonstrated reversibility with clinical defervescence. In patients with a suggestive history, a normal EKG cannot definitively rule out BS as the Brugada pattern can be unmasked by stress, which in this case was represented by a pneumonia-induced fever.

  14. Sonography in the Diagnosis and Assessment of Dengue Fever

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    V R Santhosh

    2014-01-01

    Full Text Available Objective: The objective of the following study is to determine the use of ultrasound as an important adjunct to clinical and laboratory profile in diagnosing dengue fever and in predicting the severity of the disease by correlating imaging features with platelet count. The variation in sonographic features seen in patients from different age groups was also studied. Materials and Methods: This is a retrospective study. 96 patients who were serologically diagnosed as having dengue fever between April and August 2012 were referred for ultrasound scanning of the abdomen and thorax and the imaging findings were analyzed. Results: Out of 96 sero-positive dengue cases, 64 (66.7% patients showed edematous gallbladder (GB wall thickening, 62 (64.5% patients showed ascites, 48 (50% patients had pleural effusion, 17 (17.7% patients had hepatomegaly, 16 (16.7% patients had splenomegaly and in 17 (17.7% patients ultrasound findings were normal. Edematous GB wall thickening, ascites and pleural effusion were the most common combination of findings in all age groups. Edematous GB wall thickening was seen in 97.8% of patients with platelet count of less than 40,000 along with ascites (86.9% and pleural effusion (58.6%. In patients with platelet count between 40,000 and 80,000 ascites was more common than edematous GB wall thickening. Significantly no abnormal sonographic finding was detected in patient with platelet count more than 150,000. Conclusion: Sonographic features of thickened GB wall, pleural effusion (bilateral or right side, ascites, hepatomegaly and splenomegaly should strongly favor the diagnosis of dengue fever in patients presenting with fever and associated symptoms, particularly during an epidemic. The degree of thrombocytopenia showed a significant direct relationship to abnormal ultrasound features.

  15. Sonography in the diagnosis and assessment of dengue Fever.

    Science.gov (United States)

    Santhosh, V R; Patil, Prashanth G; Srinath, M G; Kumar, Ashok; Jain, Aditi; Archana, M

    2014-01-01

    The objective of the following study is to determine the use of ultrasound as an important adjunct to clinical and laboratory profile in diagnosing dengue fever and in predicting the severity of the disease by correlating imaging features with platelet count. The variation in sonographic features seen in patients from different age groups was also studied. This is a retrospective study. 96 patients who were serologically diagnosed as having dengue fever between April and August 2012 were referred for ultrasound scanning of the abdomen and thorax and the imaging findings were analyzed. Out of 96 sero-positive dengue cases, 64 (66.7%) patients showed edematous gallbladder (GB) wall thickening, 62 (64.5%) patients showed ascites, 48 (50%) patients had pleural effusion, 17 (17.7%) patients had hepatomegaly, 16 (16.7%) patients had splenomegaly and in 17 (17.7%) patients ultrasound findings were normal. Edematous GB wall thickening, ascites and pleural effusion were the most common combination of findings in all age groups. Edematous GB wall thickening was seen in 97.8% of patients with platelet count of less than 40,000 along with ascites (86.9%) and pleural effusion (58.6%). In patients with platelet count between 40,000 and 80,000 ascites was more common than edematous GB wall thickening. Significantly no abnormal sonographic finding was detected in patient with platelet count more than 150,000. Sonographic features of thickened GB wall, pleural effusion (bilateral or right side), ascites, hepatomegaly and splenomegaly should strongly favor the diagnosis of dengue fever in patients presenting with fever and associated symptoms, particularly during an epidemic. The degree of thrombocytopenia showed a significant direct relationship to abnormal ultrasound features.

  16. FAMILIAL MEDITERRANEAN FEVER AND HYPERCOAGULABILITY

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    Oshrat E. Tayer-Shifman

    2011-01-01

    Full Text Available Familial Mediterranean fever (FMF is an autosomal recessive hereditary disease which is characterized by recurrent attacks of fever and peritonitis, pleuritis, arthritis, or erysipelas-like skin disease. As such, FMF is a prototype of autoinflammatory diseases where genetic changes lead to acute inflammatory episodes. Systemic inflammation – in general - may increase procoagulant factors, and decrease natural anticoagulants and fibrinolytic activity. Therefore, it is anticipated to see more thrombotic events among FMF patients compared with healthy subjects. However, reviewing the current available literature and based upon our personal experience, thrombotic events related purely to FMF are very rare. Possible explanation for this discrepancy is that along with the procoagulant activity during FMF acute attacks, anticoagulant and fibrinolytic changes are also taking place. Furthermore, it may well be that during the acute attack of FMF the procoagulant factors are consumed or used for the purpose of inflammation so that nothing is left for their role in the coagulation pathway. Colchicine may also play a role in reducing inflammation thereby decreasing hypercoagulabilty

  17. Fever in Children: Pearls and Pitfalls.

    Science.gov (United States)

    Barbi, Egidio; Marzuillo, Pierluigi; Neri, Elena; Naviglio, Samuele; Krauss, Baruch S

    2017-09-01

    Fever in children is a common concern for parents and one of the most frequent presenting complaints in emergency department visits, often involving non-pediatric emergency physicians. Although the incidence of serious infections has decreased after the introduction of conjugate vaccines, fever remains a major cause of laboratory investigation and hospital admissions. Furthermore, antipyretics are the most common medications administered to children. We review the epidemiology and measurement of fever, the meaning of fever and associated clinical signs in children of different ages and under special conditions, including fever in children with cognitive impairment, recurrent fevers, and fever of unknown origin. While the majority of febrile children have mild, self-resolving viral illness, a minority may be at risk of life-threatening infections. Clinical assessment differs markedly from adult patients. Hands-off evaluation is paramount for a correct evaluation of breathing, circulation and level of interaction. Laboratory markers and clinical prediction rules provide limited help in identifying children at risk for serious infections; however, clinical examination, prudent utilization of laboratory tests, and post-discharge guidance ("safety netting") remain the cornerstone of safe management of febrile children.

  18. Isolated fever induced by mesalamine treatment.

    Science.gov (United States)

    Slim, Rita; Amara, Joseph; Nasnas, Roy; Honein, Khalil; Jaoude, Joseph Bou; Yaghi, Cesar; Daniel, Fady; Sayegh, Raymond

    2013-02-21

    Adverse reactions to mesalamine, a treatment used to induce and maintain remission in inflammatory bowel diseases, particularly ulcerative colitis, have been described in the literature as case reports. This case illustrates an unusual adverse reaction. Our patient developed an isolated fever of unexplained etiology, which was found to be related to mesalamine treatment. A 22-year-old patient diagnosed with ulcerative colitis developed a fever with rigors and anorexia 10 d after starting oral mesalamine while his colitis was clinically resolving. Testing revealed no infection. A mesalamine-induced fever was considered, and treatment was stopped, which led to spontaneous resolution of the fever. The diagnosis was confirmed by reintroducing the mesalamine. One year later, this side effect was noticed again in the same patient after he was administered topical mesalamine. This reaction to mesalamine seems to be idiosyncratic, and the mechanism that induces fever remains unclear. Fever encountered in the course of a mesalamine treatment in ulcerative colitis must be considered a mesalamine-induced fever when it cannot be explained by the disease activity, an associated extraintestinal manifestation, or an infectious etiology.

  19. Fever in Children: Pearls and Pitfalls

    Science.gov (United States)

    Barbi, Egidio; Marzuillo, Pierluigi; Neri, Elena; Krauss, Baruch S.

    2017-01-01

    Fever in children is a common concern for parents and one of the most frequent presenting complaints in emergency department visits, often involving non-pediatric emergency physicians. Although the incidence of serious infections has decreased after the introduction of conjugate vaccines, fever remains a major cause of laboratory investigation and hospital admissions. Furthermore, antipyretics are the most common medications administered to children. We review the epidemiology and measurement of fever, the meaning of fever and associated clinical signs in children of different ages and under special conditions, including fever in children with cognitive impairment, recurrent fevers, and fever of unknown origin. While the majority of febrile children have mild, self-resolving viral illness, a minority may be at risk of life-threatening infections. Clinical assessment differs markedly from adult patients. Hands-off evaluation is paramount for a correct evaluation of breathing, circulation and level of interaction. Laboratory markers and clinical prediction rules provide limited help in identifying children at risk for serious infections; however, clinical examination, prudent utilization of laboratory tests, and post-discharge guidance (“safety netting”) remain the cornerstone of safe management of febrile children. PMID:28862659

  20. Fever in Children: Pearls and Pitfalls

    Directory of Open Access Journals (Sweden)

    Egidio Barbi

    2017-09-01

    Full Text Available Fever in children is a common concern for parents and one of the most frequent presenting complaints in emergency department visits, often involving non-pediatric emergency physicians. Although the incidence of serious infections has decreased after the introduction of conjugate vaccines, fever remains a major cause of laboratory investigation and hospital admissions. Furthermore, antipyretics are the most common medications administered to children. We review the epidemiology and measurement of fever, the meaning of fever and associated clinical signs in children of different ages and under special conditions, including fever in children with cognitive impairment, recurrent fevers, and fever of unknown origin. While the majority of febrile children have mild, self-resolving viral illness, a minority may be at risk of life-threatening infections. Clinical assessment differs markedly from adult patients. Hands-off evaluation is paramount for a correct evaluation of breathing, circulation and level of interaction. Laboratory markers and clinical prediction rules provide limited help in identifying children at risk for serious infections; however, clinical examination, prudent utilization of laboratory tests, and post-discharge guidance (“safety netting” remain the cornerstone of safe management of febrile children.

  1. Rheumatic fever, autoimmunity, and molecular mimicry: the streptococcal connection.

    Science.gov (United States)

    Cunningham, Madeleine W

    2014-01-01

    The group A streptococcus, Streptococcus pyogenes, and its link to autoimmune sequelae, has acquired a new level of understanding. Studies support the hypothesis that molecular mimicry between the group A streptococcus and heart or brain are important in directing immune responses in rheumatic fever. Rheumatic carditis, Sydenham chorea and a new group of behavioral disorders called pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections are reviewed with consideration of autoantibody and T cell responses and the role of molecular mimicry between the heart, brain and group A streptococcus as well as how immune responses contribute to pathogenic mechanisms in disease. In rheumatic carditis, studies have investigated human monoclonal autoantibodies and T cell clones for their crossreactivity and their mechanisms leading to valve damage in rheumatic heart disease. Although studies of human and animal sera from group A streptococcal diseases or immunization models have been crucial in providing clues to molecular mimicry and its role in the pathogenesis of rheumatic fever, study of human monoclonal autoantibodies have provided important insights into how antibodies against the valve may activate the valve endothelium and lead to T cell infiltration. Passive transfer of anti-streptococcal T cell lines in a rat model of rheumatic carditis illustrates effects of CD4+ T cells on the valve. Although Sydenham chorea has been known as the neurological manifestation of rheumatic fever for decades, the combination of autoimmunity and behavior is a relatively new concept linking brain, behavior and neuropsychiatric disorders with streptococcal infections. In Sydenham chorea, human mAbs and their expression in transgenic mice have linked autoimmunity to central dopamine pathways as well as dopamine receptors and dopaminergic neurons in basal ganglia. Taken together, the studies reviewed provide a basis for understanding streptococcal sequelae and

  2. Clinical and molecular aspects of malaria fever.

    Science.gov (United States)

    Oakley, Miranda S; Gerald, Noel; McCutchan, Thomas F; Aravind, L; Kumar, Sanjai

    2011-10-01

    Although clinically benign, malaria fever is thought to have significant relevance in terms of parasite growth and survival and its virulence which in turn may alter the clinical course of illness. In this article, the historical literature is reviewed, providing some evolutionary perspective on the genesis and biological relevance of malaria fever, and the available molecular data on the febrile-temperature-inducible parasite factors that may contribute towards the regulation of parasite density and alteration of virulence in the host is also discussed. The potential molecular mechanisms that could be responsible for the induction and regulation of cyclical malaria fevers caused by different species of Plasmodium are also discussed.

  3. Anterior ischemic optic neuropathy following dengue fever.

    Science.gov (United States)

    Ramakrishnan, Reshma; Shrivastava, Saurabh; Deshpande, Shrikant; Patkar, Priyanka

    2016-01-01

    Dengue fever is caused by a flavivirus. This infection is endemic in the tropics and warm temperate regions of the world. Ocular manifestations of dengue fever include subconjunctival, vitreous, and retinal haemorrhages; posterior uveitis; optic neuritis; and maculopathies, haemorrhage, and oedema. However anterior ischemic optic neuropathy is a rare presentation. Optic nerve ischemia most frequently occurs at the optic nerve head, where structural crowding of nerve fibers and reduction of the vascular supply may combine to impair perfusion to a critical degree and produce optic disc oedema. Here we present a case of anterior ischemic optic neurapathy associated with dengue fever.

  4. Lassa fever: another threat from West Africa.

    Science.gov (United States)

    Brosh-Nissimov, Tal

    2016-01-01

    Lassa fever, a zoonotic viral infection, is endemic in West Africa. The disease causes annual wide spread morbidity and mortality in Africa, and can be imported by travelers. Possible importation of Lassa fever and the potential for the use of Lassa virus as an agent of bioterrorism mandate clinicians in Israel and other countries to be vigilant and familiar with the basic characteristics of this disease. The article reviews the basis of this infection and the clinical management of patients with Lassa fever. Special emphasis is given to antiviral treatment and infection control.

  5. Clara Maass, yellow fever and human experimentation.

    Science.gov (United States)

    Chaves-Carballo, Enrique

    2013-05-01

    Clara Louise Maass, a 25-year-old American nurse, died of yellow fever on August 24, 1901, following experimental inoculation by infected mosquitoes in Havana, Cuba. The human yellow fever experiments were initially conducted by MAJ Walter Reed, who first used written informed consent and proved the validity of Finlay's mosquito-vector hypothesis. Despite informed consent form and an incentive of $100 in U.S. gold, human subjects were exposed to a deadly virus. The deaths of Clara Maass and two Spanish immigrants resulted in a public outcry and the immediate cessation of yellow fever human experiments in Cuba.

  6. Appendicular perforation in dengue fever: our experience

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    Gunjan Desai

    2014-09-01

    Full Text Available Dengue viral infections have become one of major emerging infectious diseases in the tropics. Acute abdomen occurring in dengue viral infection is not uncommon. The spectrums of acute surgical emergencies which raise suspicion of an abdominal catastrophe in patients presenting with dengue fever include acute pancreatitis, acute acalculous cholecystitis, non-specific peritonitis and very rarely acute appendicitis. The presence of low white cell count and platelet count can raise suspicion of a diagnosis of dengue in a patient presenting with acute abdominal pain, during a dengue epidemic. We herein report three patients with dengue fever who had appendicular perforation during the course of their viral fever.

  7. Performance of Different Diagnostic Criteria for Familial Mediterranean Fever in Children with Periodic Fevers: Results from a Multicenter International Registry.

    Science.gov (United States)

    Demirkaya, Erkan; Saglam, Celal; Turker, Turker; Koné-Paut, Isabelle; Woo, Pat; Doglio, Matteo; Amaryan, Gayane; Frenkel, Joost; Uziel, Yosef; Insalaco, Antonella; Cantarini, Luca; Hofer, Michael; Boiu, Sorina; Duzova, Ali; Modesto, Consuelo; Bryant, Annette; Rigante, Donato; Papadopoulou-Alataki, Efimia; Guillaume-Czitrom, Severine; Kuemmerle-Deschner, Jasmine; Neven, Bénédicte; Lachmann, Helen; Martini, Alberto; Ruperto, Nicolino; Gattorno, Marco; Ozen, Seza

    2016-01-01

    Our aims were to validate the pediatric diagnostic criteria in a large international registry and to compare them with the performance of previous criteria for the diagnosis of familial Mediterranean fever (FMF). Pediatric patients with FMF from the Eurofever registry were used for the validation of the existing criteria. The other periodic fevers served as controls: mevalonate kinase deficiency (MKD), tumor necrosis factor receptor-associated periodic syndrome (TRAPS), cryopyrin-associated periodic syndrome (CAPS), aphthous stomatitis, pharyngitis, adenitis syndrome (PFAPA), and undefined periodic fever from the same registry. The performances of Tel Hashomer, Livneh, and the Yalcinkaya-Ozen criteria were assessed. The FMF group included 339 patients. The control group consisted of 377 patients (53 TRAPS, 45 MKD, 32 CAPS, 160 PFAPA, 87 undefined periodic fevers). Patients with FMF were correctly diagnosed using the Yalcinkaya-Ozen criteria with a sensitivity rate of 87.4% and a specificity rate of 40.7%. On the other hand, Tel Hashomer and Livneh criteria displayed a sensitivity of 45.0 and 77.3%, respectively. Both of the latter criteria displayed a better specificity than the Yalcinkaya-Ozen criteria: 97.2 and 41.1% for the Tel Hashomer and Livneh criteria, respectively. The overall accuracy for the Yalcinkaya-Ozen criteria was 65 and 69.6% (using 2 and 3 criteria), respectively. Ethnicity and residence had no effect on the performance of the Yalcinkaya-Ozen criteria. The Yalcinkaya-Ozen criteria yielded a better sensitivity than the other criteria in this international cohort of patients and thus can be used as a tool for FMF diagnosis in pediatric patients from either the European or eastern Mediterranean region. However, the specificity was lower than the previously suggested adult criteria.

  8. Determination of serum adenosine deaminase and xanthine oxidase levels in patients with crimean-congo hemorrhagic fever

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    V. Kenan Celik

    2010-01-01

    Full Text Available OBJECTIVE: Crimean-Congo hemorrhagic fever is an acute viral hemorrhagic fever with a high mortality rate. Despite increasing knowledge about hemorrhagic fever viruses, little is known about the pathogenesis of Crimean-Congo hemorrhagic fever. In this study, we measured serum adenosine deaminase and xanthine oxidase levels in Crimean-Congo hemorrhagic fever patients. METHODS: Serum adenosine deaminase levels were measured with a sensitive colorimetric method described by Giusti and xanthine oxidase levels by the method of Worthington in 30 consecutive hospitalized patients (mean age 42.6 ± 21.0. Laboratory tests confirmed their diagnoses of Crimean-Congo hemorrhagic fever. Thirty-five subjects (mean age 42.9 ± 19.1 served as the control group. RESULTS: There was a significant difference in adenosine deaminase and xanthine oxidase levels between cases and controls (p0.05. CONCLUSION: Adenosine deaminase and xanthine oxidase levels were increased in patients with Crimean-Congo hemorrhagic fever. Elevated serum xanthine oxidase activity in patients with Crimean-Congo hemorrhagic fever may be associated with reactive oxygen species generated by the xanthine/xanthine oxidase system during inflammatory responses. In addition, elevated lipid peroxidation may contribute to cell damage and hemorrhage. The association of cell damage and hemorrhage with xanthine oxidase activity should be further investigated in large-scale studies.

  9. Familial Mediterranean fever presenting as fever of unknown origin in Korea

    OpenAIRE

    Lee, Jun Hee; Kim, Jong Hyun; Shim, Jung Ok; Lee, Kwang Chul; Lee, Joo Won; Lee, Jung Hwa; Chae, Jae Jin

    2016-01-01

    Familial Mediterranean fever (FMF) is the most common Mendelian autoinflammatory disease, characterized by uncontrolled activation of the innate immune system that manifests as recurrent brief fever and polyserositis (e.g., peritonitis, pleuritic, and arthritis). FMF is caused by autosomal recessive mutations of the Mediterranean fever gene, MEFV which encodes the pyrin protein. Although FMF predominantly affects people from Mediterranean and Middle Eastern ethnic origins, 3 cases of FMF have...

  10. A comparative study of Cefixime and Chloramphenicole for treatment of patients with typhoid fever

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    Emadi J

    2001-08-01

    Full Text Available Typhoid fever is an endemic disease in Iran and other developing countries. This disease has gradually become resistant to the first line of drugs, and because of this resistancy we have studied a new alternative drug (cefixime on typhoid fever patients and compared it's effectiveness with chloramphenicol. For this purpose, by a randomized clinical trial in Emam Khomeini hospital between 1995-2000, we allocated 44 uncomplicated patient with established typhoid fever (positive blood or bone marrow culture and by random selection, 24 patient were given cefixime (400 mg PO bid and 20 patient received chloramphenicol (500 mg po Q6h. The duration of therapy were 10 and 14 days for chloramphenicol and cefixime group respectively. Median fever clearance times were 5±1.9 for cefixime recipients and 3.8±1.2 days for chloramphenicol treated patients, but for improvement in other clinical and laboratory findings, there were not any significant difference. Bacteriologic and clinical cure rate for cefixime was 100 and 92 percents respectively. Though, even cefixime like other betalactam drugs is slow in helping the fever disappearance but our study suggests that oral cefixime is effective and can be used as an alternate treatment of typhoid fever.

  11. The Validity and Reliability of the Parent Fever Management Scale: A Study from Palestine.

    Science.gov (United States)

    Zyoud, Sa'ed H; Al-Jabi, Samah W; Nabulsi, Masa M; Tubaila, Mais F; Sweileh, Waleed M; Awang, Rahmat; Walsh, Anne

    2015-08-01

    Parental concern about childhood fever and consequent use of antipyretics is increasing. Little is known about childhood fever management among Arab parents. No scales to measure parents' fever management practices in Palestine are available. The aim of this study was to validate the Arabic version of the Parent Fever Management Scale (PFMS) using a sample of parents in Palestine. A standard "forward-backward" procedure was used to translate PFMS into Arabic language. It was then validated on a convenience sample of 402 parents between July and October 2012. Descriptive statistics were used, and instrument reliability was assessed for internal consistency using Cronbach's alpha coefficient. Validity was confirmed using convergent and known group validation. Applying the recommended scoring method, the median (interquartile range) score of the PFMS was 26 (23-30). Acceptable internal consistency was found (Cronbach's alpha = 0.733) and the test-retest reliability value was 0.92 (P parents' fever management practices. The Arabic version of the PFMS can be used to reduce unnecessary parental practices in fever management for a febrile child.

  12. Dengue fever in patients admitted in tertiary care hospitals in Pakistan.

    Science.gov (United States)

    Munir, Muhammad Arif; Alam, Syed Ejaz; Khan, Zareef Uddin; Saeed, Quaid; Arif, Ambreen; Iqbal, Rizwan; Saqib, Muhammad Arif Nadeem; Qureshi, Huma

    2014-05-01

    To assess the gaps in the diagnosis and management of dengue fever cases. The retrospective descriptive analytical study was done with a case record analysis of patients with dengue fever admitted from January to December 2010 at five tertiary care hospitals in different Pakistani cities. Using a questionnaire, information was gathered on demography, haematological profile, management, use of blood and platelet transfusions and the outcome. For comparison, data of serologically-confirmed dengue patients from a private laboratory in Islamabad was collected to see the age, gender and month-wise distribution of cases tested over the same period. SPSS 16 was used for statistical analysis. Out of the 841 confirmed dengue cases, 514 (79%) were males and 139 (21%) females. The overall mean age was 31.3 +/- 14.0 years. Dengue fever was seen in 653 (78%) and dengue haemorrhagic fever (DHF) in 188 (22%) patients. Most cases were between 20 and 49 years of age. A gradual increase in dengue fever and dengue haemorrhagic fever was seen from August, with a peak in October/November. Tourniquet test was done only in 20 (2.3%) cases, out of which 11 (55%) were positive and 9 (45%) were negative. Serial haematocrit was not done in any case. Total deaths were 5 (0.6%). Most cases were seen in October/November with the majority being in the 20-39 age group. Tourniquet test and serial haematocrit were infrequently used. No standard national guidelines were employed.

  13. (18) F-FDG-PET/CT as adjunctive diagnostic modalities in canine fever of unknown origin.

    Science.gov (United States)

    Grobman, Megan; Cohn, Leah; Knapp, Stephanie; Bryan, Jeffrey N; Reinero, Carol

    2017-09-18

    Fever of unknown origin (FUO) is a persistent or recurrent fever for which the underlying source has not been identified despite diagnostic investigation. In people, (18) F-fluoro-2-deoxyglucose positron emission tomography ((18) F-FDG-PET) alone or in combination with computed tomography (CT) is often beneficial in detecting the source of fever when other diagnostics have failed. Veterinary reports describing use of these modalities in animals with fever of unknown origin are currently lacking. Aims of this retrospective case series were to describe (18) F-FDG-PET or (18) F-FDG-PET/CT findings in a group of dogs with fever of unknown origin. Dogs presenting to a single center between April 2012 and August 2015 were included. A total of four dogs met inclusion criteria and underwent either positron emission tomography (n = 2) or positron emission tomography/CT (n = 2) as a part of their diagnostic investigation. All subjects underwent extensive diagnostic testing prior to (18) F-FDG-PET/CT. Initial diagnostic evaluation failed to identify either a cause of fever or an anatomic location of disease in these four dogs. In each dog, positron emission tomography or positron emission tomography/CT was either able to localize or rule out the presence of focal lesion thereby allowing for directed sampling and/or informed disease treatment. Follow up (18) F-FDG-PET/CT scans performed in two patients showed improvement of observed abnormalities (n = 1) or detected recurrence of disease allowing for repeated treatment before clinical signs recurred (n = 1). Fever resolved after specific treatment in each dog. Findings from the current study supported the use of positron emission tomography or positron emission tomography/CT as adjunctive imaging modalities for diagnosis and gauging response to therapy in dogs with fever of unknown origin. © 2017 American College of Veterinary Radiology.

  14. Narcolepsy Following Yellow Fever Vaccination: A Case Report.

    Science.gov (United States)

    Rosch, Richard E; Farquhar, Michael; Gringras, Paul; Pal, Deb K

    2016-01-01

    Narcolepsy with cataplexy is a rare, but important differential diagnosis for daytime sleepiness and atonic paroxysms in an adolescent. A recent increase in incidence in the pediatric age group probably linked to the use of the Pandemrix influenza vaccine in 2009, has increased awareness that different environmental factors can "trigger" narcolepsy with cataplexy in a genetically susceptible population. Here, we describe the case of a 13-year-old boy with narcolepsy following yellow fever vaccination. He carries the HLA DQB1*0602 haplotype strongly associated with narcolepsy and cataplexy. Polysomnography showed rapid sleep onset with rapid eye movement (REM) latency of 47 min, significant sleep fragmentation and a mean sleep latency of 1.6 min with sleep onset REM in four out of four nap periods. Together with the clinical history, these findings are diagnostic of narcolepsy type 1. The envelope protein E of the yellow fever vaccine strain 17D has significant amino acid sequence overlap with both hypocretin and the hypocretin receptor 2 receptors in protein regions that are predicted to act as epitopes for antibody production. These findings raise the question whether the yellow fever vaccine strain may, through a potential molecular mimicry mechanism, be another infectious trigger for this neuro-immunological disorder.

  15. Narcolepsy following yellow fever vaccination: A case report

    Directory of Open Access Journals (Sweden)

    Richard Ewald Rosch

    2016-08-01

    Full Text Available Narcolepsy with cataplexy is a rare, but important differential diagnosis for daytime sleepiness and atonic paroxysms in an adolescent. A recent increase in incidence in the paediatric age-group probably linked to the use of the Pandremix influenza vaccine in 2009, has increased awareness that different environmental factors can ‘trigger’ narcolepsy with cataplexy in a genetically susceptible population.Here we describe the case of a 13 year-old boy with narcolepsy following yellow-fever vaccination. He carries the HLA DQB1*0602 haplotype strongly associated with narcolepsy and cataplexy. Polysomnography showed rapid sleep onset with rapid eye movement (REM latency of 47 minutes, significant sleep fragmentation and a mean sleep latency of 1.6 minutes with sleep onset REM in 4 out of 4 nap periods. Together with the clinical history, these findings are diagnostic of narcolepsy type 1. The envelope protein E of the yellow fever vaccine strain 17D has significant amino acid sequence overlap with both hypocretin and the hypocretin receptor 2 receptors in protein regions that are predicted to act as epitopes for antibody production. These findings raise the question whether the yellow fever vaccine strain may, through a potential molecular mimicry mechanism, be another infectious trigger for this neuro-immunological disorder.

  16. Intrapartum fever and the risk for perinatal complications - the effect of fever duration and positive cultures.

    Science.gov (United States)

    Ashwal, Eran; Salman, Lina; Tzur, Yossi; Aviram, Amir; Ben-Mayor Bashi, Tali; Yogev, Yariv; Hiersch, Liran

    2017-04-24

    To estimate the association between intrapartum fever and adverse perinatal outcome. A retrospective cohort study of women attempting vaginal delivery at term in a tertiary hospital (2012-2015). Perinatal outcome of deliveries complicated by intrapartum fever (≥38.0 °C) were compared to women with no intrapartum fever matched by parity and gestational age at delivery in a 1:2 ratio. Maternal outcome included cesarean section (CS), operative vaginal delivery (OVD), retained placenta or post-partum hemorrhage. Neonatal outcome included 5-minute Apgar score fever and 618 served as controls. Women with intrapartum fever had higher rates of OVD (34.3 versus 19.6%, p fever was independently associated with adverse maternal (3.75, 95%CI 2.65-5.30, p fever duration was related to maternal complications, specifically to CS. In addition, maternal bacteremia and positive placental cultures were risk factors for neonatal complications compared to those with negative cultures (23.3 versus 9.8%, p = .01). Intrapartum fever was associated with adverse perinatal complications. The duration of intrapartum fever, maternal bacteremia, and positive cultures further increase this risk.

  17. Typhoid fever and paratyphoid fever: Systematic review to estimate global morbidity and mortality for 2010

    Directory of Open Access Journals (Sweden)

    Geoffrey C. Buckle

    2012-06-01

    Full Text Available Typhoid and paratyphoid fever remain important causes of morbidity worldwide. Accurate disease burden estimates are needed to guide policy decisions and prevention and control strategies.

  18. Classical swine fever (CSF) marker vaccine - Trial I. Challenge studies in weaner pigs

    DEFF Research Database (Denmark)

    Uttenthal, Åse; Le Potier, M.F.; Romero, L.

    2001-01-01

    , -10 or -7, and subsequently challenged at day 0. The challenge virus was CSFV 277, originating from a recent outbreak of classical swine fever (CSF) in Germany. In all groups, only 5 out of 10 pigs were challenged; the remaining 5 pigs served as vaccinated contact controls. Also, three control groups...

  19. The global burden of typhoid fever

    National Research Council Canada - National Science Library

    Crump, John A; Luby, Stephen P; Mintz, Eric D

    2004-01-01

    To use new data to make a revised estimate of the global burden of typhoid fever, an accurate understanding of which is necessary to guide public health decisions for disease control and prevention efforts...

  20. Transfusion support in patients with dengue fever.

    Science.gov (United States)

    Kaur, Paramjit; Kaur, Gagandeep

    2014-09-01

    Dengue fever has emerged as a global public health problem in the recent decades. The clinical spectrum of the disease ranges from dengue fever to dengue hemorrhagic fever and dengue shock syndrome. The disease is characterized by increased capillary permeability, thrombocytopenia and coagulopathy. Thrombocytopenia with hemorrhagic manifestations warrants platelet transfusions. There is lack of evidence-based guidelines for transfusion support in patients with dengue fever. This contributes to inappropriate use of blood components and blood centers constantly face the challenge of inventory management during dengue outbreaks. The current review is aimed to highlight the role of platelets and other blood components in the management of dengue. The review was performed after searching relevant published literature in PubMed, Science Direct, Google scholar and various text books and journal articles.