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Maria Koshy, John Mathew, Reginald Alex, John Antony Jude, Ravikar Ralph, Thambu David Sudarsanam, Sowmya Sathyendra, J Visalakshi, John Victor Peter
Background & objectives: The pathological hallmark of scrub typhus infection is focal or disseminated vasculitis. As with other infections, antinuclear antibodies (ANA) have been previously described in scrub typhus. However, the underlying mechanisms and implications of this immunological phenomenon is not well understood. In the present work it was assessed whether ANA is associated with illness severity and outcomes. Methods: In this prospective study spanning one year, patients fulfilling the diagnostic criteria for scrub typhus were recruited...
January 2018: Journal of Vector Borne Diseases
Sarah S Premraj, K Mayilananthi, Durga Krishnan, K Padmanabhan, D Rajasekaran
Background & objectives: Scrub typhus is as an emerging infectious disease that generally causes acute febrile illness, with disease spectrum ranging from mild illness to multiorgan dysfunction. This study was aimed to report the clinical profile, complications and risk factors associated with severe illness in patients with scrub typhus, outside the intensive care setting. Methods: It was a prospective study, which involved recruitment of patients with acute febrile illness and diagnosed to have scrub typhus, who were admitted to the general medical wards of a tertiary care centre in Kanchipuram district, in semi-urban south India, over a 12 month period between June 2015 and May 2016...
January 2018: Journal of Vector Borne Diseases
Jessica Rauch, Philip Eisermann, Bernd Noack, Ute Mehlhoop, Birgit Muntau, Johannes Schäfer, Dennis Tappe
Typhus group rickettsiosis is caused by the vectorborne bacteria Rickettsia typhi and R. prowazekii. R. typhi, which causes murine typhus, the less severe endemic form of typhus, is transmitted by fleas; R. prowazekii, which causes the severe epidemic form of typhus, is transmitted by body lice. To examine the immunology of human infection with typhus group rickettsiae, we retrospectively reviewed clinical signs and symptoms, laboratory changes, and travel destinations of 28 patients who had typhus group rickettsiosis diagnosed by the German Reference Center for Tropical Pathogens, Hamburg, Germany, during 2010-2017...
July 2018: Emerging Infectious Diseases
Akanksha Garg, Aditi Jain, Rajesh Kashyap
No abstract text is available yet for this article.
April 2018: Journal of Global Infectious Diseases
Isabella Princess, R Ebenezer, Nagarajan Ramakrishnan, S Nandini
Pulmonary infections are not uncommon in patients with an underlying immunocompromised condition. Unusual combination of microorganisms causing concomitant infections among these patients has also been reported. However, certain rare dual occurrences are usually unanticipated as in the case we present here. This case highlights the importance of being aware of the possible coexistence of infections in immunocompromised patients. To the best of our knowledge, this is the first report of coinfection with Nocardia otitidiscaviarum and Orientia tsutsugamushi in a critically ill immunocompromised patient from South India...
April 2018: Journal of Global Infectious Diseases
Elizabeth M Batty, Suwittra Chaemchuen, Stuart Blacksell, Allen Richards, Daniel Paris, Rory Bowden, Caroline Chan, Ramkumar Lachumanan, Nicholas Day, Peter Donnelly, Swaine Chen, Jeanne Salje
BACKGROUND: Orientia tsutsugamushi is a clinically important but neglected obligate intracellular bacterial pathogen of the Rickettsiaceae family that causes the potentially life-threatening human disease scrub typhus. In contrast to the genome reduction seen in many obligate intracellular bacteria, early genetic studies of Orientia have revealed one of the most repetitive bacterial genomes sequenced to date. The dramatic expansion of mobile elements has hampered efforts to generate complete genome sequences using short read sequencing methodologies, and consequently there have been few studies of the comparative genomics of this neglected species...
June 6, 2018: PLoS Neglected Tropical Diseases
Dong Ho Jo, Tae Yang Yu, Young Jun Kim, Jae Hoon Lee
We report a case of a patient with scrub typhus who presented with diabetic ketoacidosis (DKA). The patient initially manifested with DKA, and was diagnosed with acute scrub typhus after evaluation the precipitating factors of DKA. No other complications of scrub typhus were noted. This case report suggests that acute scrub typhus should be considered as a precipitating factor of DKA, especially during the endemic season.
2018: IDCases
Dong-Seob Kim, Dilaram Acharya, Kwan Lee, Seok-Ju Yoo, Ji-Hyuk Park, Hyun-Sul Lim
This study aimed to examine the awareness and the work-related factors associated with scrub typhus to provide data essential for evidence-based preventive strategies. A community-based case control study was carried out in the rural areas of Gyeongsangbuk-do, South Korea. Confirmed cases of scrub typhus ( n = 57) were based on laboratory tests performed by the Korean Centers for Disease Control and Prevention (KCDC), 114 matched neighborhood controls, age (±6 years), gender and area of residence in the Gyeongsangbuk-do of South Korea...
June 1, 2018: International Journal of Environmental Research and Public Health
Tri Wangrangsimakul, Thomas Althaus, Mavuto Mukaka, Pacharee Kantipong, Vanaporn Wuthiekanun, Wirongrong Chierakul, Stuart D Blacksell, Nicholas P Day, Achara Laongnualpanich, Daniel H Paris
BACKGROUND: Tropical infectious diseases like dengue, scrub typhus, murine typhus, leptospirosis, and enteric fever continue to contribute substantially to the febrile disease burden throughout Southeast Asia while malaria is declining. Recently, there has been increasing focus on biomarkers (i.e. C-reactive protein (CRP) and procalcitonin) in delineating bacterial from viral infections. METHODOLOGY/PRINCIPAL FINDINGS: A prospective observational study was performed to investigate the causes of acute undifferentiated fever (AUF) in adults admitted to Chiangrai Prachanukroh hospital, northern Thailand, which included an evaluation of CRP and procalcitonin as diagnostic tools...
May 2018: PLoS Neglected Tropical Diseases
Felipe S Krawczak, Marcelo B Labruna, Joy A Hecht, Christopher D Paddock, Sandor E Karpathy
The bacterium Rickettsia bellii belongs to a basal group of rickettsiae that diverged prior to the pathogenic spotted fever group and typhus group Rickettsia species. Despite a diverse representation of R. bellii across more than 25 species of hard and soft ticks in the American continent, phylogeographical relationships among strains of this basal group- Rickettsia species are unknown; the work described here explores these relationships. DNA was extracted from 30 R. bellii tick isolates: 15 from the United States, 14 from Brazil, and 1 from Argentina...
2018: BioMed Research International
Evangelia Sarikloglou, Anastasia Goula, Charalampos Sidiropoulos, Maria Tsolia, Anna Papa
We report a case of murine typhus in a 4-year-old boy living in northern Greece. Although the illness started with mild symptoms, maculopapular rash was presented at the end of the first week of illness followed by marked thrombocytopenia. The detection of IgM antibodies against Rickettsia typhi and a positive PCR result in blood combined by sequencing confirmed the diagnosis of infection by Rickettsia typhi. Clinicians in northern Greece should be aware of the disease, even in cases presented with no specific initial symptoms...
May 31, 2018: Japanese Journal of Infectious Diseases
S J Seyyed-Zadeh, F Bozorg-Omid, Z Telmadarraiy, O Terenius, A R Chavshin
Fleas are important vectors of diseases such as murine typhus, tularaemia, hymenolepiasis and plague. The presence of active foci and history of human- and flea-transmitted plague in northwest Iran prompted the present group to collect and identify fleas from human and livestock dwellings across West Azerbaijan Province. Adult fleas were collected and identified using routine taxonomic keys. Species designation was confirmed by sequencing the cytochrome oxidase subunit I (COI). Of the collected specimens (n = 989), 104 were collected off-host (30 from human dwellings and 74 in light traps) and the rest were found on hosts (107 on animals and 778 by human bait)...
May 28, 2018: Medical and Veterinary Entomology
Suprit Basu, Arpan Saha, Sumantra Sarkar, Malay Kumar Sinha, Mrinal Kanti Das, Ranjabati Datta, Avijit Hazra, Sumana Datta Kanjilal, Supratim Datta
Objective: The aim of this study was to assess the clinico-laboratory parameters, complications and therapeutic responses in children with scrub typhus in Eastern India. Materials and methods: In this prospective, observational study, all children (age, <12 years) with suspected scrub typhus with a compatible clinical scenario were enrolled consecutively over six months. Cases confirmed by means of a positive IgM serology or a positive Weil-Felix reaction (OXK = 1/80 or above) were administered enteral doxycycline (4...
May 23, 2018: Journal of Tropical Pediatrics
Felix Moek, Poe Poe, Prakaykaew Charunwatthana, Wirichada Pan-Ngum, Yupaporn Wattanagoon, Wirongrong Chierakul
Introduction: The clinical examination alone is widely considered unreliable when assessing fluid responsiveness in critically ill patients. Little evidence exists on the performance of the clinical examination to predict other hemodynamic derangements or more complex hemodynamic states. Materials and methods: Patients with acute febrile illness were assessed on admission, both clinically and per non-invasive hemodynamic measurement. Correlations between clinical signs and hemodynamics patterns were analyzed, and the predictive capacity of the clinical signs was examined...
May 19, 2018: Transactions of the Royal Society of Tropical Medicine and Hygiene
Christine Carroll, Simon Sarkisian, Daniel Brillhart
A 20-year-old female presented to the emergency department complaining of fever, cough, and dyspnea after a recent camping trip. The patient remained ill appearing, persistently tachycardic and dyspneic despite nebulizer treatments, and fluids in the emergency department. She was admitted for observation and gradually improved over the next 4 d. Inpatient laboratory studies indicated acute Epstein-Barr virus infection and she was discharged with a presumptive diagnosis of infectious mononucleosis. However, further testing showed a simultaneous rickettsial infection producing murine typhus...
May 18, 2018: Military Medicine
Shiba Kumar Rai
Many infectious/communicable diseases (IDs) are endemic in Nepal. Until a decade and half ago, IDs were the major cause of both morbidity and mortality accounting 70% for both. However, as a result of various preventive measures implemented by both the state and non-state actors, the overall IDs have shown a changing (declining) trend. The most impressive decline has been seen in the intestinal helminth infection. Though the overall burden of IDs is decreasing, several newer infectious diseases (emerging infections) namely, dengue fever, scrub typhus, influenza (H5N1 and H1N1), and others are posing a great public health problem...
2018: Advances in Experimental Medicine and Biology
Rebecca J Eisen, Linda A Atiku, Karen A Boegler, Joseph T Mpanga, Russell E Enscore, Katherine MacMillan, Kenneth L Gage
Rodents pose a significant threat to human health, particularly in rural subsistence farming communities in Africa, where rodents threaten food security and serve as reservoirs of human pathogens, including the agents of plague, leptospirosis, murine typhus, rat-bite fever, Lassa fever, salmonellosis, and campylobacteriosis. Our study focused on the plague-endemic West Nile region of Uganda, where a majority of residents live in Uganda government-defined poverty, rely on subsistence farming for a living, and frequently experience incursions of rodents into their homes...
May 16, 2018: Vector Borne and Zoonotic Diseases
Le Jiang, Erin K Morris, Rodrigo Aguilera-Olvera, Zhiwen Zhang, Teik-Chye Chan, Soumya Shashikumar, Chien-Chung Chao, Sofia A Casares, Wei-Mei Ching
Scrub typhus is caused by Orientia tsutsugamushi , an obligated intracellular bacterium that affects over one million people per year. Several mouse models have been used to study its pathogenesis, disease immunology, and for testing vaccine candidates. However, due to the intrinsic differences between the immune systems in mouse and human, these mouse models could not faithfully mimic the pathology and immunological responses developed by human patients, limiting their value in both basic and translational studies...
2018: Frontiers in Immunology
Mahima Mittal, Vijay Bondre, Manoj Murhekar, Hirawati Deval, Winsley Rose, Valsan Philip Verghese, Mahim Mittal, Gajanan Patil, R Sabarinathan, Jeromie Wesley Vivian Thangaraj, K Kanagasabai, John Antony Jude Prakash, Nivedita Gupta, Manish Gupte, Mohan D Gupte
BACKGROUND: Seasonal outbreaks of acute encephalitis syndrome (AES) with high fatality have been occurring in Gorakhpur, Uttar Pradesh, India for several years. We conducted investigations during the 2016 outbreak, to identify the etiology. METHODS: We included 407 hospitalized AES patients with CSF pleocytosis (>5 cells/cmm) in our study. These patients were clinically examined; their blood and CSF samples were collected and investigated for scrub typhus (ST), Japanese encephalitis virus (JEV), dengue virus and spotted fever group of rickettsia (SFGR) by serology and/or PCR...
May 9, 2018: Pediatric Infectious Disease Journal
Maria A Karalexi, Marina Mitrogiorgou, Erato Atsali, Antonios Theodorakopoulos, Achilleas Attilakos, Vasileios Tsagris
We report the case of an 11-year-old pre-adolescent girl presenting with prolonged fever, lymphadenitis, non-purulent conjuctivitis, a generalized maculopapular rash, erythematous lips and edema of hands/feet. Although major diagnostic criteria for Kawasaki disease were met, local epidemiologic data suggested a possible vector-borne etiology. Treatment with doxycycline was initiated and defervescence occurred. Laboratory investigation confirmed the diagnosis of Rikettsia typhi infection.
May 4, 2018: Pediatric Infectious Disease Journal
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