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PubMed1994

Clinical picture of cutaneous leishmaniasis in Isfahan, Iran.

BACKGROUND: Cutaneous leishmaniasis caused by Leishmania tropica is endemic in Iran, being the second most prevalent vector-borne disease in the country (after malaria). From the five most infected provinces, Isfahan is third after Boushehr and Khouzestan. METHODS: To study the clinical picture of this disease, 1250 patients referred to the Leishmaniasis Training and Treatment Center (affiliated with Isfahan University of Medical Sciences) were studied during a 2-year period. RESULTS: The disease was more prevalent in the age group of 10-15 years. Nonindigenes had more lesions and their lesions were more acute and more severe than those of indigenes. The face was the most frequent site of involvement (39.7%), followed by the upper (32.4%) and lower extremities (19.4%), whereas only 8.1% of the lesions were found on the trunk. No direct relation was seen with age, sex, and clinical features of the lesions except for the erysipeloid cases that were rare and seen only in middle-aged and elderly women. Noduloulcerative and papular lesions dominated the clinical picture, followed by plaque, impetiginized, and nodular lesions. CONCLUSIONS: The reason why nonindigenous patients have more severe lesions and in greater number is not clear. It can be postulated that nonindigenous people were more exposed to the vector biting since they were living in more infected areas and that during a long period of time, a mild immunity might have developed in indigenous people.

Adolescent↗
PubMed2005

Clinical and histopathological features of zoonotic cutaneous leishmaniasis in Saudi Arabia.

BACKGROUND: Zoonotic cutaneous leishmaniasis (ZCL) caused by Leishmania major is a growing public health problem and endemic in many parts of the Kingdom of Saudi Arabia. The vector is Phlebotomus papatasi and the animal reservoirs are mainly desert rodents. METHODS: In this prospective study, the clinical and histopathological features of ZCL in 120 patients are described and classified. The majority of these patients (n = 84) were non-Saudi expatriate workers who suffered mostly from multiple and severely inflamed nodulo-ulcerative lesions on the exposed parts of the body. Saudi patients were mainly children (n = 21) with few(1-3) lesions on their limbs or sometimes unique erysipeloid facial lesions. RESULTS: Histopathological grouping of ZCL lesions showed four types of granulomatous reactions based on the predominant types of inflammatory cells, presence or absence of necrosis and ranking of parasitic index. CONCLUSION: A possible correlation between histopathologic evolution of ZCL lesions and the immune status of the host is discussed.

Adult↗
PubMed2003

Adhesive surface proteins of Erysipelothrix rhusiopathiae bind to polystyrene, fibronectin, and type I and IV collagens.

Erysipelothrix rhusiopathiae is a gram-positive bacterium that causes erysipelas in animals and erysipeloid in humans. We found two adhesive surface proteins of E. rhusiopathiae and determined the nucleotide sequences of the genes, which were colocalized and designated rspA and rspB. The two genes were present in all of the serovars of E. rhusiopathiae strains examined. The deduced RspA and RspB proteins contain the C-terminal anchoring motif, LPXTG, which is preceded by repeats of consensus amino acid sequences. The consensus sequences are composed of 78 to 92 amino acids and repeat 16 and 3 times in RspA and RspB, respectively. Adhesive surface proteins of other gram-positive bacteria, including Listeria monocytogenes adhesin-like protein, Streptococcus pyogenes protein F2 and F2-like protein, Streptococcus dysgalactiae FnBB, and Staphylococcus aureus Cna, share the same consensus repeats. Furthermore, the N-terminal regions of RspA and RspB showed characteristics of the collagen-binding domain that was described for Cna. RspA and RspB were expressed in Escherichia coli as histidine-tagged fusion proteins and purified. The recombinant proteins showed a high degree of capacity to bind to polystyrene and inhibited the binding of E. rhusiopathiae onto the abiotic surface in a dose dependent manner. In a solid-phase binding assay, both of the recombinant proteins bound to fibronectin, type I and IV collagens, indicating broad spectrum of their binding ability. It was suggested that both RspA and RspB were exposed on the cell surface of E. rhusiopathiae, as were the bacterial cells agglutinated by the anti-RspA immunoglobulin G (IgG) and anti-RspB IgG. RspA and RspB were present both in surface-antigen extracts and the culture supernatants of E. rhusiopathiae Fujisawa-SmR (serovar 1a) and SE-9 (serovar 2). The recombinant RspA, but not RspB, elicited protection in mice against experimental challenge. These results suggest that RspA and RspB participate in initiation of biofilm formation through their binding abilities to abiotic and biotic surfaces.

Amino Acid Sequence↗
PubMed2000

Potential errors in recognition of Erysipelothrix rhusiopathiae.

Here we describe four isolations of Erysipelothrix rhusiopathiae associated with polyarthralgia and renal failure, septic arthritis, classic erysipeloid, and peritonitis. Although the biochemical identification was straightforward in each case, recognition presented a challenge to the clinical microbiologist, since in three cases E. rhusiopathiae was not initially considered due to unusual clinical presentations, in two cases the significance might not have been appreciated because growth was in broth only, and in one case the infection was thought to be polymicrobic. Because the Gram stain can be confusing, abbreviated identification schemes that do not include testing for H(2)S production could allow E. rhusiopathiae isolates to be misidentified as Lactobacillus spp. or Enterococcus spp. in atypical infections.

Aged↗
PubMedDate not supplied

Erysipelothrix endocarditis with previous cutaneous lesion: report of a case and review of the literature.

This report describes the first documented case of Erysipelothrix rhusiopathiae endocarditis in Latin America. The patient was a 51-years-old male, moderate alcoholic, with a previous history of aortic failure. He was used to fishing and cooking as a hobby and had his left hand wounded by a fish-bone. The disease began with erysipeloid form and developed to septicemia and endocarditis. He was treated with antibiotics and surgery for aortic valve replacement. There are only 46 cases of E. rhusiopathiae endocarditis reported to date. The authors wonder if several other cases might go unreported for lack of microbiological laboratorial diagnosis.

Anti-Bacterial Agents↗
PubMed1992

The phlebopathies of the fasciitis panniculitis syndrome.

The fasciitis-panniculitis syndrome is histologically characterized by fibrous thickening and inflammation of the subcutaneous septa, fascia and perimysium. These morphological features were the common denominator in 13 patients with Shulman's eosinophilic fasciitis, scleroderma profunda, venous lipodermatosclerosis, induration following recurrent erysipelas and erysipeloid erythema nodosum. Small to medium-sized vessel phlebitis was found in the subcutaneous and perimysial tissues of 11 of the patients and subcutaneous phlebosclerosis was encountered in all cases. These data contrast with the low incidence of phlebopathy reported by others in these disorders.

Adolescent↗
PubMed2006

Childhood cutaneous leishmaniasis: report of 117 cases from Iran.

Cutaneous leishmaniasis (CL), due to Leishmania major, is endemic in different parts of Iran and has long been recognized in most provinces of Iran. This study was conducted to determine the prevalence of childhood leishmaniasis in 3 areas at the southeast of Kashan. A descriptive study was carried out on all children referred to central laboratories during a 3-year period. Initial information including age, sex, sites of ulcer on the body, number of lesions, address, and the place of the disease was obtained. The study gathered 117 children, and the results showed a prevalence of 7.2% in patients with lesions among the population and 4.2% of people displayed lesion and scar. The ages of subjects were from 6 to 15 years (average 9.75 years). The boy: girl ratio was 1.2. All of our patients lived in an endemic area. The face was affected in 47.0% of cases. The encountered forms of leishmaniasis are as follows: papulonodular 27.4%, ulcer 60.7%, sporotrichoid 6%, impetiginous 2.5%, and erysipeloid 3.4%. Treatment with intramuscular meglumine antimoniate 20-30 mg/kg/day was done for 93 patients. Meglumine antimoniate treatment was tolerated with no side effects. All leishmaniasis lesions healed within an average period of 2-14 months. Hyperpigmented scars were formed in 25.6% of the patients, atrophic scars in 4.3%, and hypopigmented scars were in 3.4%, respectively. The findings of this study indicate increased prevalence of CL in the villages at the area of Kashan and Aran-Bidgol. The clinical finding patterns belonged to different endemic strains of L. major in Isfahan, which indicates the possible transmission of infection from Isfahan to this area.

Adolescent↗
PubMedDate not supplied

Chronic zosteriform cutaneous leishmaniasis.

Cutaneous leishmanasis (CL) may present with unusual clinical variants such as acute paronychial, annular, palmoplantar, zosteriform, erysipeloid, and sporotrichoid. The zosteriform variant has rarely been reported. Unusual lesions may be morphologically attributed to an altered host response or owing to an atypical strain of parasites in these lesions. We report a patient with CL in a multidermatomal pattern on the back and buttock of a man in Khozestan province in the south of Iran. To our knowledge, this is the first reported case of multidermatomal zosteriform CL. It was resistant to conventional treatment but responded well to a combination of meglumine antimoniate, allopurinol, and cryotherapy.

Allopurinol↗
PubMed2001

[Diagnostic criteria for erysipelas].

Diagnosis of erysipelas is based upon the association of an acute inflammatory plaque with fever, lymphagiitis, adenopathy and hyperleukocytosis. These associated symptoms are variable (20-70 p. 100 of cases). Bacteriology is not helpful for the diagnosis of erysipelas because of a low sensitivity (hemoculture 5 p. 100, standard examinations 5-41 p. 100), or delayed positivity (serology). Moreover cutaneous bacteriology is difficult to assess when other bacteria than streptococci are isolated. Erysipelas have to be distinguished from non-necrotizing cellulitis by peculiar clinical features (such as erysipeloid, facial staphylococcal infection, Pasteurella, Haemophilus influenzae) and from necrotizing fasciitis. Some non-infectious diseases may mimic erysipelas such as venous thrombosis, familial Mediterranean fever, prosthesis intolerance, and compartment syndrome. Because the diagnostic value of clinical symptoms is not known and no diagnostic gold standard has been established, it is impossible to be sure that non-streptococcal erysipelas (especially staphylococcal) really exists. Thus, the first line treatment for all erysipelas must be an antistreptococcal antibiotic. Before prescribing a treatment, hemoculture and blood cell count could be useful. If antistreptococcal antibiotherapy is inefficient, all the differential diagnoses must be reviewed.

Diagnosis, Differential↗
PubMed2003

[Occupational infectious diseases in the Czech Republic].

INTRODUCTION: The authors present a survey on the incidence of occupational infectious and parasitic diseases in the Czech Republic. MATERIALS AND METHODS: Between 1996 and 2000, occupational infectious and invasive diseases were diagnosed in 1906 patients. This is about 18% of the total number of diagnosed cases in the period under study. The total number of the diagnosed diseases included 68% of those occurring due to interhuman transmission, 29% of zoonoses and 3% of tropical diseases. The majority of occupational infectious diseases developed in health care workers (66%). This was followed by agriculture, game management and forestry workers (20%). In the group of sick workers, women outnumbered men (74% vs. 26%). The mean age of those affected was 39.2 +/- 11.9, range, 16-79 years. RESULTS: Scabies, viral hepatitis and tuberculosis predominated in the group of transmitted diseases and trichophytoses, erysipeloid and Lyme borreliosis among zoonoses. During the whole period of investigation, scabies occupied the first place among occupational infectious diseases. The increased incidence of diseases is mostly due to epidemics in the general population, and its spread is attributed to a low hygiene and social standards, overcrowding, increased migration that creates a higher risk for the elderly, mentally retarded and immunocompromised subjects. In tropical and subtropical countries, contract workers suffered mostly from malaria, amebiasis and infectious hepatitis A. CONCLUSIONS: It was possible to clearly identify occupational infectious and parasitic disease in different working conditions. The results of the survey confirm that infectious and parasitic diseases still create a difficult problem especially among health care and agriculture or forestry workers.

Communicable Diseases↗
PubMed1991

[Analysis of communicable occupational diseases in the South Moravian Region 1975-1989].

In 1975 to 1989 in the South Moravian region 2732 communicable and parasitic diseases were diagnosed and notified. The long-term trend has a declining character. At the end of the period of investigation a decline to 43% of the initial level was recorded. As to the occupation of the affected subjects, 56% were health workers and 26% agricultural workers. The most frequent disease was in 43% viral hepatitis, in 20% trichophytosis, in 5% erysipeloid and in 4% tubera mulgentium. Health workers suffered most frequently from viral hepatitis; in 68% it was type B hepatitis. The mean age of the patients was 35.6 years. The authors analyzed the findings, discuss the criteria of occupational character according to the list of occupational diseases which is the appendix 1 of decree 149/1988 Sb.

Adult↗
PubMed1991

[Groups of female workers with lowered adaptation to the working conditions in footwear industry].

The Republican Centre for Occupational Diseases was set in Estonia in 1971. The Centre performs administrative and methodological guidance for the republican clinical institutions in diagnostics, prevention and treatment of occupational diseases. The Centre also runs an out-patient department and a 40-bed in-patient stationary. In the occupational diseases structure, communicable diseases are prevalent (particularly, erysipeloid), followed by occupational hypoacusis, vibration related and allergic diseases.

Adult↗
PubMedDate not supplied

[The gray rat (Rattus norvegicus) as a carrier of infectious causative agents in Siberia and the Far East].

Literary data and antiplague institutions' reports demonstrate that Norway rats carry over 24 nosological forms and groups of infectious diseases: plague, tularemia, pseudotuberculosis, intestinal yersiniosis, salmonellosis, erysipeloid, listeriosis, leptospirosis, pasteurellosis, brucellosis, dysentery, paratuberculosis, hemorrhagic nephroso-nephritis, Omsk hemorrhagic fever and Q fever, tick-borne and Japanese encephalitis, lymphocytic choriomeningitis, tick-borne rickettsiosis and rickettsial pox, murine typhus, tsutsugamushi disease and toxoplasmosis.

Animals↗
PubMedDate not supplied

[Familial Mediterranean fever--an important differential diagnosis in systemic juvenile chronic arthritis].

Familial Mediterranean Fever (FMF), characterized by recurring episodes of fever, serositis, arthritis, skin changes and complicated by amyloidosis in 30%-60% of cases frequently begins in childhood. Systemic juvenile rheumatoid arthritis (systemic JRA, Still's disease) is the most important differential diagnosis. In our series of 10 patients the mean age of onset was 4.9 +/- 2.2 years (range 2-9 years). The mean time period elapsed before the diagnosis was established was 4.1 +/- 2.7 years (range 1.5-10 years). Three of our 10 patients already had developed renal amyloidosis at the time of diagnosis. Essential criteria for differential diagnosis against systemic JRA were positive family history for FMF (4/10), ethnic background (9/10 of Turkish decent), typical erysipeloid skin rashes (4/10), attacks of abdominal pain accompanied by fever (10/10) and the characteristic pattern of recurrent episodes lasting only a few days each (a patient's diary monitoring the attacks may be helpful). In problematic cases the metaraminol provocative test can be helpful. If an elevated plasma dopamine beta-hydroxylase activity appears to be a specific finding in FMF patients, this may well open up new avenues in the early diagnosis of the disease. Since amyloidosis can be prevented by prophylactic long lasting treatment with colchicine, a timely diagnosis of FMF is the physician's challenge.

Adolescent↗
PubMed1985

[Complex method for epizootiological and epidemiological surveillance].

A complex method for the epizootological and epidemiological surveillance of a number of bacterial and viral infections on the territories inside and outside their natural foci has been developed. The investigation techniques are described and the data on the isolation rate of each causative agent in different geographical zones are presented. In the natural foci of plague and tularemia, as well as on the territories outside such foci, the causative agents of intestinal yersiniosis, pseudotuberculosis, salmonellosis, erysipeloid, staphylococci and streptococci, arena- and arboviruses have been isolated from the rodents and ectoparasites under study. The results of this investigation suggest that the method may be recommended for use in medical institutions dealing with the problems of infections originating from natural foci.

Animals↗
PubMedDate not supplied

[Compression in lymphedema].

The author discusses the indications and contraindication of compression. The study of auto-immune complexes in the circulating blood has shown a significant increase in lymphedema patients with erysipeloid inflammations and a definite increase, but less marked, in lymphedema patients without a past history of fever. Then, the compression values are studied in the 5 stages of the treatment of lymphedema by compression: elevation with Thuasne 18 bandages, Lymphapress and if necessary Tubing (always general anesthesia) limited to the leg. For the thigh, lymphatic "drainage" is recommended. Then comes the walking bandage (non elastic !). Once the edema has disappeared, elastic stockings (compression e.g. 60 mm at the level of the malleolus) are custom made. Statistics of 57 cases, where the regular replacement of the stockings after 9 to 13 years was controlled, conclude the study.

Bandages↗
PubMed1986

Erythrocyte reagents in the study of Erysipelothrix antigens.

The activity of species-specific and type-specific antigens in various preparations isolated from the bacterial mass of standard strains of Erysipelothrix, and also in bacterial cells was studied by means of prepared erysipeloid erythrocyte antigen (species-specific and with general type- and species-specificity) and antibody (species-specific, with general type- and species-specificity as also with type-specificity only) diagnosticums. It has been demonstrated that the activity of these antigens differs in preparations from different strains, depending on the method of extraction. An efficient method of serotyping of Erysipelothrix, based on agglutination of erythrocyte antibody diagnosticums, was proposed.

Antigens, Bacterial↗
PubMed1984

[Zoonotic infections in persons working in plants producing meat and bone meal].

The present study has revealed that persons working at offal and bone processing plants show no specific pathology, peculiar to such plants, in the state of their health and severe mass diseases among these persons are absent. Nevertheless, rather frequent occurrence of erysipeloid should be noted. The survey of workers employed at different stages of the production process has revealed the presence of ornithosis, listeriosis and leptospirosis infections. No clinically manifest cases of these diseases have been detected. The infection of individual workers occurs in the process of production as the result of contacts with infected raw materials of animal origin. For preventing the possible spread of infection great attention should be paid to sanitary, hygienic and epidemiological measures.

Absenteeism↗