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The level of medium-weight molecules (MWM) over the course of disease and changes in the lipid share of MWM fractions at the peak of disease were studied in patients with Astrakhan rickettsial fever (ARF). The level of MWM was significantly increased in comparison with the control and MWM concentration clearly correlated with the severity of intoxication. A level higher than 600 U is an unfavorable sign of a grave course. The significance of the lipid part of MWM fraction in the formation of the intoxication syndrome in ARF is shown.
A case of Rocky Mountain Spotted Fever in a human is presented with special emphasis on ultrastructural aspects of the disease. Electron microscopic examination of the tick bite site demonstrated the presence of rickettsial organisms both within the cytoplasm and nucleus of endothelial cells, as well as within the periendothelial cell environment. Several ultrastructural reports of rickettsia localization and morphology within experimental animal and tissue culture models have been reviewed. This report, to our knowledge, represents the first documented demonstration of rickettsial organisms in an acute human disease case. The size, location and morphologic features of the organisms in our case compare closely with the previously reported experimental results.
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A focal outbreak of highly fatal disease occurred in eastern Costa Rica in 1974. No rickettsial spotted fevers have previously been reported in Costa Rica. Nevertheless, the available evidence points to an unidentified rickettsial pathogen, probably of the spotted fever group, as the agent responsible for this outbreak.
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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.
We developed a nested polymerase chain reaction (PCR) method to detect Rickettsia tsutsugamushi (R. tsutsugamushi) DNA and determined its sensitivity. Primers were selected from the DNA sequence of the 58-kDa group-specific antigen gene of the Karp strain. The target sequence of rickettsial DNA was detectable as the band corresponding to 88 bp in 1.0 microgram of the DNA extracted from BS-C-1 cells infected with R. tsutsugamushi. Rickettsia-specific bands were observed not only for the homologous Karp strain, but also for four heterologous strains: two other reference strains (Gilliam and Kato) and two prototype strains prevalent in Miyazaki district (Irie and Hirano). The minimum copy number detectable by this method was estimated to be five rickettsiae. All of nine peripheral blood mononuclear cell samples from patients with tsutsugamushi disease who were seen 2-11 days after disease onset tested positive for rickettsial DNA. The PCR assay method presented here could be a specific diagnostic tool for tsutsugamushi disease, especially in its early acute stage.
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Specific seroagglutination tests were performed in 70 patients with Buerger's disease to detect possible antibodies to rickettsia, the test being repeated in 8 cases after activation by doxycycline administration over 10 days. In 21 patients a Weil-Felix test was also carried out. Tests were assessed as positive in 44 cases (62.8%): 18 times for Rickettsia Q. 18, 14 times for Rickettsia Mooseri, 13 times for Rickettsia Burnetii, 5 times for Rickettsia Conorii and 3 times for Rickettsia Prowazekii. After activation by doxycycline the antibody titre was increased 5 times, unchanged 3 times and reduced once. The Weil-Felix gave positive results in 3 of the 21 cases (14.28%), the reaction being positive to Rickettsia Prowazekii. These findings provide supplementary arguments for a possible pathogenic role of rickettsial infection in Buerger's disease.
An international conference on the control of ticks and tick-borne diseases sponsored by the European Commission was held in Shanghai between 11 and 15 September 2000. Participants from China, Europe, Australia, India, Iran, Israel, Japan and Thailand attended the meeting. The main objectives were: (1) determining the current situation concerning the epidemiology, economics, diagnosis and integrated control measures of ticks and tick-borne diseases caused by protozoan and rickettsial pathogens; (2) the creation of regional and international research networks and priority settings; (3) the creation of training possibilities for young scientists; (4) the identification of new research directions and priority settings in relation to vaccine development and diagnostics. The papers presented during this meeting focused on parasite characterisation and the description of yet unidentified Theileria and Babesia species pathogenic for large and small ruminants in China. In addition, progress made in immunity and vaccine development against the pathogens mentioned above and their vector ticks was also discussed.
It has been suggested that bacillary (epithelioid) angiomatosis (BEA) is a manifestation of cat scratch disease (CSD). Because of clinical similarity between this condition and the verruga peruana phase of bartonellosis, we sought to further characterize this disease as well as its causative agent and to compare it to bartonellosis. We isolated a small flagellated pleomorphic bacillus from skin lesions of two patients with BEA. Organisms were stained successfully with Warthin-Starry silver stains, but immunohistochemistry failed to demonstrate binding with a polyclonal antibody directed against the cat scratch bacillus. Whole cell fatty-acid gas chromatography performed on both BEA organisms and Bartonella bacilliformis demonstrated marked similarity between the two. Electron microscopy of BEA organisms in tissue and in suspension revealed features characteristic of a gram negative bacillus. Based on these findings, we propose that this unusual rickettsial infectious disease with vascular proliferation may represent an unusual variant of infection with a bartonella-like organism rather than a manifestation of cat scratch disease.
Q fever is an zoonosis caused by Coxiella burnetti, the clinical features of which are often nonspecific and self-limited. Involvement of the central nervous system is rare and is usually seen as a complication of endocarditis caused by this rickettsial organism in the chronic disease. Specific neurological manifestations in the course of the acute illness aseptic meningitis, encephalitis, toxic confusional states, extrapyramidal signs, dementia and behavioral disturbances. We describe a patient who developed reversible bilateral abducens nerve paralysis and bilateral optic neuritis in the course of acute Q fever meningoencephalitis.
Myocarditis has been described during and after a wide variety of infectious agents: viral, rickettsial, bacterial, protozoal, and metazoal diseases may cause cardiac inflammation. We report a case of toxoplasma myocarditis in a young healthy man.