When febrile illnesses develop a rash in children, parents are very concerned about a serious disease. Many rashes associated with fever are caused by infectious diseases. Rashes are generally nonspecific and play a s...When febrile illnesses develop a rash in children, parents are very concerned about a serious disease. Many rashes associated with fever are caused by infectious diseases. Rashes are generally nonspecific and play a supportive role in differential diagnosis, but for some diseases, the appearance of the rash is essential in making a diagnosis. Here is presented the case of a 4-year-old boy with high fever, headache, abdominal pain, vomiting, diarrhea, and a generalized maculo-papular rash including palms and soles. On physical examination were found a black eschar, cervical lymphadenopathy, and hepatosplenomegaly. Laboratory findings resulted in moderate leukocytosis and moderate involvement of the liver and renal function. Based on this finding, a diagnosis of Mediterranean Spotted Fever was performed. The child recovered after medication with azithromycin. Because there is no reliable test that can confirm MSF in its early stages, the diagnosis is commonly made on the basis of clinical findings, so a high index of suspicion should be maintained while evaluating a child with fever and rash.展开更多
Brazilian spotted fever and bartonellosis are zoonotic, emerging and under diagnosed diseases. Pets may be co-infected by multiple pathogens and become transmissions sources to humans. The study reports the first case...Brazilian spotted fever and bartonellosis are zoonotic, emerging and under diagnosed diseases. Pets may be co-infected by multiple pathogens and become transmissions sources to humans. The study reports the first case of active co-infection by Brazilian spotted fever and bartonellosis based on serological evidence. The authors aim to demonstrate the importance of performing systematic syndromic investigations on nonspecific febrile syndromes, guided by the epidemiological history and considering the possibility of co-infection by zoonosis sharing the same ecological niche.展开更多
Background: Spotted Fever (SF) is an acute febrile zoonosis of variable severity that typically occurs in an endemic manner with worldwide distribution. Considering that SF is a disease of significant public health im...Background: Spotted Fever (SF) is an acute febrile zoonosis of variable severity that typically occurs in an endemic manner with worldwide distribution. Considering that SF is a disease of significant public health importance, this study aims to identify the mortality profile due to SF in Brazil from 2018 to 2022. Methods: Quantitative and descriptive cross-sectional approach. Data were collected from Brazilian Spotted Fever (BSF) cases registered in the Notifiable Diseases Information System (SINAN-DATASUS) across all regions of Brazil. The data collected includes information on the following variables: year of symptom, evolution, sex, race, environment of infection, region of notification, and age group. Subsequently, the data was entered into Microsoft Excel to create tables and graphs. The chi-square test was then applied to statistically analyze the associations between qualitative variables. A modified Poisson regression model with robust variance was constructed to analyze the age group data and determine which categories had different probabilities of death. The results show the estimates obtained for prevalence ratios, as well as their respective confidence intervals and p-values. The statistical software SAS version 9.4 was used to perform the analysis and a significance level of 5% was considered. Results: From 2018 to 2022, a total of 1126 cases of BSF were reported. Out of these cases, 59.3% (668) were cured, 32.4% (364) resulted in death, 1.1% (13) died from other causes and 7.2% (81) had no recorded outcome. Regarding the region with the highest death rate, the Southeast region led with 99.45% (362) of cases, followed by the Northeast region with 0.45% (2). As for the age group, the majority (63.7%) fell between the ages of 20 and 59 years old. In terms of race/color, 52.7% of the population identified as white. Regarding the contamination environment, 39.3% were in leisure areas. The outcome of death by BSF showed statistically significant associations with sex (p-value = 0.03) and age group (p-value = 0.003). Conclusion: The profile of deaths from Brazilian Spotted Fever primarily affects individuals from the Southeast region of the country, particularly men, and whites aged 20 years or older being contaminated mainly in leisure environments. This study provides a detailed understanding of the pattern of BSP-related deaths, providing crucial information for public health authorities. These insights provide valuable support for formulating informed policies and effective BSP control and prevention strategies.展开更多
Rocky Mountain spotted fever(RMSF)is a fatal tick-borne zoonotic disease that has emerged as an epidemic in western North America since the turn of the 21st century.Along the US south-western border and across norther...Rocky Mountain spotted fever(RMSF)is a fatal tick-borne zoonotic disease that has emerged as an epidemic in western North America since the turn of the 21st century.Along the US south-western border and across northern Mexico,the brown dog tick,Rhipicephalus sanguineus,is responsible for spreading the disease between dogs and humans.The widespread nature of the disease and the ongoing epidemics contrast with historically sporadic patterns of the disease.Because dogs are amplifying hosts for the Rickettsia rickettsii bacteria,transmission dynamics between dogs and ticks are critical for understanding the epidemic.In this paper,we developed a compartment metapopulation model and used it to explore the dynamics and drivers of RMSF in dogs and brown dog ticks in a theoretical region in western North America.We discovered that there is an extended lag—as much as two years—between introduction of the pathogen to a naïve population and epidemic-level transmission,suggesting that infected ticks could disseminate extensively before disease is detected.A single large city-size population of dogs was sufficient to maintain the disease over a decade and serve as a source for disease in surrounding smaller towns.This model is a novel tool that can be used to identify high risk areas and key intervention points for epidemic RMSF spread by brown dog ticks.展开更多
Optic neuritis(ON) may be associated to a range of autoimmune or infectious diseases.We report herein a case of ON induced by Rickettsia conorii.A 53-year-old woman presented with a recent decrease in visual acuity an...Optic neuritis(ON) may be associated to a range of autoimmune or infectious diseases.We report herein a case of ON induced by Rickettsia conorii.A 53-year-old woman presented with a recent decrease in visual acuity and headache.ON was diagnosed on the basis of ophthalmologic examination and flash visual evoked potentials.Etiological investigation made in our department eliminated first autoimmune disorders(vasculitis and connective tissue diseases).Rickettsial optic neuritis was confirmed by detection of specific antibodies in serum and the negativity of other serologic tests.An association between corticosteroids and cyclines was prescribed with improvement of visual acuity.展开更多
Tick-borne diseases(TBDs)pose a substantial threat to global public health,including China.This article systematically reviews the epidemiology of TBDs in Chinese mainland between 2003 and 2023.We retrieved and analyz...Tick-borne diseases(TBDs)pose a substantial threat to global public health,including China.This article systematically reviews the epidemiology of TBDs in Chinese mainland between 2003 and 2023.We retrieved and analyzed the incidence and distribution of notable bacterial,viral,and parasitic TBDs in China,and discussed their clinical characteristics,diagnostic approaches,and vectors.Severe fever with thrombocytopenia syndrome is the leading TBD in China,with cases rapidly increasing since its first report in 2009,and a high case fatality rate of 5%–33%in patients with severe disease.Other TBDs reported in China include spotted fever group rickettsiosis,human granulocytic anaplasmosis,Lyme borreliosis,babesiosis,and tick-borne encephalitis.Infections with emerging tick-borne pathogens,such as Yezo virus and Beiji nairovirus,have appeared very recently.Although evidence of human infection with Crimean-Congo hemorrhagic fever virus,Francisella tularensis,and Bartonella is currently unavailable,continuous monitoring of these pathogens remains necessary.This study enhances our understanding of TBDs,provides guidance for public health decisionmaking regarding important bacterial,viral,and parasitic TBDs,and offers new opportunities for TBD research in China.展开更多
Mediterranean spotted fever(MSF)has been diagnosed clinically in the Crimean Peninsula since the 1930s.We describe the recent illness of an elderly patient from Crimea who had developed a classic triad of MSF symptoms...Mediterranean spotted fever(MSF)has been diagnosed clinically in the Crimean Peninsula since the 1930s.We describe the recent illness of an elderly patient from Crimea who had developed a classic triad of MSF symptoms consisting of fever,maculopapular rash,and eschar.Clinical diagnosis of rickettsiosis was confirmed using real-time PCR and sequencing of 4 Rickettsia protein genes.The strain causing clinical illness was characterized as Rickettsia conorii subspecies conorii Malish 7.This report corroborates the utility of eschar swab material as a source of DNA for PCR-based diagnostics that enables timely patient treatment and management.展开更多
Background:In this study,we present a case of Japanese spotted fever(JSF)caused by Rickettsia japonica and use this case to investigate the process of diagnosing and reintegrating traceability of infectious diseases v...Background:In this study,we present a case of Japanese spotted fever(JSF)caused by Rickettsia japonica and use this case to investigate the process of diagnosing and reintegrating traceability of infectious diseases via metagenomic next-generation sequencing(mNGS).Methods:From data relating to epidemiological history,clinical and laboratory examinations,and mNGS se-quencing,a diagnosis of severe JSF was concluded.Results:A detailed field epidemiological investigation discovered parasitic Haemaphysalis longicornis from a host animal(dog)in the domicile of the patient,within which R.japonica was detected,along with a diverse array of other potentially pathogenic microorganisms that could cause other infectious diseases.Conclusion:The mNGS provided an efficient method to diagnose JSF infection.This methodology could also be applied to field epidemiological investigations to establish the traceability of infectious diseases.展开更多
Background:Tetracyclines,such as minocycline(MINO),are widely used in the treatment of infectious diseases.Japanese spotted fever(JSF)is usually treated with MINO.When MINO alone is ineffective in treating severe case...Background:Tetracyclines,such as minocycline(MINO),are widely used in the treatment of infectious diseases.Japanese spotted fever(JSF)is usually treated with MINO.When MINO alone is ineffective in treating severe cases of JSF with complications,patients can be successfully treated with tetracycline combined with a quinolone such as ciprofloxacin(CPFX).However,the mechanisms underlying the efficacy of combination therapies remain unclear.We focused on cytokine suppression caused by antimicrobial agents.Methods:THP-1 cells(2×10^(5)/mL)were stimulated with 0.1μg/mL lipopolysaccharide(LPS)and various con-centrations of CPFX,MINO,or CPFX+MINO.TNF-𝛼levels in the supernatant were measured using enzyme-linked immunosorbent assay(ELISA)after 4 h of stimulation.Results:MINO or CPFX alone significantly inhibited TNF-𝛼and chemokine production,and their combination exerted an even greater inhibitory effect than either drug alone.Conclusions:Combination therapy with MINO and CPFX enhanced the inhibitory effects on inflammatory cytokine and chemokine production in vitro.This combination therapy is expected to provide both antimicrobial and anti-inflammatory effects.Enhanced cytokine modulation by antibiotics may be a key mechanism in the treatment of severe infectious diseases such as JSF.展开更多
文摘When febrile illnesses develop a rash in children, parents are very concerned about a serious disease. Many rashes associated with fever are caused by infectious diseases. Rashes are generally nonspecific and play a supportive role in differential diagnosis, but for some diseases, the appearance of the rash is essential in making a diagnosis. Here is presented the case of a 4-year-old boy with high fever, headache, abdominal pain, vomiting, diarrhea, and a generalized maculo-papular rash including palms and soles. On physical examination were found a black eschar, cervical lymphadenopathy, and hepatosplenomegaly. Laboratory findings resulted in moderate leukocytosis and moderate involvement of the liver and renal function. Based on this finding, a diagnosis of Mediterranean Spotted Fever was performed. The child recovered after medication with azithromycin. Because there is no reliable test that can confirm MSF in its early stages, the diagnosis is commonly made on the basis of clinical findings, so a high index of suspicion should be maintained while evaluating a child with fever and rash.
文摘Brazilian spotted fever and bartonellosis are zoonotic, emerging and under diagnosed diseases. Pets may be co-infected by multiple pathogens and become transmissions sources to humans. The study reports the first case of active co-infection by Brazilian spotted fever and bartonellosis based on serological evidence. The authors aim to demonstrate the importance of performing systematic syndromic investigations on nonspecific febrile syndromes, guided by the epidemiological history and considering the possibility of co-infection by zoonosis sharing the same ecological niche.
文摘Background: Spotted Fever (SF) is an acute febrile zoonosis of variable severity that typically occurs in an endemic manner with worldwide distribution. Considering that SF is a disease of significant public health importance, this study aims to identify the mortality profile due to SF in Brazil from 2018 to 2022. Methods: Quantitative and descriptive cross-sectional approach. Data were collected from Brazilian Spotted Fever (BSF) cases registered in the Notifiable Diseases Information System (SINAN-DATASUS) across all regions of Brazil. The data collected includes information on the following variables: year of symptom, evolution, sex, race, environment of infection, region of notification, and age group. Subsequently, the data was entered into Microsoft Excel to create tables and graphs. The chi-square test was then applied to statistically analyze the associations between qualitative variables. A modified Poisson regression model with robust variance was constructed to analyze the age group data and determine which categories had different probabilities of death. The results show the estimates obtained for prevalence ratios, as well as their respective confidence intervals and p-values. The statistical software SAS version 9.4 was used to perform the analysis and a significance level of 5% was considered. Results: From 2018 to 2022, a total of 1126 cases of BSF were reported. Out of these cases, 59.3% (668) were cured, 32.4% (364) resulted in death, 1.1% (13) died from other causes and 7.2% (81) had no recorded outcome. Regarding the region with the highest death rate, the Southeast region led with 99.45% (362) of cases, followed by the Northeast region with 0.45% (2). As for the age group, the majority (63.7%) fell between the ages of 20 and 59 years old. In terms of race/color, 52.7% of the population identified as white. Regarding the contamination environment, 39.3% were in leisure areas. The outcome of death by BSF showed statistically significant associations with sex (p-value = 0.03) and age group (p-value = 0.003). Conclusion: The profile of deaths from Brazilian Spotted Fever primarily affects individuals from the Southeast region of the country, particularly men, and whites aged 20 years or older being contaminated mainly in leisure environments. This study provides a detailed understanding of the pattern of BSP-related deaths, providing crucial information for public health authorities. These insights provide valuable support for formulating informed policies and effective BSP control and prevention strategies.
基金This project was funded by the Pacific Southwest Regional Center of Excellence for Vector-borne Diseases funded by the US Centers for Disease Control and Prevention(Cooperative Agreement 1U01CK000649).
文摘Rocky Mountain spotted fever(RMSF)is a fatal tick-borne zoonotic disease that has emerged as an epidemic in western North America since the turn of the 21st century.Along the US south-western border and across northern Mexico,the brown dog tick,Rhipicephalus sanguineus,is responsible for spreading the disease between dogs and humans.The widespread nature of the disease and the ongoing epidemics contrast with historically sporadic patterns of the disease.Because dogs are amplifying hosts for the Rickettsia rickettsii bacteria,transmission dynamics between dogs and ticks are critical for understanding the epidemic.In this paper,we developed a compartment metapopulation model and used it to explore the dynamics and drivers of RMSF in dogs and brown dog ticks in a theoretical region in western North America.We discovered that there is an extended lag—as much as two years—between introduction of the pathogen to a naïve population and epidemic-level transmission,suggesting that infected ticks could disseminate extensively before disease is detected.A single large city-size population of dogs was sufficient to maintain the disease over a decade and serve as a source for disease in surrounding smaller towns.This model is a novel tool that can be used to identify high risk areas and key intervention points for epidemic RMSF spread by brown dog ticks.
文摘Optic neuritis(ON) may be associated to a range of autoimmune or infectious diseases.We report herein a case of ON induced by Rickettsia conorii.A 53-year-old woman presented with a recent decrease in visual acuity and headache.ON was diagnosed on the basis of ophthalmologic examination and flash visual evoked potentials.Etiological investigation made in our department eliminated first autoimmune disorders(vasculitis and connective tissue diseases).Rickettsial optic neuritis was confirmed by detection of specific antibodies in serum and the negativity of other serologic tests.An association between corticosteroids and cyclines was prescribed with improvement of visual acuity.
文摘Tick-borne diseases(TBDs)pose a substantial threat to global public health,including China.This article systematically reviews the epidemiology of TBDs in Chinese mainland between 2003 and 2023.We retrieved and analyzed the incidence and distribution of notable bacterial,viral,and parasitic TBDs in China,and discussed their clinical characteristics,diagnostic approaches,and vectors.Severe fever with thrombocytopenia syndrome is the leading TBD in China,with cases rapidly increasing since its first report in 2009,and a high case fatality rate of 5%–33%in patients with severe disease.Other TBDs reported in China include spotted fever group rickettsiosis,human granulocytic anaplasmosis,Lyme borreliosis,babesiosis,and tick-borne encephalitis.Infections with emerging tick-borne pathogens,such as Yezo virus and Beiji nairovirus,have appeared very recently.Although evidence of human infection with Crimean-Congo hemorrhagic fever virus,Francisella tularensis,and Bartonella is currently unavailable,continuous monitoring of these pathogens remains necessary.This study enhances our understanding of TBDs,provides guidance for public health decisionmaking regarding important bacterial,viral,and parasitic TBDs,and offers new opportunities for TBD research in China.
文摘Mediterranean spotted fever(MSF)has been diagnosed clinically in the Crimean Peninsula since the 1930s.We describe the recent illness of an elderly patient from Crimea who had developed a classic triad of MSF symptoms consisting of fever,maculopapular rash,and eschar.Clinical diagnosis of rickettsiosis was confirmed using real-time PCR and sequencing of 4 Rickettsia protein genes.The strain causing clinical illness was characterized as Rickettsia conorii subspecies conorii Malish 7.This report corroborates the utility of eschar swab material as a source of DNA for PCR-based diagnostics that enables timely patient treatment and management.
基金supported by the National Natural Science Foundation of China(82273689)Key Research and Development Program of Shaanxi(2024SF-YBXM-289).
文摘Background:In this study,we present a case of Japanese spotted fever(JSF)caused by Rickettsia japonica and use this case to investigate the process of diagnosing and reintegrating traceability of infectious diseases via metagenomic next-generation sequencing(mNGS).Methods:From data relating to epidemiological history,clinical and laboratory examinations,and mNGS se-quencing,a diagnosis of severe JSF was concluded.Results:A detailed field epidemiological investigation discovered parasitic Haemaphysalis longicornis from a host animal(dog)in the domicile of the patient,within which R.japonica was detected,along with a diverse array of other potentially pathogenic microorganisms that could cause other infectious diseases.Conclusion:The mNGS provided an efficient method to diagnose JSF infection.This methodology could also be applied to field epidemiological investigations to establish the traceability of infectious diseases.
文摘Background:Tetracyclines,such as minocycline(MINO),are widely used in the treatment of infectious diseases.Japanese spotted fever(JSF)is usually treated with MINO.When MINO alone is ineffective in treating severe cases of JSF with complications,patients can be successfully treated with tetracycline combined with a quinolone such as ciprofloxacin(CPFX).However,the mechanisms underlying the efficacy of combination therapies remain unclear.We focused on cytokine suppression caused by antimicrobial agents.Methods:THP-1 cells(2×10^(5)/mL)were stimulated with 0.1μg/mL lipopolysaccharide(LPS)and various con-centrations of CPFX,MINO,or CPFX+MINO.TNF-𝛼levels in the supernatant were measured using enzyme-linked immunosorbent assay(ELISA)after 4 h of stimulation.Results:MINO or CPFX alone significantly inhibited TNF-𝛼and chemokine production,and their combination exerted an even greater inhibitory effect than either drug alone.Conclusions:Combination therapy with MINO and CPFX enhanced the inhibitory effects on inflammatory cytokine and chemokine production in vitro.This combination therapy is expected to provide both antimicrobial and anti-inflammatory effects.Enhanced cytokine modulation by antibiotics may be a key mechanism in the treatment of severe infectious diseases such as JSF.
