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At least 145 records · Page 8Linked to original sources
PubMed2000

[A clinical analysis of 31 cases with pulmonary damage caused by scrub typhus].

OBJECTIVE: To deepen the understanding of pulmonary damage caused by scrub typhus. METHODS: 31 cases of pulmonary damage caused by scrub typhus from 1993 to 1998 were reviewed with chest radiographs, chest B-ultrasound, etc. RESULTS: 44% cases with scrub typhus showed a pulmonary damage (31/70), in which 66% (20/31) had cough, 53% (16-31) had sputum, 53% (16/31) had rales and the most symptoms were mild. Chest X-rays: 45% (14/31) showed pulmonary interstitial lesion, 53%(16/31) pulmonary effusion lesion and 8 cases pleural lesion. 26% (8/31) of pleural effusion was confirmed by chest B-ultrasound. Respiratory failure was found in 5 cases. All cases were treated with chloramphenicol and(or) doxycyclinum and made a good recovery. CONCLUSION: The pulmonary damage caused by scrub typhus should be paid more attention to for avoiding misdiagnosis.

Adolescent↗
PubMed2001

Endemic typhus in Singapore--a re-emerging infectious disease?

UNLABELLED: Singapore is a modern urban city and endemic typhus is thought to be a disease of the past. This may be due to lack of specific serological testing as indirect immunoperoxidase testing using specific rickettsial antigens (U.S. Army Medical Research Unit, Institute of Medical Research, Kuala Lumpur, Malaysia) has only recently become available. In the last fourteen months, twenty-one cases of endemic typhus were diagnosed in patients hospitalised for acute febrile illnesses at the National University Hospital. We conducted a case control study to define the clinical and laboratory features of endemic typhus in Singapore. METHOD: Demographic, clinical and laboratory data were reviewed for cases and twenty-one age and sex matched controls who had negative serologic tests as part of a work-up for fever of unknown origin. RESULTS: Apart from a higher initial temperature (39 degrees C vs 37.9 degrees C (p < 0.001)) and ALT(p = 0.002), cases and controls had similar presentations of fever, myalgia, headache, cough, normal WBC and platelet counts. Singapore residents and migrant workers were represented in both groups (p = ns). CONCLUSION: Endemic typhus remains an important cause of acute febrile illness in Singaporein both the local and migrant worker populations. The presentation is similar to other causes of acute febrile illnesses and the diagnosis will be missed unless it is specifically sought.

Adult↗
PubMed2002

Septic shock secondary to scrub typhus: characteristics and complications.

Scrub typhus is an acute febrile illness caused by infection with Orientia tsutsugamushi transmitted by the bite of larval trombiculid mites (chiggers). A prospective study was conducted in septic shock patients in Maharat Hospital, Nakhon Ratchasima Province, Thailand, from 12 November 2001 to 5 January 2002. Of the 51 septic shock patients studied during the 7 week period, 18 (35.3%) were found to have evidence of scrub typhus infection; 3 patients (16.7%) died. In this study, septic shock caused by Orientia tsutsugamushi is the most prominent (35.3%) in endemic area of scrub typhus. Scrub typhus with septic shock patients results in organ failure: respiratory failure, DIC were predominant, followed by renal and hepatic involvement. Two deaths were due to respiratory failure and one death was as a result of combined respiratory and renal failure. Fever was the most common symptom, followed by headache, myalgia and dyspnea; lymphadenophathy and eschar are common signs. Laboratory findings revealed that almost all of the patients had a mild leukocytosis, reduced hematocrit and thrombocytopenia; SGOT, ALP, direct bilirubin (DB), total billirubin (TB), BUN, Cr were elevated; hypoalbuminemia was noted. Urinalysis showed that 88.9% of the patients had albuminuria. 77.8% of patients had abnormal chest X-rays.

Adult↗
PubMed2003

Laboratory diagnosis of two scrub typhus outbreaks at Camp Fuji, Japan in 2000 and 2001 by enzyme-linked immunosorbent assay, rapid flow assay, and Western blot assay using outer membrane 56-kD recombinant proteins.

Two scrub typhus outbreaks occurred among U.S. Marines training at Camp Fuji, Japan, between October 25 and November 3, 2000 and October 17 and November 30, 2001. Nine cases in approximately 800 Marines in 2000 and eight cases in approximately 900 Marines in 2001 (approximate attack rates = 1.1% and 0.9%, respectively) reported with signs and symptoms of fever, rash, headache, lymphadenopathy, myalgia, and eschar. Serologies and rapid response to doxycycline treatment indicated they had scrub typhus. Sixty-four convalescent serum samples (18 suspected cases and 46 negative controls) from U.S. Marines training at Camp Fuji during the outbreaks were assessed by enzyme-linked immunosorbent assay (ELISA), rapid flow assay (RFA), and Western blot assay for evidence of infection with Orientia tsutsugamushi, the causative agent of scrub typhus. All but one suspected case had serologic evidence of scrub typhus and all 46 control sera were non-reactive to O. tsutsugamushi antigens. The recombinant 56-kD antigen (r56) from the Karp, Kato and Gilliam strains of O. tsutsugamushi in an ELISA format provided better results than Karp r56 alone (ELISA and RFA) or whole cell antigen preparation from Karp, Kato and Gilliam (ELISA).

Adult↗
PubMed2003

Acute acalculous cholecystitis and pancreatitis in a patient with concomitant leptospirosis and scrub typhus.

Concomitant leptospirosis and scrub typhus is rare. The spectrum of clinical severity for both scrub typhus and leptospirosis ranges from mild to fatal. Acute pancreatitis and cholecystitis are infrequent complications in adult patients with either leptospirosis or scrub typhus. We report a case of leptospirosis and scrub typhus coinfection in a 41-year-old man presenting with acute acalculous cholecystitis, pancreatitis and acute renal failure. Abdominal computed tomography revealed edematous change of the gallbladder without intrahepatic or pancreatic lesions. The patient was successfully treated with doxycycline and ceftriaxone, and supportive management.

Acalculous Cholecystitis↗
PubMed2003

Early diagnosis of scrub typhus in Thailand from clinical specimens by nested polymerase chain reaction.

The early detection of scrub typhus in Thailand by nested polymerase chain reaction (PCR) is presented. The diagnosis of scrub typhus, from clinical samples obtained from hospitals in the northern part of Thailand, by nested PCR was compared to immunofluorescence (IF) and Weil-Felix (WF) tests. The primer pairs used for the nested PCR were designed on the basis of the nucleotide sequence of the gene that encodes the 56-kDa antigen, and RFLP analysis was used for identification. Clotted blood from 80 patients suspected of scrub typhus infection were tested. With the IF test, antibodies for Orientia tsutsugamushi were observed in 38 patients checking IgM and IgG titers. Only 21 patients showed positive seroconversion while 17 patients were negative. For the WF test, only 13 patients gave a positive seroconversion. In the early stage of infection, 19, 13 and 3 patients were detected with a sensitivity of 90.47% (19/21), 61.90% (13/21) and 14.28% (3/21) by the nested PCR, IF and WF test respectively. Two patients who were negative for seroconvesion by IF and WF were positive by nested PCR. Therefore, this suggests that nested PCR is applicable for specific rapid diagnosis at an early stage of scrub typhus in endemic regions.

Adolescent↗
PubMed2004

[The epidemic typhus of 1813/14 in the area of lower Franconia].

When Napoleon left for Moscow, in June 1812, he marched at the head of a huge army, perhaps more than half a million men strong. Roughly one fifth of them survived and came back to Germany at the turn of 1812/13. The "Grande Armée" had been subject to open battles and guerilla warfare, but even more to the ravages of hunger and infectious disease - it was epidemic typhus that killed off the soldiers. On their way back to France, the soldiers carried that disease to some areas of Germany, esp. those along the Main river. In late winter of 1813 some parts of Franconia suffered terribly. The epidemic subsided in summer 1813 when the lice - typhus is a louse-born disease - were less and better under control. But again in the winter of 1813/14, after the battle of Leipzig (Oct. 1813), a murderous epidemic of typhus broke out and killed very many people in cities like Wurzburg, Aschaffenburg, and Mainz. Mortality rose to a high percentage. Some contemporary German doctors had a rough idea that the carrier of the disease must be in the clothes. According to very conservative estimates one out of ten Germans fell sick, and ten percent of the sick died of typhus, a quarter of a million out of 23 million people. German historiography normally does not mention this epidemic in history text-books, so this epidemic is rather unknown.

Disease Outbreaks↗
PubMed1992

Murine typhus: forgotten but not gone.

An occasional patient presents the classical symptoms of a disease that has become uncommon. Typhus is an example of such a disease, since it is now well contained through control of its rodent reservoir. It is readily treated with tetracycline or one of its long-acting analogues, doxycycline or minocycline. Because typhus is infrequently encountered, the physician may not initially include it in his differential diagnosis. Our case serves as a remainder that with the increasingly frequent movement of persons from one geographic area to another, the uncommon rickettsial infection, murine typhus, should continue to be in the differential of a febrile patient. Furthermore, our case underscores the importance of including typhus in the differential of typhoid fever.

Acute Disease↗
PubMed2006

[Petechial typhus. History of men, armies and pedicula].

Since the Classical age, humankind has had to cope with petechial typhus, especially during wars and famine. Epidemics chiefly occurred during sieges and followed the paths of armies, when infected soldiers transmitted the infection to populations with whom they came into contact. Winter exacerbated the disease due to the use of unhygienic woollen clothes that allowed the spread of pediculosis. It was only in the early 18th century that petechial typhus outbreaks diminished thanks to the use of Marseille soap and to the new custom of changing clothing at bedtime. In many military campaigns, deaths from typhus were higher than those due to war wounds: recent studies established that the French defeat during the Napoleonic Russian military campaign has to be attributed more to typhus than to the military superiority of the enemy. Indeed, the contagion is estimated to have affected 80% of the 600,000 troops involved. The role of Pediculus as a vehicle of infection established in 1909 by Charles Nicolle, microbiological isolation performed by Howard Ricketts and Stanislaus von Prowazck, and finally the advent of antibiotic therapy, all laid the basis for controlling the disease in the 20th century.

Animals↗
PubMed1991

Scrub typhus in Hong Kong.

A retrospective analysis of cases of scrub typhus in military personnel in Hong Kong during the years 1979-1989 is presented. Fifty-nine cases were identified, most occurring during the hot humid season between May and October. Few civilian cases of scrub typhus are notified to the Hong Kong Medical and Health Department and possible reasons for the disparity in case numbers between military and civilian personnel are discussed. Reports from other areas of South-east Asia have documented a previously unrecognized high incidence of scrub typhus in the indigenous population. It is suggested that a prospective study utilizing specific serological diagnostic techniques would be of value in assessing the importance of scrub typhus as a cause of 'fever of undetermined origin' in the civilian population of Hong Kong.

Doxycycline↗
PubMed1980

Prevention of scrub typhus. Prophylactic administration of doxycycline in a randomized double blind trial.

We conducted a prospective randomized double blind study on the effects of doxycycline as a prophylactic antibiotic against scrub typhus. A total of 1,125 military subjects was followed for periods as long as 5 months of exposure in a hyperendemic focus in the Pescadores Islands of Taiwan. Oral 200 mg doses of doxycycline (Vibramycin) or placebo were given once each week throughout the trial. The incidence rate of scrub typhus in the placebo group was 2.5 times greater than that of the group taking doxycycline (P = 0.11). When subjects who failed to comply with scheduled administration of doxycycline were removed from the analysis, the incidence rate of scrub typhus in the control group was five times greater than that in the drug group (P = 0.04). The rates of infection with Rickettsia tsutsugamushi and of sick call reports were the same in experimental and control groups. The drug was well tolerated in pretrial tests and complaints were negligible during the conduct of the trial. Doxycycline appears to be an excellent antibiotic for the prevention of scrub typhus among personnel exposed to high risk of infection with R. tsutsugamushi.

Dose-Response Relationship, Drug↗
PubMed1993

[Surveillance of scrub typhus in Taiwan].

Although scrub typhus, a rickettsial exanthematous febrile disease, has designated as a reportable communicable disease in Taiwan since 1955, only Pescadores island, Hualien and Taitung counties had more reported and confirmed cases. Suspected dengue fever and scrub typhus serum specimens sent from the Bureau of Health and health stations to this institute from January 1991 to December 1992 were tested for antibody to scrub typhus by indirect fluorescent antibody technique (IFA). The results showed that: 1) there were serologically positive cases in many counties except Hsinchu and Iilan, 2) the disease occurred mostly from July to October, 3) more males than females were infected and their age ranged from 21 to 60 years old with a peak of the twenties and 4) higher incidence rate in children under five years old was observed in Pescadores and Orchid islands. The above data call the attention of people and physicians to be aware of the fact that there were probable scrub typhus cases in every county in Taiwan.

Adolescent↗
PubMedDate not supplied

Seroprevalence of scrub typhus infection in patients with pyrexia at some malaria clinics in three western provinces of Thailand.

In Thailand, the epidemiological data on scrub typhus infection represents only "the tip of an iceberg" especially in malaria clinics where patients come to seek attention because of other febrile illnesses that may have initial clinical signs that are indistinguishable from malaria. The objectives of this study were to determine the prevalence of antibody titers to Orientia tsutsugamushi, and its various strains, among patients at some malaria clinics in three western provinces of Thailand. The sample was represented by 200 patients from 6 malaria clinics in Ratchaburi, Petchaburi and Kanchanaburi provinces between June and November, 1994. Blood specimens were collected with their consent. Immunofluorescent antibody assays (IFA) were used for measuring IgM and IgG antibody titers for scrub typhus infection. The results showed that the prevalence rate for scrub typhus infection (IgM and/or IgG titer > or = 50) was 59.50% (119 cases). The immunofluorescent antibody response to various strains of O. tsutsugamushi showed that co-infections with the Karp, the Gilliam and the Kato strains were the most common (found in 68.10% of cases). Geometric mean antibody titers (GMT) were highest for the Karp strain, followed by the Gilliam then Kato strains. In conclusion, this study indicates that the prevalence rate of scrub typhus is not rare in these areas.

Adolescent↗
PubMed1978

Antigenic relationships between the typhus and spotted fever groups of rickettsiae.

Paired sera from cases of epidemic typhus in Ethiopia and from probable cases of Rocky Mountain spotted fever (RMSF) in the United States were examined by microagglutination (MA) and microimmunofluorescence (micro-IF) tests for antibodies against Rickettsia prowazekii, Rickettsia typhi, Rickettsia canada, Rickettsia rickettsii, Rickettsia conorii and Ricksettsia akari. IgG and IgM antibodies against the various rickettsiae were titrated with specific fluorescein-conjugated anti-IgG and anti-IgM sera. Purified, particulate rickettsial antigens were employed in all tests. A majority of patients acutely ill with epidemic typhus produced both IgG and IgM antibodies against R. prowazekii, R. typhi and R. canada. Concurrently they produced IgG (but seldom IgM) antibodies against members of the spotted fever group. In contrast, patients ill with probably spotted fever, while producing IgG and IgM antibodies against R. rickettsii, R. conorii and R. akari, also produced both IgG and IgM antibodies with about equal frequency against members of the typhus group. It was concluded that a relatively broad antigenic relationship exists between rickettsiae of the typhus and spotted fever groups.

Agglutination Tests↗
PubMed1957

Eradication of murine typhus fever in a rural area: preliminary report.

An attempt to eradicate murine typhus fever by control of rats and rat-fleas in rural foci was carried out in Georgia between July 1953 and May 1954. Anticoagulant rat poisons and DDT powder were the principal agents used. Rats were eliminated from 89% of rat-infested premises and satisfactory flea reduction was achieved.Although premises cleared of rats have become reinfested at a rate of 25% 10-18 months after clearance, typhus fever has apparently been eliminated. On the results reported, the authors believe that eradication of murine typhus fever from rural areas is economically and practically feasible, and that plague in commensal rats may also be eliminated by measures similar to those adopted in this experiment.

Animals↗
PubMed1994

Ancestral divergence of Rickettsia bellii from the spotted fever and typhus groups of Rickettsia and antiquity of the genus Rickettsia.

The eubacterial genus Rickettsia belongs to the alpha subgroup of the phylum Proteobacteria. This genus is usually divided into three biotypes on the basis of vector host and antigenic cross-reactivity characteristics. However, the species Rickettsia bellii does not fit into this classification scheme; this organism has characteristics common to both the spotted fever group and the typhus group biotypes and also exhibits some unique features. Sequences of the 16S rRNA and 23S rRNA genes from Rickettsia rickettsii (spotted fever group), Rickettsia prowazekii (typhus group), and R. bellii were studied to determine the position of R. bellii in the rickettsial classification scheme. The 23S rRNA gene sequences described in this paper are the first 23S rRNA sequences reported for any member of the Rickettsiaceae. The 23S rRNA gene contains substantially more phylogenetic information than is contained in the 16S rRNA sequences, and the 23S rRNA gene sequence has diverged about 1.9 times faster in the three Rickettsia species which we studied. Taken together, the molecular data obtained from the two genes indicate that R. bellii is not a member of either the spotted fever group or the typhus group; rather, this organism appears to be the product of a divergence which predates the separation of the genus into the spotted fever group and the typhus group. Consequently, different combinations of the ancestral characteristics retained by R. bellii have been retained in the more derived lineages of the genus.(ABSTRACT TRUNCATED AT 250 WORDS)

Base Sequence↗
PubMedDate not supplied

Clinical features and epidemiology of tick typhus in travelers.

BACKGROUND: Epidemiologic features of tick typhus among German travelers has not been surveyed recently. METHODS: Clinical features, travel and medical histories in 78 patients with tick typhus who presented to a German outpatient clinic for Infectious and Tropical Diseases were investigated, in order to identify common epidemiological factors and potential strategies of prevention. Diagnosis was confirmed by serological detection of IgG- and IgM-antibodies to Rickettsia conorii by indirect immunofluorescence. RESULTS: The majority of patients (71.8%) had visited southern Africa prior to presentation. All patients presented with fever as the main symptom. An eschar was still present in 68 patients (87.2%) with regional lymphadenitis in 19.2%. However, only a minority of patients (17.9%) remembered a tick bite at the location of the eschar. CONCLUSION: Efforts to reduce the incidence of tick typhus in travelers should focus on preventive measures targeting behavioral changes. Avoiding tick bites during travel to endemic areas appears to be the single most important prophylactic action. Taking this into consideration, it should be possible to decrease the number of travelers returning with tick typhus significantly by adequate pretravel counseling.

Antibodies, Bacterial↗
PubMed1998

Is murine typhus re-emerging in Portugal ?

Murine typhus or endemic typhus is an infectious disease, clinically very similar to epidemic typhus, and caused by Rickettsia typhi(sometimes referred to as R. mooseri). Murine typhus was fairly common in Portugal until the 1940s, when several cases diag

Journal Article↗