Prospective Evaluation of Rickettsioses in the Trakya (European) Region of Turkey and Atypic Presentations of Rickettsia Conorii (original) (raw)
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Serologic Study of Rickettsioses among Acute Febrile Patients in Central Tunisia
Annals of the New York Academy of Sciences, 2006
Although Mediterranean spotted or "boutonneuse" fever (MSF) has been documented in central Tunisia, other spotted fever group rickettsioses (SFGR) and typhus group rickettsioses (TGR) have received little attention in our region. We sought to determine the role of rickettsioses, Q fever, ehrlichioses, and bartonelloses among patients with acute fever. The results of this study of 47 persons with acute fever of undetermined origin are reported in this paper. We concluded that SFGR, murine typhus, and acute Q fever are common causes of acute isolate fever in summer in central Tunisia and should be investigated systematically in patients with acute fever of unknown origin.
Seroprevalance of rickettsioses among healthy individuals in Mersin province, Turkey
Türkiye Halk Sağlığı Dergisi, 2016
Objective: Studies relevant to rikettsial biology, its pathogenesis and diagnosis have increase due to the increase of rickettsioses incidents in the world, particularly over the the past two decades. We investigated the seroprevalence of the ricketsia disease in the Mersin province of Turkey. Methods: This study included 450 healthy individuals aged 5 years and over, who had attended family health centers in Mersin city center. Serum samples collected during November 2011 were evaluated. Rickettsia antibody assays were used indirect immunofluorescenc techniques.
Study of rickettsia infection in patients suffering from fever of unknown origin
2021
Introduction: FUO/ PUO (Fever/Pyrexia of Unknown Origin) is referred to when temperature is observed above 38.30C (1010F) on many occasions over a period of > 3 weeks and unable to diagnose despite 1week of thorough investigations. Different studies reported diagnosis of malaria in 5 to 50% cases; leptospirosis in 3 to 10% cases and influenza in 8 to 12% cases Dengue fever and malaria are arthropod born diseases and endemic in many parts of India during the monsoon season. Leptospirosis and scrub typhus are zoonotic infections and are widely prevalent in areas with heavy monsoon and agrarian way of life. Aim : To evaluate the study of various Rickettsia infections in patients suffering from Fever Of Unknown Origin. Objectives: To understand the occurrence of infections caused by rickettsial species in suspected cases of FUO. To increase awareness and clinical suspicion among doctors for these infections. Materials and Methods: The assay was performed using P.vulgaris OX19, OX2, O...
Unsuspected Rickettsioses among Patients with Acute Febrile Illness, Sri Lanka, 2007
Emerging Infectious Diseases, 2012
We studied rickettsioses in southern Sri Lanka. Of 883 febrile patients with paired serum samples, 156 (17.7%) had acute rickettsioses; rickettsioses were unsuspected at presentation. Additionally, 342 (38.7%) had exposure to spotted fever and/or typhus group rickettsioses and 121 (13.7%) scrub typhus. Increased awareness of rickettsioses and better tests are needed. G lobally, rickettsioses are increasingly recognized as causes of undifferentiated fever. Paired serum samples are infrequently obtained, but testing acute-phase serum alone is insensitive (IgG is initially absent) and nonspecifi c (IgG can persist for years, and IgM results represent crossreactions). Sentinel studies in Malaysia (1), Thailand (2), India (3), Laos (4), and Nepal (5) suggest that scrub and murine typhus are frequent and that misdiagnosis as enteric fever results in ineffective therapy (5). Unrecognized rickettsial species are likely present in Sri Lanka, an island connected to the southern tip of India by an underwater 30-km land bridge. Kularatne reported acute rickettsioses diagnosed by using only acute-phase serum IgM in 56 of 118 patients who had fever in hilly central Sri Lanka (6); another study in the Western Province confi rmed few (5/31cases) of suspected rickettsioses (7). Both studies were limited by selective enrollment. To characterize rickettsioses among undifferentiated febrile illnesses in southern Sri Lanka, we prospectively studied patients who came to a large hospital. The Study Consecutive patients >2 years of age with fever (>38°C tympanic) who came to Teaching Hospital Karapitiya were enrolled (8). Standardized epidemiologic and clinical data and blood were obtained during acute illness and 2-4 weeks later. During the study (March-October 2007), the atmospheric temperature ranged from 27.5°C-32°C (high) to 24°C-26°C (low), and rainfall was variable (mean 301 mm/mo, range 36-657 mm/mo). Because rickettsial species broadly cross-react within groups (9,10), paired serum samples were tested by using an IgG indirect immunofl uorescence assay (IFA) and Rickettsia rickettsii and R. typhi antigens (Focus Diagnostics, Cypress, CA, USA) to identify infections with spotted fever group (SFGR) and typhus group (TGR) rickettsial infections. Serum samples reactive at a titer of 80 were considered potentially positive and were titered. To identify scrub typhus (ST) infections, we tested paired serum samples using IgG ELISA as described (11), except for use of recombinant antigens (0.2 μg each of r56 Chimeric1, Gilliam, and Kato strains) to detect antibodies to Orientia tsutsugamushi. Comparative blind testing of 200 serum samples with an established (pooled-antigen) quantitative assay enabled validation (12). Acute rickettsioses (SFGR, TGR, and ST) required a >4-fold rise in specifi c IgG titer or its equivalent; patients with equal SFGR and TGR convalescent-phase titers were SFGR/TGR group-indeterminate. IgG (titer >160) in acutephase serum defi ned rickettsial exposure (seroprevalence). Stata IC version 11.0 (StataCorp LP, College Station, TX, USA) was used for analyses. We analyzed paired serum samples for rickettsioses for 883 (81.9%) of 1,079 patients. Median acute-convalescent phase follow-up was 21 days (intraquartile range 15−33 days). Patients with and without paired serum samples were comparable (8). Acute rickettsioses were documented in 156 (17.7%) patients (Table 1). The increase in convalescent-phase geometric mean titer was 14-fold (845) for SFGR, 17-fold (920) for TGR, and 11-fold (951) for SFGR/TGR rickettsiae. Acute rickettsioses were found in 19.7% of patients >18 years of age and 10.5% of patients <18 years of age (p = 0.003); patients with rickettisoses were older than those without rickettsioses (median age 34.5 vs. 28.0 years; p = 0.005) (Figure 1). Among patients <18 years of age, acute rickettsioses were more common in male than in female patients (14.6% vs. 5.8%; p<0.05). Patients with acute ST alone were older than those with other rickettsioses and those without rickettsioses (median 36.5 vs. 34.4 vs. 28.0 years; p = 0.02) and more likely to report rice paddy
International Journal of Current Microbiology and Applied Sciences, 2019
Rickettsial diseases are an important cause of undifferentiated acute febrile illness. The lack of classical manifestations can make their diagnosis difficult. Even though the diseases are endemic in India, they are less reported from New Delhi and surrounding regions. Aim is to estimate the seropositivity of Rickettsial infections in cases of undifferentiated acute febrile illness from a tertiary care hospital in New Delhi and to analyze their clinical profile. This prospective observational study was conducted from November 2016 to March 2018. Samples were first screened for Typhoid, Dengue, Chikungunya and Malaria. Samples seronegative for these diseases were tested further by Weil- Felix test (WFT) and clinical findings were recorded on a pre designed proforma. Data was analyzed using statistical software SPSS version 21. A total of 370 seronegative samples were tested. Out of 370 cases, 12.4% (46) cases were positive by Weil- Felix reaction and most of the cases showed titre between ≥1:80- ≥1:160. Of the positive cases, 7.29% were positive for scrub typhus (OXK) and 3.78% cases were positive for tick typhus (OX2) whereas only 1.35% cases were found positive for typhus group (OX19). The most common presentation was fever with headache and pulmonary manifestations or rashes. The most common laboratory findings were increase in AST/ALT, anaemia and thrombocytopenia. The findings of our study indicate significant presence of rickettsial diseases in cases of undifferentiated febrile illness in Delhi population.
PLOS Neglected Tropical Diseases, 2021
Background Current knowledge on Rickettsia felis infection in humans is based on sporadic case reports. Here we conducted a retrospective seroepidemiological survey of R. felis infection among febrile patients visiting a medical center in Taipei. Methodology/Principal findings A total of 122 patients with suspected rickettsioses presenting with fever of unknown origin (FUO) but tested negative for scrub typhus, murine typhus, or Q fever were retrospectively identified during 2009 to 2010. The archived serum samples were examined for the presence of antibodies against R. felis, Rickettsia japonica, and Rickettsia typhi using microimmunofluorescence (MIF) assay. Serological evidence of Rickettsia exposure was found in 23 (19%, 23/122) patients. Eight patients had antibodies reactive to R. felis, including four with current infection (a ≥4-fold increase in IgG titer between acute and convalescent sera). The clinical presentations of these four patients included fever, skin rash, lympha...
Molecular diagnosis of Rickettsia infection in patients from Tunisia
Ticks and Tick-borne Diseases, 2016
Diagnosis of rickettsioses had largely benefited from the development of molecular techniques. Unfortunately, in Tunisia, despite the large number of rickettsial cases registered every year, the Rickettsia species remain unidentified. In this study, we aimed to detect the Rickettsia species in clinical samples using molecular tests. A study was established to analyze skin biopsies, cutaneous swabs, and cerebrospinal fluid samples taken from clinically suspected patients to have rickettsial infection. Two molecular techniques were used to detect Rickettsia DNA: Quantitative Real time PCR (qPCR) and Reverse Line Blot test (RLB). An analysis of the RLB hybridization assay results revealed the presence of Rickettsia DNA in skin biopsies (40.6%) and swabs (46.7%). R. conorii was the most prevalent identified species among tested samples. Other species of interest include R. typhi and R. massiliae. Using qPCR positivity rates in skin biopsies was 63.7% against 80% in swabs. R. conorii was the most frequently detected species, followed by R. typhi. The agreement between the two techniques was 68.6% (kappa = 0.33). Molecular tests, especially using specific probes qPCR, allow for a rapid, better and confident diagnosis in clinical practice. They improve the survey of Mediterranean spotted fever which is considered to be the most important rickettsial infection in humans in Tunisia.
Seroprevalence of Rickettsial Diseases in a Tertiary Care Hospital
International Journal of Current Microbiology and Applied Sciences, 2016
Rickettsiae comprise of group of small nonmotile gram negative coccobacilli and are obligate intracellular, transmitted by arthropod vector like lice, fleas, ticks (Raghu Kumar et al., 2015). Species of Rickettsia can be categorized into spotted fever, typhus, and scrub typhus groups based on clinical manifestations (Tay et al., 2003). Rickettsial infections are one of the important causes of pyrexia of unknown origin (PUO) and this needs to be differentiated from other common febrile illnesses like enteric fever, malaria, dengue etc (Veena Mittal et al., 2012). They have a global distribution and are reported from almost all parts of
Prevalence of Rickettsial infections in a tertiary care centre
IP innovative publication pvt ltd, 2020
Introduction: Rickettsial infections are the most covert re-emerging infections of the present times. They are considered one of the important causes of Pyrexia of Unknown origin (PUO). They are often under diagnosed due to low index of suspicion, nonspecific signs and symptoms and absence of widely available sensitive and specific diagnostic tests. These diseases have a high mortality, which can be averted if diagnosed and treated early. Weil- Felix test is the cheapest and widely used test for diagnosis in India. Aim: The present study was undertaken with the objective of evaluating the patients with Febrile illness, for rickettsial infection using Weil- Felix test and study their demographic and clinical profile. Materials and Methods: Weil-Felix test was done on serum samples of 120 patients with fever since 7-10 days, from October 2017 to October 2019 and evaluated for Rickettsial infection. Detailed history, signs, symptoms were recorded. Results: Out the 120 patients, 25 showed a titre of >1:80 in OX2, OX19 and 5 cases showed titre of >1:160 in OX K. The disease was more common in children and in the cooler months. Fever, rash, headache, vomiting and pain abdomen were common symptoms. Most common signs were rash (27 cases) and conjunctival congestion (19 cases). Conclusion: Though the sensitivity and specificity of Weil-Felix test is low, it is done even today as it is the most convenient and economical test available for the diagnosis of Rickettsial infections. Prevalence of Rickettsial diseases is significant in this region and greater clinical awareness in the differential diagnosis of fevers is required for early diagnosis and treatment.