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[The so-called "ocular histoplasmosis syndrome"].

The authors describe seven patients presenting with ophthalmoscopic findings typical of "presumed ocular histoplasmosis syndrome." However, no humoral antibodies could be demonstrated. Moreover, the results of skin tests were all negative even after "boostering." Hence, the diagnosis of ocular histoplasmosis had to be ruled out. Tests for listeriosis, lues, leptospirosis, ornithosis, Toxocara canis, toxoplasmosis, Larva migrans, and Candida albicans were also negative. There are evidently other, so far unknown, agents which lead to an ophthalmoscopic picture that mimics ocular histoplasmosis with its typical "punched-out lesions" and central hemorrhagic chorioretinopathy. One of these agents may be Epstein-Barr virus, because two of six patients had increased antibody levels of Epstein-Barr nuclear antigen and early antigen, indicating an active or persistent state of viral infection.

Adult↗

Resistance of wild birds to infection by Chlamydia psittaci of mammalian origin.

Numerous species of birds are natural hosts of C. psittaci and have been implicated as sources of certain strains that cause disease in other vertebrate species, notably those producing psittacosis or ornithosis in humans [1]. Although direct evidence of their involvement in the transmission of chlamydiae to other mammals, especially domesticated ruminants, has not been reported, a careful examination of this possibility is justified [1]. When inoculated parenterally, polyarthritis-producing chlamydiae of ovine origin affected leg joints of turkeys, and abortion-producing chlamydiae of ovine origin was infectious for pigeons and fatal for sparrows [2]. However, several species of small wild birds (three of which were used in the experiments reported here), when inoculated perorally with C. psittaci of turkey origin, seroconverted (36%) and shed the organism (79%) [3]. Therefore, the present study was undertaken to determine whether strains of C. psittaci from domesticated ruminants would infect, multiply in, or be shed by these wild birds. The results indicate that these species of birds are not natural hosts or biologic vectors of these strains. However, considering the heterogeneity of Chlamydia species, certain birds may harbor strains that are associated with naturally occurring infections in some animals. The results also are additional evidence of the more restricted host range of mammalian Chlamydia species as compared to that of avian isolates.

Animals↗

Countrywide epidemics of Chlamydia pneumoniae, strain TWAR, in Scandinavia, 1981-1983.

There was a large increase in incidence of reported cases of ornithosis in Norway, Sweden, and Denmark in 1981-1983. Serologic evidence indicated that the epidemic was caused by the newly described Chlamydia organism, C. pneumoniae, strain TWAR. When serum samples that had been shown to contain Chlamydia complement fixing antibodies were tested by the microimmunofluorescence method with TWAR antigen, 49%-71% showed evidence of current TWAR infection during the epidemic years compared with 10%-20% in nonepidemic years.

Adolescent↗

The problems of treating atypical pneumonia.

Atypical pneumonia has been recognized for at least four decades as a clinical syndrome characterized by a less severe clinical course than typical bacterial pneumonia. It is caused by a variety of different organisms including Mycoplasma pneumoniae, chlamydiae, rickettsiae, viruses and Legionella pneumophila. Of the chlamydiae, TWAR-strain (Chlamydia pneumonia) is now considered the most important pathogen. Its prevalence in community-acquired pneumonia varies considerably depending on the cyclical nature of the disease, but also on the diagnostic methods applied. The first line therapy in community-acquired pneumonia is usually empirical administration of a penicillin or cephalosporin to cover the bacterial pathogens which usually cause 'typical' pneumonia, most importantly Streptococcus pneumoniae. If, however, atypical pneumonia is diagnosed by bacteriological or serological testing, or is suspected clinically or on the basis of treatment failure, the treatment of choice would be erythromycin 2-4 g or tetracyclines (doxycycline 200 mg) daily for M. pneumoniae pneumonia and C. pneumoniae (TWAR-strain) infection. For coxiella pneumonia tetracycline is preferred. Psittacosis (ornithosis) has a high mortality and must be treated with tetracyclines immediately. Legionella pneumonia is preferably treated with erythromycin 2-4 g for at least three weeks; as an alternative, tetracyclines or quinolones may be given. Quinolones are less effective in mycoplasma and chlamydial infection. The new macrolide antibiotics are promising agents in pneumonia due to M. pneumoniae, L. pneumophila and C. pneumoniae. Compared to erythromycin they have improved pharmacological properties. They have long half-lives allowing once-daily dosing and achieve high tissue and intracellular concentrations.

Bacterial Infections↗

Acute encephalitis.

Acute encephalitis: etiology, clinical findings and prognosis. We studied 44 patients with acute encephalitis diagnosed in a neurological university clinic during an 11-year period. An etiology was found in 11 cases (25%). In 3 the cause was herpes simplex virus; in 2 morbilli. There were single patients in which the cause was mycoplasma pneumoniae, epidemic parotitis, ornithosis, infectious mononucleosis, influenza B-virus and recent tetanus immunization. No specific etiology was found in 33 (75%). Besides fever the most frequent sign was impairment of consciousness in 39% of cases. Four patients (9%) died. Among the survivors mental and/or focal neurological deficits persisted in 22 (55%). Most frequent was dementia in 6 cases (15% of survivors). Impaired consciousness in the acute phase indicated a worse prognosis (p < 0.005).

Acute Disease↗

Psittacosis in Egypt: A Case Study.

Psittacosis, also referred to as ornithosis, is a disease primarily of birds, which may be transmitted to humans. Psittacosis is caused by Chlamydia psittaci, an obligate intracellular parasite found worldwide. Humans are infected with C. psittaci when the organism enters the blood stream, usually through inhalation of dried excrement from diseased birds or through wound contamination with infected avian secretions. C. psittaci replicates in the liver and spleen and infects the lung and other organs hematogenously.1 The clinical manifestations of human psittacosis range from a mild respiratory infection to a severe systemic illness.1,2 Symptoms are frequently described as flu-like with fever, headache, body aches, and dry or productive cough. Sore throat, chest pain, abdominal pain, vomiting, and diarrhea are variably present. Physical findings may include a pulse-temperature dissociation, localized lung crackles, hepatomegaly, splenomegaly, and a pale macular skin rash. Chest radiographs may demonstrate lesions that are atelectatic, patchy, miliary, nodular, or consolidated in one or both lungs. White cell counts, erythrocyte sedimentation rates, and liver function tests are usually normal. In severe illness, signs and symptoms of liver dysfunction, neurological impairment, and respiratory and renal failure may be present. Since 1879 when psittacosis was recognized as a disease entity, cases have been reported in North and South America, Europe, Asia, and Australia. However, reports of psittacosis in Africa have been rare. An Ethiopian group, studying community-acquired pneumonia, published what they claimed to be the first report of psittacosis in Africa in 1994.3 The report published here is believed to be the first documented case of human psittacosis in Egypt.

Journal Article↗

Comparison of Chlamydia psittaci isolates by restriction endonuclease and DNA probe analyses.

DNAs from eight Chlamydia psittaci isolates (koala conjunctivitis, avian psittacosis, avian ornithosis, ovine abortion, ovine polyarthritis, sporadic bovine encephalomyelitis, and feline conjunctivitis) and one Chlamydia trachomatis isolate (lymphogranuloma venereum) were compared by restriction endonuclease and DNA probe analyses. Digestion with HindIII yielded a series of discrete fragments which allowed the differentiation of most isolates. A gene probe, pFEN207, which encodes the chlamydia-specific component of the lipopolysaccharide group antigen was used in Southern hybridizations. The probe was chlamydia specific and hybridized to a single BamHI fragment and multiple HindIII fragments in each isolate. The variation in size of the hybridizing fragments allowed easy differentiation of the isolates and may eventually lead to a meaningful subgrouping of the diverse group of disease agents presently included in the species C. psittaci.

Animals↗

Dietary changes in temporal relation to multiple sclerosis in the Faroe Islands: an evaluation of literary sources.

In order to generate additional hypotheses on a possible role of dietary factors in the etiology of multiple sclerosis, the ethnographic literature and other relevant sources from the Faroe Islands were reviewed. A transitory occurrence in the first half of the 20th century was evident for the extended consumption of oat products, of fulmars possibly infected with ornithosis virus, and of foodstuffs treated with wood smoke or smoke condensates. The hypothetical basis of these considerations must be emphasized.

Denmark↗

Role of virus for the induction of myasthenia gravis.

Virus has been suggested as an etiological agent in myasthenia gravis. In this investigation 36 patients with the clinical diagnosis of myasthenia gravis were tested for antibodies against ornithosis, mycoplasma pneumoniae and 16 viral antigens. Rabbits with experimentally induced autoimmune myasthenia gravis were similarly tested. There was no overall correlation to any microorganism, which might have suggested the involvement of a viral infection in the pathogenesis of the disease. Neither was there any difference in incidence of antibodies in female patients carrying the HLA B8 antigen, an antigen which is associated with myasthenia gravis, as compared to HLA B8 negative individuals.

Adolescent↗

Compendium of measures to control Chlamydophila psittaci (formerly Chlamydia psittaci) infection among humans (psittacosis) and pet birds, 2005.

Psittacosis, also known as parrot fever and ornithosis, is a bacterial infection of humans that can cause severe pneumonia and other serious health problems. It is caused by Chlamydophila psittaci, formerly known as Chlamydia psittaci. From 1988 through 2003, 935 human cases of psittacosis were reported to the CDC and most resulted from exposure to infected pet birds, usually cockatiels, parakeets, parrots, and macaws. In birds, C. psittaci infection is referred to as avian chlamydiosis. Infected birds shed the bacteria through feces and nasal discharges, and humans become infected from exposure to these materials. This compendium provides information about psittacosis and avian chlamydiosis to public health officials, physicians, veterinarians, the pet bird industry, and others concerned with controlling these diseases and protecting public health. The recommendations in this compendium provide standardized procedures for controlling avian chlamydiosis in birds, a vital step to protecting human health. This document will be reviewed and revised as necessary.

Animals↗

Chlamydia pneumoniae in Swedish patients.

Chlamydia pneumoniae infections have earlier been described as mycoplasma-like illnesses in young people, and also appear to be associated with community-acquired pneumonia in adults. In this retrospective study, 12.2% (23/188) of patients with pneumonia who required hospitalization during the 3 years 1985-87 had serological evidence of recent C. pneumoniae infection. Many of these patients had symptoms similar to ornithosis. The most interesting finding was that half of the patients with a 4-fold IgG antibody titre rise to C. pneumoniae also had an increased alkaline phosphatase concentration.

Alkaline Phosphatase↗

Ampicillin plus mecillinam vs. cefotaxime/cefadroxil treatment of patients with severe pneumonia or pyelonephritis: a double-blind multicentre study evaluated by intention-to-treat analysis.

In this double-blind multicentre study, using the intention-to-treat approach, a total of 293 patients with fever (> or = 38.5 degrees C), symptoms of sepsis and signs of pneumonia or pyelonephritis were randomly assigned to treatment with ampicillin and mecillinam (A+M) or cefotaxime followed by cefadroxil. In the febrile phase, treatment was given intravenously twice daily, either with 1,200 mg ampicillin together with 600 mg mecillinam or with 2 g cefotaxime alone. When the patients stayed afebrile, the intravenous administration was replaced by oral treatment twice daily for 14 days, either with 500 mg pivampicillin and 400 mg pivmecillinam or 1 g cefadroxil. In the A+M group, 33% (48/144) of the patients did not complete the full course of treatment as compared with 32% (47/149) in the cephalosporin group, the reasons being treatment failure in 27 and 29, respectively, or adverse effects (n = 16 in both groups). The median duration of fever was 47 h in the A + M group and 50 h in the cephalosporin group. Of 135 patients with pneumonia, 68% were completely cured in the A + M group, and 65% in the cephalosporin group, the main reasons for treatment failure being Mycoplasma pneumonia or ornithosis. Of 136 patients with pyelonephritis, 63% were cured in each group. The main reason for failure was bacteriological relapse. Side-effects were reported by 32 patients (22%) of the A+M group, as compared with 41 (28%) of the cephalosporin group. Epigastric complaints were equally frequent in both groups, but there was a tendency for a higher frequency of exanthema in the A+M group, and for antibiotic-associated diarrhoea and fungal superinfections in the cephalosporin group.

Amdinocillin↗

Australia's notifiable diseases status, 2001: annual report of the National Notifiable Diseases Surveillance System.

In 2001 there were 104,187 notifications of communicable diseases in Australia reported to the National Notifiable Diseases Surveillance System (NNDSS). The number of notifications in 2001 was an increase of 16 per cent of those reported in 2000 (89,740) and the largest annual total since the NNDSS commenced in 1991. In 2001, nine new diseases were added to the list of diseases reported to NNDSS and four diseases were removed. The new diseases were cryptosporidiosis, laboratory-confirmed influenza, invasive pneumococcal disease, Japanese encephalitis, Kunjin virus infection, Murray Valley encephalitis virus infection, anthrax, Australian bat lyssavirus, and other lyssaviruses (not elsewhere classified). Bloodborne virus infections remained the most frequently notified disease (29,057 reports, 27.9% of total), followed by sexually transmitted infections (27,647, 26.5%), gastrointestinal diseases (26,086, 25%), vaccine preventable diseases (13,030 (12.5%), vectorborne diseases (5,294, 5.1%), other bacterial infections (1,978, 1.9%), zoonotic infections (1,091, 1%) and four cases of quarantinable diseases. In 2001 there were increases in the number of notifications of incident hepatitis C, chlamydial infections, pertussis, Barmah Forest virus infection and ornithosis. There were decreases in the number of notifications of hepatitis A, Haemophilus influenzae type b infections, measles, rubella, Ross River virus infections and brucellosis. This report also summarises data on communicable diseases from other surveillance systems including the Laboratory Virology and Serology Reporting Scheme and sentinel general practitioner schemes. In addition, this report comments on other important developments in communicable disease control in Australia in 2001.

Australia↗

Some infectious and parasitic diseases in Oklahoma raptors.

Blood films and sera samples from wild Oklahoma raptors (Strigiformes--36 birds, 3 species; Falconiformes--50 birds, 7 species) were examined for hematozoa and tested for serologic antibody response to Newcastle Disease Virus (NDV), encephalitis (EEE and WEE), ornithosis, and influenza. Twenty-nine of 36 (80.5) Strigiformes and 24 of 50 (48.0%) Falconiformes showed the presence of one or more hematozoa. Serologic testing revealed the serum of one adult male red-tailed hawk positive for antibody to NDV and one additional adult male red-tailed hawk positive for antibody to type-A influenza.

Animals↗

Compendium of measures to control Chlamydia psittaci infection among humans (psittacosis) and pet birds (avian chlamydiosis), 2000. Centers for Disease Control and Prevention.

Psittacosis--also known as parrot fever and ornithosis--is spread by a bacterial infection of birds that can cause severe pneumonia and other serious health problems among humans. From 1988 through 1998, 813 cases of psittacosis (infection with Chlamydia psittaci) were reported to CDC, and most resulted from exposure to infected pet birds, usually cockatiels, parakeets, parrots, and macaws. In birds, C. psittaci infection is referred to as avian chlamydiosis (AC). Infected birds shed the bacteria through feces and nasal discharges, and humans become infected from exposure to these materials. This compendium provides information about psittacosis and AC to public health officials, physicians, veterinarians, the pet bird industry, and others concerned about controlling these diseases and protecting public health. The recommendations in this compendium provide standardized procedures for controlling AC in birds, a vital step to protecting human health.

Animals↗

[Chlamydial diseases of domestic animals--zoonotic potential of the agents and diagnostic issues].

The role of chlamydiae as agents of a number of important animal and human diseases is still the subject of intensive research. Recently, a proposal for taxonomic reclassification of this group of obligate intracellular bacteria was published, which was based on a large amount of new data on genetic relatedness. According to this proposal, the family Chlamydiaceae now comprises two genera (Chlamydia and Chlamydophila) with 9 largely host-related species. The previously accepted classification scheme had distinguished 4 species within the genus Chlamydia. The most important animal chlamydiosis with zoonotic character is psittacosis, a systemic disease in psittacine birds of acute, protracted, chronic or subclinical manifestation. The analogous infection in domestic and wild fowl is known as ornithosis. Avian strains of C. psittaci (new classification: Chlamydophila psittaci) can also infect humans, the symptoms being mainly unspecific and influenza-like, but severe pneumonia, endocarditis and encephalitis are also known. The main group of persons facing an elevated risk of infection includes those having frequent contact with domestic and companion birds at work or in their spare time. In Germany, the annual average of notified cases is approximately 100. Cases of transmission to humans were repeatedly reported in connection with enzootic abortion in sheep (causative agent: C. psittaci or Chlamydophila abortus, respectively). Various chlamydial species occur as pathogens and commensals as well in cattle, pigs, horses, and cats. The assessment of the actual epidemiological importance is, however, often difficult because of their almost ubiquitous spread. Likewise, those strains of C. pneumoniae (new classification: Chlamydophila pneumoniae) found in several animal species can not yet be assessed for pathogenic properties. The possibilities for diagnostic detection of chlamydiae have considerably improved following the introduction of molecular methods, particularly the polymerase chain reaction (PCR), which permits direct identification from clinical specimens and differentiation of species.

Animals↗

[Respiratory diseases due to noxious agents in agriculture workers].

Better working and living conditions resulted by scientific technical revolution in agriculture. Nevertheless specialization of agricultural labor created a higher risk against inhalative hazards among few professions. Among biological hazards that are for instant zoonoses and ornithosis, Q-fever, tularemia and tuberculosis. A series of allergenic dusts is of vegetable origin. Among chemical hazards pesticides, fertilizers and disinfectants and other hazards are discussed. Among physical hazards in building and in repair shops for agricultural machines single risk is possible by silicosis and asbestosis but dominating are unspecific dusts.

Agricultural Workers' Diseases↗

[Mediastinal form of cat-scratch disease].

The authors reported a case of Cat--Scratch Disease (CSD) in a 14-year-old boy; it was an unusual CSD by its mediastinal mass location. Histopathological lesions which appeared as pseudo-tubercular folliculi mislead us. Disease was finally diagnosed by biological exams: a strongly positive Hanger-Rose reaction and serological assays used for the diagnosis of psittacosis, ornithosis, lymphagranuloma venereum and trachoma. CSD is a common cause of chronic lymphadenopathy in children. In the majority of patients, CSD is a mild illness. Some unusual forms as Parinaud's oculoglandular syndrome, neurological lesions, osteomyelitis and exceptionaly mediastinal lymphadenopathy have been reported. 2 cases of the latest ones were already described.

Adolescent↗