[Tsutsugamushi fever. Case report on an imported disease].
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Rocky Mountain spotted fever, caused by a rickettsial organism transmitted by the bite of a tick, can be confused with many more common diseases. Diagnosis is made more challenging by the fact that treatment is most efficacious if begun before the second week of illness. Tetracycline and doxycycline are the most successful therapeutic agents against this potentially fatal disease.
After the louse transmission of epidemic typhus had been established (1909), a small microorganism (thought to belong to a new genus, Rickettsia) was shown in enormous numbers in the guts of lice that had fed on human typhus victims. Attempts at cultivating this organism on inert media failed; transfer from louse to louse without loss of virulence for the vertebrate host was successful. Some scientists were not convinced of the etiologic role of Rickettsiae, because the presence of this microbe in blood and organs of victims or of experimentally infected animals was difficult to demonstrate. This uncertainty was dispelled in 1928, when in guinea pigs infected with material from the closely related disease Tabardillo (murine typhus) abundant Rickettsiae were revealed in the tunica vaginalis. Live vaccines, derived from strains of murine typhus and deployed in French North Africa, were considered by outside observers as unsafe. Killed vaccines were derived from the masses of Rickettsiae present in louse guts, in chick embryo yolk sacs or in vertebrate lungs. These developments were not spurned by any 'upswing of virology' but by the threat of typhus in endemic areas and, after 1938, in a war-torn world. Their basis was firmly anchored in bacteriological thought styles and techniques.
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Radiographic dissimilarities exist between the chest radiographs of patients with epidemic and sporadically-occurring Q fever pneumonia. Chest radiographs of 25 patients with Q fever pneumonia were retrospectively assessed, and demonstrated previously unreported differences between these two broad groups. Differing strains of Coxiella burnetii, or varying doses of the pathogen, are postulated as the pathogenetic mechanisms for the observed discrepant findings.
Case of an 48 year old man who has presented from 1968 to 1973 a lot of diseases such as: --mitral incompletence discovered in 1968 in Madagascar island in spite of many previous clinical examinations; --acute pneumonia and heart failure in January 1973. Serological reactions of Ricketsia were quite positive; --acute thrombosis of right humeral artery in May 1973. It has been treated by surgical way, bay "desobstruction" and by pass and medical treatment chloramphenicol). Pathologic endartery has been inoculated to an hamster, cobaye. These animal became feverish, and presented an inflammation of testis. A least serological reaction of Ricketsia became positive for all of them; --few weeks, thrombosis of left femoral and posterior tibial arteries treated by surgical and medical ways. Some commens are exposed about evolution of Coxiella Burneti infections, about the frequency of arterial and cardiac lesions, and about the effect of tifomycine which seems to be decreasing and the action of cycline (doxicycline).
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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.
New, so far unknown epidemically active natural foci of tick-borne rickettsiosis have been identified in Suzun District, Novosibirsk Province. The patients had a typical clinical pattern and epidemiological history of the disease. The cases were recorded in a number of communities in the northern forest-steppe zones. The results of the epidemiological survey and rickettsial studies of Ixodes ticks and blood sera of farm animals demonstrate the existence of clear-cut natural foci of tick-borne rickettsiosis, with its main vectors being ticks D. silvarum. The infestation of ticks was proved by biotests in passive hemagglutination tests, using an immunoglobulin diagnostic kit. Some measures for the monitoring of foci and disease prevention are suggested.
Thrombomodulin (TM), a high affinity thrombin receptor present on endothelial cell membrane, plays an important role as a natural anticoagulant. It acts as a cofactor of thrombin-catalyzed activation of protein C, and inhibits the procoagulant functions of thrombin. TM is also located in other cells (keratinocytes, osteoblasts, macrophages,...) where it might be involved in cell differentiation or in inflammation. In the presence of cytokines, activated neutrophils and macrophages, endothelial TM is cleaved enzymatically, releasing soluble fragments which circulate in the blood and are eliminated in urine. Plasma TM level (pTM) can be measured using a two-site enzyme-linked immunosorbent assay (ELISA). pTM level is regarded as a molecular marker reflecting injury of endothelial cells. It is often increased in case of diffuse endothelial damage as in disseminated intravascular coagulation, diabetic microangiopathy, Plasmodium falciparum and rickettsial infections. pTM is also a predictive marker of hypertensive complications in pregnancy. In several systemic inflammatory diseases, pTM levels are correlated to the activity of the disease.