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Diagnostic tests for Rocky Mountain spotted fever and other rickettsial diseases.

Rickettsial diseases continue to confound physicians because of their usually sporadic occurrence and nonspecific clinical presentation. In past years, diagnosis was confirmed only during convalescence; however, newer, more widely available methods, such as antigen detection and improved in vitro cultivation, have enabled a diagnosis at a time when therapeutic decisions are made. Molecular nucleic acid-based techniques have also expanded the spectrum of etiologic agents and illnesses caused by rickettsiae.

Angiomatosis, Bacillary↗

[Rickettsiosis].

Explore the source record for details and available documents.

Adult↗

[Role of Leptotrombidium (L.) scutellare in transmission of human diseases].

A series of cases of hemorrhagic fever with renal syndrome (HFRS) in Shaanxi province and autumn-type tsutsugamushi disease in Jiangsu province were studied during 1988 to 1990 and 1986 to 1993 to explore the role of Leptotrombidium (L.) scutellare in transmission of these diseases. Results showed that L. (L.) scutellare is a dominant strain of mites inhabiting in rats and its seasonal fluctuation conformed to the seasonal distribution of these diseases. L. (L.) scutellare could naturally infect with HFRS virus and Rickettsia tsutsugamushi and transmit them by stinging and transovarial route. It indicated that L. (L.) scutellare could be a vector in transmission of HFRS and autumntype tsutsugamushi disease.

Animals↗

The role of Leptotrombidium scutellare in the transmission of human diseases.

OBJECTIVE: To investigate the role of Leptotrombidium (L.) scutellare in the transmission of hemorrhagic fever with renal syndrome (HFRS) and tsutsugamushi disease of autumn-type. MATERIALS AND METHODS: Four criteria were used to ascertain this mite as transmitting vector of disease: (1) epidemiological evidence; (2) natural infection of pathogen; (3) ability to transmit pathogen via biting; (4) ability to transfer pathogen via transovarian route. RESULTS: The results indicated that L. scutellare was the dominant species of chigger mite on rats. Its seasonal distribution was correlated with the incidence of these two diseases. This mite could be naturally infected by HFRS virus (HFRSV) and Rickettsia tsutsugamushi (Rt) and the mite could transmit HFRSV and Rt to vertebrates by biting and to its offspring via transovarian transmission. CONCLUSIONS: These results have proved that L. scutellare can be a transmitting vector of HFRS and tsutsugamushi disease of autumn-type.

Animals↗

[Studies on clinical epidemiology of Tsutsugamushi disease of the autumn-winter type in the easten suburbs of Jinan].

This paper reported the epidemiological characteristics of 154 cases under investigation for tsutsugamushi disease of autumn-winter type in the eastern suburb of Jinan. Results showed that the characteristics differed greatly from those in the southern part of China. Majority of patients had toxic symptoms due to infections but specific characteristics were less obvious. Eschars and ulcers appeared only in 14.94% of the cases and occurred only in autumn-winter season. Clinically mild cases constituted the majority. Cases not only distributed sporadically, but also had multi-organ lesions (MOL). Young peasants seemed to be most vulnerable. The pathogen of the disease belonged to low virulent strain. Serological typing belonged to the Gilliam type. The diagnosis and the treatment of the disease were discussed. Specific serum IgG of the disease was detected 6 years after convalescence.

Adolescent↗

[Peritoneal reaction to infection with tsutsugamushi rickettsia in mice with different sensitivity to the agent].

Infection of white random-bred mice and C57B1(6) mice with a culture of R. tsutsugamushi demonstrated that white mice were highly susceptible to the infection which ended in death of the animals and accumulation of rickettsia in the body and necrotization of cell elements of the exudate. Mice of C57B1(6) strain developed acymptomatic infection, rickettsia did not multiply in the peritoneal cavity and exudate cells did not undergo necribiosis. The mechanism of resistance of cells of these mice to the agent requires a further study.

Acid Phosphatase↗

Serologic evidence of infection with ehrlichiae and spotted fever group rickettsiae among residents of Gag Island, Indonesia.

The causative agents of scrub and murine typhus are considered endemic to Indonesia. However, the presence of spotted fever group rickettsiae and ehrlichiae have not been previously described in this country. During an investigation of arthropod-borne diseases on Gag Island, located northwest of the island of New Guinea in eastern Indonesia, the prevalence of antibody to the etiologic agents of monocytic ehrlichiosis, spotted fever rickettsiosis, and scrub and murine typhus were determined. Analysis of 55 blood samples from residents of Gag Island showed seroreactivity to antigen preparations of Ehrlichia chaffeensis (7 of 48, 14.6%), two spotted fever group rickettsiae: Rickettsia rickettsii (5 of 48, 10.4%) and R. conorii (10 of 49, 20.4%), Orientia tsutsugamushi (5 of 53, 9.4%), and R. typhi (1 of 48, 2.1% [by an indirect immunofluorescence assay] and 1 of 50, 2.0% [by an enzyme-linked immunosorbent assay]). These results show serologic evidence of infection with ehrlichiae and spotted fever group rickettsiae for the first time in Indonesia in a location where the prevalence of antibody to O. tsutsugamushi and R. typhi was lower.

Antibodies, Bacterial↗

Rickettsial infection presenting as culture-negative meningitis.

Meningitis is an unusual presentation of rickettsial infection. We report a patient who was confirmed by serology to have typhus fever (not scrub), but who presented with the typical findings of culture-negative bacterial meningitis. Neurological manifestations of different types of rickettsial infection are discussed.

Chloramphenicol↗

Spotted fever group rickettsial infections in Australia.

More than four decades ago, Rickettsia australis was discovered to be the etiologic agent of Queensland tick typhus (QTT), yet many unanswered questions persist about the ecology, epidemiology, and clinical features of this disease. We review 46 previously published cases of QTT along with 16 cases discovered by active surveillance. QTT is usually a mild disease. Patients often have regional lymphadenopathy and eschars. Some have vesicular rashes. Because clinical features overlap, serologic tests are necessary to distinguish QTT from other endemic Australian rickettsial diseases (scrub and murine typhus). Only two tick vectors of R. australis have been identified: Ixodes holocyclus and Ixodes tasmani. Until rickettsiae are isolated from patients in Victoria and Tasmania, it remains unproven that spotted fever group infections in these locations are due to R. australis. However, available serologic, epidemiologic, and clinical data suggest that QTT is not confined to the area in which R. australis was first isolated (Queensland); rather, it occurs along a 3,200-km span of eastern coastal Australia, from tropical to temperate climates.

Adolescent↗

Mycoplasma pneumonia: a study on hospitalized American patients with pneumonia in Vietnam.

A prospective study on consecutively hospitalized pneumonia patients showed that 41.5% of 58 patients had a fourfold rise in the complement-fixation titer for Mycoplasma pneumoniae. Viral isolation techniques and serologic tests for influenza A1, A2 and B, parainfluenza 1 and 3, respiratory syncytial virus and the adeno virus group yielded only a single positive isolate for influenza A2. Serologic tests for melioidosis, leptospirosis, scrub, murine and epidemic typhus and psittacosis were all negative. The clinical manifestations were not distinctive for the positive M. pneumoniae patients when compared with the patients having a negative M. pneumoniae complement-fixation test. The symptoms and signs and laboratory and radiologic findings were similar to those described in other reports on primary atypical pneumonia.

Adult↗

Rescue of the remnants: the British emergency medical relief operation in Belsen Camp 1945.

The British Army liberated the German concentration camp at Belsen on April 15, 1945. The thousands of inmates (estimates range from 60,000 to 78,900 inmates), mostly Jews from eastern Europe, were dying at a rate of 500-600 per day from disease, and many more were being killed by the German guards and co-workers. Diseases prevalent included typhus, tuberculosis, nutritional and infective diarrhoea, severe malnutrition and starvation, and others. Despite huge obstacles including the ongoing war effort, shortages of supplies, and limited numbers of workers, a relief operation was rapidly organized to control the typhus epidemic and salvage as many inmates as possible. The 10,000 emaciated corpses which had been lying all over the camp were collected and buried in mass graves. Inmates were disinfected with D.D.T., scrubbed in a "human laundry," and evacuated from the typhus-ridden Horror Camp (Camp 1) to a hospital organized in the barracks of the Panzer Training School (Camp 2). Feeding of the inmates was carefully regulated, and some basic medical treatment organized. The relief operation was performed by British Army units, detachments of the British Red Cross, British and Belgian medical students, and other volunteers including those from among the less debilitated inmates. Although 13,000 inmates died after the liberation despite the relief operation, thousands of others were rescued.

Emergency Medical Services↗