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PubMed2004

[Tick-borne infections].

Ticks are obligate, blood-sucking ectoparasites that are the most common agents of vector-borne infectious disease in the United States and European countries. Ticks play an important role in transmitting several infectious agents, such as viruses, bacteria, spirochetes, rickettsia, and parasites, and tick bites cause a variety of acute and chronic infectious diseases, including Lyme disease, tick-borne relapsing fever, Rocky Mountain and Mediterranean spotted fevers, ehrlichiosis, Q fever, tularemia, babesiosis, and tick-borne viral encephalitis. Since its identification nearly 30 years ago, Lyme disease has continued to spread, and it is now the most commonly reported arthropod-borne illness in American and European countries. Rickettsial infections are widely distributed throughout the world and have a remarkable influence on public health and military activities as a possible biological weapon. Tick-borne encephalitis virus is endemic in central, eastern and northern Europe and may cause a wide spectrum of clinical forms, ranging from asymptomatic infection to severe meningo-encephalitis. This article reviews the epidemiology, microbiology, clinical manifestation, diagnosis and treatment of the major tick-borne infectious diseases in the United States and Europe.

Animals↗
PubMed2005

[Causes of death in patients with rheumatic diseases in Moscow].

AIM: To study causes of death of rheumatic patients in Moscow. MATERIAL AND METHODS: Autopsy protocols for 1999-2002 were analysed for two pathoanatomic departments of Moscow. RESULTS: Rheumatic diseases were detected in 165 cases (2.0% of overall number of autopsies in these departments). Rheumatic heart disease (RHD) was stated in 99 (60.0%) cases, rheumatic fever relapse (RFR) in 4 (2.4%), rheumatoid arthritis (RA) in 28 (17.0%), systemic lupus erythematosus (SLE) in 8 (4.8%), systemic sclerosis (SS) in 3 (1.8%), ankylosing spondilarthritis (AS) in 2 (1.2%), systemic vasculitis (SV) in 2 (1.2%), osteoarthrosis in 11 (7.3%), gout in 3 (1.8%), polymyositis in 1 (0.6%). RHD patients died of decompensated circulation (DC) (54%), acute heart failure (AHF) (14%), thromboembolism (TE) (6%), other causes (26%). RF patients died of TE (n = 2), DC (n = 1), AHF (n = 1). Out of 28 RA patients, 5 patients died of secondary amyloidosis, 3 of DC, 7 of AHF, 1 of TE, 5 of infectious complications, 7 of other causes. SLE patients died of uremia (n = 2), acute adrenal failure (n = 1), infectious complications (n = 2), AHF (n = 2), brain edema (n = 1). CONCLUSION: Among rheumatic diseases, rheumatic heart valve disease was most severe as it caused the highest mortality. Cardiovascular pathology caused death in most of the rheumatic patients.

Adult↗
PubMed1991

[The Borrelia of ornithodoros in tropical Africa: value and limits of cross protection tests in the mouse].

The identification of Borrelia strains isolated from ticks or relapsing fever patients is not easy. Seizing the opportunity of recent isolation of such strains from Western Africa, we tried to evaluate the interest and the limits of a method classically proposed for that aim; cross protection test in mouse. This technique is proving rather difficult to perform because of different technical reasons; the results are critical to read. In some cases, these results seem undeniable, but the observed differences in protection levels are often weak, inconstant, insufficiently reliable to constitute a diagnostic tool. So it appears important to develop other identification methods, based on molecular analysis of Borrelia DNA, which will be more subtle and more specific.

Africa, Western↗
PubMed1985

[Somatostatinoma of the liver].

A case report is given of a 45 year old patient, who had a tumor of the liver, pain in the upper abdomen and relapsing fever. Surgery was done and part of the liver was removed. On microscopic examination a somatostatinoma was found. The clinical symptoms of this very rare type of tumor, which belongs to the APUD cell system, is discussed as well as therapeutical implications.

Adenoma, Islet Cell↗
PubMed1979

Some transfusion-induced parasitic infections in Zambia.

The risk of acquiring a transfusion-induced infection in Zambia was studied for the first time. Blood slide examination of donors, despite the insensitivity of the method, established malaria as the most serious hazard. The species involved was Plasmodium falciparum, the cause of cerebral malaria, and which could be rapidly fatal in a non-immune host visiting an endemic area. Microfilariae of Dipetalonema perstans and Wuchereria bancrofti were also found in donor populations. While no disease may be induced, allergic reactions due to the breakdown products of dead microfilariae may manifest themselves. Several cases of transfusion-induced malaria, a case of relapsing fever and a case of rhodesian trypanosomiasis are reported. Toxoplasmosis and kalatazar, which may also be transfusion-induced, are both known to occur in the country but no cases were observed. It is emphasized that prophylactic measures should be mandatory in areas where no regular, screened, donor panel is available. The awareness and ackowledgement of the risk of transfusion-induced infections may be the best safeguard against the serious consequences in developing countries.

Adult↗
PubMed1982

[Course and results of the Karlsbad cure after cholecystectomy].

The course and the result of a cure in Karlovy Vary was pursued in 148 cholecystectomized patients. With the exception of 5 patients who were transferred to the surgeon after a bilious attack and 1 patient with malignoma of the biliary ducts 142 patients spoke of a subjective improvement at the end of the cure. The cure passed systematically in 50 patients with slight biliary complaints. In more considerable complaints, however, in 23 of 98 patients a bilious attack occurred during the cure, which made necessary the surgical intervention in 5 patients. Relapsing fever episodes could be clinically governed in 41 patients. Antibiotics remained without any effect in 41 patients. The values of the alkaline serum phosphatase and gamma-glutamyl-transpeptidase normalised only in 8 of this group, not, however, in 45 patients. The results altogether refer to the fat that the indications to a cure in Karlovy Vary must be made more carefully. After a cholecystectomy they should be recommended only then, when the biliary ducts eventually were cleant up. In these cases the only cholangiitis is no contraindication. The treatment may be supplemented by antibiotics.

Adult↗
PubMedDate not supplied

Isolation and cultivation of Lyme disease spirochetes.

The successful isolation and cultivation of Lyme disease spirochetes traces its lineage to early attempts at cultivating relapsing fever borreliae. Observations on the growth of Lyme disease spirochetes under different in vitro conditions may yield important clues to both the metabolic characteristics of these newly discovered organisms and the pathogenesis of Lyme disease.

Bacteriological Techniques↗
PubMed1980

[Ultrasonic diagnosis and control of an amebic obscess of the liver (author's transl)].

A case report is given of a patient, who suffered from relapsing fever, loss of weight, and right-sided upper abdominal colicky pain. A tentative diagnosis of amebic abscess was established on clinical grounds and after ultrasonography. Metronidazol was given and body temperature normalized within 24 hours; 6 weeks later only scarring of the liver remained. Sonographic controls were performed once weekly during the course of the disease, showing that the central parts of the abscess were liquified increasingly; at the same time a marginal zone about 1 cm broad was formed. This type of marginal zone could be demonstrated in another patient with amebic abscess of the liver as well by ultrasonography, whereas it could never be shown in patients with purulant abscesses of the liver.

Adult↗
PubMed1978

Wild rodents as laboratory models and their part in the study of diseases.

The paper describes the use of 14 South African wild rodent species as experimental models and demonstrates the proven value of many of these as laboratory animals in research on bacterial infections (plague, relapsing fever), rickettsial infections (tickbite fever, louse typhus), viral infections (poliomyelitis. Rift-Valley fever and other arbovirus infections, Lassa fever), fungal infections (histoplasmosis), parasitic infections (schistosomiasis) and in diabetes mellitus and cancer research.

Animal Husbandry↗
PubMed1995

The forgotten first career of Doctor Henry Van Dyke Carter.

BACKGROUND: While Henry Gray's Anatomy: Descriptive and Surgical, first published in 1858, is distinguished by superb illustrations, its original illustrator is remembered for an entirely different set of accomplishments, notably significant contributions to tropical medicine. STUDY DESIGN: Literature review. RESULTS: Dr. Henry Van Dyke Carter, Professor of Anatomy and Physiology and subsequently Dean of the Grant Medical College in Bombay, India, was a skillful researcher and keen clinician who made significant contributions to tropical medicine, including the discovery of Spirillum minus, the spirochetal organism that causes relapsing fever. For his discoveries he was honored by both the British Medical Association and the English government. Before his departure for India in 1858, however, he and Henry Gray worked at St. George's Hospital Medical School and collaborated on the first edition of the text that is still the "Bible" of anatomy to many medical students. His drawings have appeared in every subsequent edition, up to the present day. CONCLUSIONS: During his first career as a medical illustrator, Carter was responsible for the drawings that have helped generations of physicians to master the intricacies of human anatomy.

History, 19th Century↗
PubMed1995

Interaction between acari ectoparasites and rodents in Suez Governorate, Egypt.

From the medical point of view, the relation between man and rodents comes in the priority. Some rodent populations are wild but others are commensal and live in close association with man. They steal his food and conveying many zoonotic diseases. Their arthropod ectoparasites play an important role in conveying or transmitting these zoonotic diseases. Several disorders and diseases of man are tick borne relapsing fever, Rocky mountain spotted fever, Lyme disease, and many others. Besides numerous species of mites occasionally infest man. They transmit several diseases as Rickettsia tsutsugamushi fever, epidemic haemorrhagic fever, and they cause severe allergic reaction. The results obtained are summarized in the following (1) Six species and subspecies of rodents were detected. In a descending order of abundance, they were (a) Rattus norvegicus, (b) Rattus rattus alexandrinus (c) Rattus rattus frugivorous (d) Acomys cahirinus (e) Gerbillus gerbillus asyutensis (f) Mus m. praetextus. (2) The most common rodent was R. norvegicus and the least common was M. musculus. (3) The collected ticks and mites were 2 genera of tick larvae; Rhipicephalus species and Hyalomma species. The collected mites were Ornithonyssus bacoti and Laelaps nuttali. (4) Most of the tick larvae were collected from wild rodents; Gerbillus g. asyutensis. (5) Most of the mites were collected from commensal rodents particularly R. norvegicus. Descriptive morphology and illustrations were given to the collected rodents and their acari ectoparasites.

Animals↗
PubMed1994

[Value of mono-antibiotic therapy using piperacillin associated with sulbactam and possibly followed by vancomycin in febrile neutropenia in solid tumors].

We evaluated the efficacy and safety of a monotherapy by piperacillin and sulbactam potentially associated to vancomycin as an empiric antimicrobial therapy in febrile neutropenic patients treated with nephrotoxic chemotherapy for solid tumors. Twenty-three patients were treated during 32 episodes with piperacillin 4 g i.v. every 8 hours and sulbactam 1 g IV every 8 hours. If the patient remained febrile after 48 hours, 1 g of vancomycin i.v. was added every 12 hours as indicated by our study design. The mean duration of neutropenia was 5.5 days (2-13 days). In ten episodes, the granulocyte nadir was < 100/mm3. Infection was microbiologically documented in seven episodes (22%) with six Gram negative bacilli and 3 Gram positive cocci. There were 19 apyrexia with piperacillin and sulbactam (59%) and further seven were resolved by the addition of vancomycin (total success: 81%). Failure was observed in six episodes consecutive to germ resistance (one episode), clinical deterioration (one episode), relapsing fever related to Pseudomonas infection (one episode), persistent fever despite withdrawal of neutropenia and no microbiological documentation (two episodes) and protocol violation (one episode). Neither septic death nor toxicity were observed. We conclude that this empirical treatment is active and safe in short period febrile neutropenic episodes in patients heavily treated with nephrotoxic chemotherapy for solid tumors.

Adolescent↗
PubMed1976

[Unusual infectious diseases in a municipal hospital (author's transl)].

UNLABELLED: The most important criteria for differential diagnosis are presented with reference to case histories: Falciparum malaria: relapsing fever, hemolytic anemia, hepatosplenomegaly, leucopenia; Kala-azar: insidious course with fever, pancytopenia, macrocytic anemia, hepatosplenomegaly, enlargement of lymph nodes; echinococcosis: symptoms of a benign tumor with displacement. DIAGNOSIS: by identification of the pathogen in malaria and kala-azar, serologically in all three diseases and also radiologically in echinococcosis.

Adult↗
PubMed1993

OSHA's bloodborne pathogens standard: analysis and recommendations.

Just over a year ago, the Occupational Safety and Health Administration (OSHA) issued the final bloodborne pathogens standard, "Occupational Exposure to Bloodborne Pathogens; Final Rule," which requires healthcare institutions to protect their employees from all occupational exposure to bloodborne pathogens." According to OSHA, the only criterion for applying the standard is the likelihood of exposure to blood and other potentially infectious materials (OPIMs). Thus, the standard is designed to protect all vulnerable personnel, from the clinical engineers who service contaminated equipment to the staff in clinical laboratories, patient care or treatment areas, and housekeeping and laundry services--any location where the nature of the work poses the risk of exposure to bloodborne pathogens. All department heads and employees must have access to the standard and should carefully review our analysis of the regulations and recommendations for implementing them, as presented in this special issue of Health Devices. The standard is aimed at protecting employees from occupational exposure to all bloodborne pathogens and, especially, to the human immunodeficiency virus (HIV) and the hepatitis B virus (HBV)--the most infamous pathogens transmitted through occupational exposure to blood and body fluids. Other bloodborne diseases referenced by OSHA in the preamble to the standard include arboviral infections, babesiosis, brucellosis, Creutzfeldt-Jakob disease, hepatitis C, human T-lymphotropic virus type I, leptospirosis, malaria, relapsing fever, syphilis, and viral hemorrhagic fever. In this issue, we provide a clinical overview of HIV and HBV and the diseases they cause, as well as a brief discussion of other bloodborne pathogens; an analysis of the most significant regulations affecting hospitals; and our recommendations for compliance. The recommendations presented in this article do not exhaust the possibilities for reducing exposure and complying with the standard. We invite you to communicate your ideas and practices regarding compliance issues to the ECRI-sponsored Center for Healthcare Environmental Management (CHEM) for possible inclusion in a future update to its loose-leaf reference publication, the Healthcare Environmental Management System. We wish to acknowledge CHEM's contribution in developing this special report, which was reviewed by the Centers for Disease Control and Prevention (CDC), the National Institute for Occupational Safety and Health (NIOSH), and OSHA. Also see "CDC's Recommendations for Hepatitis B Vaccination and Postexposure Follow-up" and "A Minimal Training Syllabus" in this issue.

Blood↗