Bevacizumab in choroidal neovascularization secondary to Indian tick typhus: A rare case report.

Tick typhus causes hemorrhagic lesions over the skin. Retina also shows hemorrhages and exudates. Many cases have been reported in western literature about this condition. To our best of knowledge, this is the first case report of tick typhus in India which was also associated with inflammatory choroidal neovascularization.

Imaging of rickettsial, spirochetal, and parasitic infections.

This article is an update and literature review of the clinical and neuroimaging findings of the commonly known rickettsial, spirochetal, and eukaryotic parasitic infections. Being familiar with clinical presentation and imaging findings of these infections is crucial for early diagnosis and treatment especially in patients who live in or have a travel history to endemic regions or are immunocompromised.

[What's new in clinical dermatology]. / Quoi de neuf en dermatologie clinique?

This selection reviews several topics in the news: - in internal medicine, the cardiovascular and pulmonary risk factors in progressive systemic sclerosis (circulating lupus anticoagulant, smoking, NT-pro BNP marker); the relations between lupus erythematous and polymorphic light eruption, or Jessner-Kanof syndrome; the diagnostic score of autoinflammatory syndromes; and the dysmetabolism syndrome of psoriasis; - in infectious diseases, the return of epidemic typhus; the emergence of TIBOLA rickettsiosis; the development of methicillin-resistant Staphylococcus aureus strains in both the nosocomial and community settings; and finally news on herpes group viral infections.

[Lice and lice-borne diseases in humans]. / Les poux et les maladies transmises á l'homme.

Among the three lice which parasite the human being, the human body louse, Pediculus humanus humanus, is a vector of infectious diseases. It lives and multiplies in clothes and human infestation is associated with cold weather and a lack of hygiene. Three pathogenic bacteria are transmitted by the body louse: 1) Rickettsia prowazekii, the agent of epidemic typhus of which the most recent outbreak (and the largest since World War II) was observed during the civil war in Burundi; 2) Borrelia recurrentis, the agent of relapsing fever, historically responsible of massive outbreaks in Eurasia and Africa, which prevails currently in Ethiopia and neighboring countries; 3) Bartonella quintana, the agent of trench fever, bacillary angiomatosis, chronic bacteremia, endocarditis, and lymphadenopathy. Body louse infestation, associated with a decline in social and hygienic conditions provoked by civil unrest and economic instability, is reemergent worldwide. Recently, a forth human pathogen, Acinetobacter baumannii, has been associated to the body louse.

Tifus exantemático / Exanthematous typhus

Contiene: 1. Microbiología; 2. Patogenia/fisiopatología; 3. Anatomía patológica; 4. Aspectos epidemiológicos; 5. Diagnóstico de laboratorio; 6. Diagnóstico diferencial; 7. Procedimientos para la vigilancia epidemiológica; 8. Medidas de prevención y control

[Characteristics of recombinant fragments of the protective antigen SPA of epidemic typhus pathogens]. / Kharakteristika rekombinantnykh fragmentov protektivnogo antigena SPA vozbuditelia épidemicheskogo sypnogo tifa.

Fragments of a gene for species-specific protective antigen SPA of Rickettsia prowazekii earlier cloned in lambda gt11 were recloned into the in-frame expression vector pQE30. Polypeptides encoded by these fragments were shown to be synthesized in Escherichia coli with a yield of up to 100 micrograms/ml of culture and to be accumulated in the cells as inclusion bodies. The partially purified antigens were used in enzyme immunoassay with the sera of humans convalescing from epidemic typhus, tick-borne rickettsioses, and other infectious diseases. One of two recombinant proteins was shown to react in immunoblotting and ELISA with homologous, but not with heterologous, sera. The immunoreactivities in ELISA of the recombinant antigens and heat-denatured SPA proved to be similar, but substantially lower than that of the native SPA. These data as well as the data of other investigators show that serodiagnostics of epidemic typhus using recombinant antigens remains a problem.

Rickettsial infection in five remote Orang Ulu villages in upper Rejang River, Sarawak, Malaysia.

People in 5 Orang Ulu villages in Sarawak, Malaysia were tested for rickettsial infection by Weil-Felix reaction and by indirect immunoperoxidase reaction. Of those surveyed 9.6% were positive for typhus. Of the positives, 3.8% were positive for tick typhus (7/11), scrub typhus (4/11) or endemic typhus (1/11). The incidence of typhus was higher among semi-nomadic Penans compared with the settled Kayans.

The body louse as a vector of reemerging human diseases.

The body louse, Pediculus humanus humanus, is a strict human parasite, living and multiplying in clothing. Louse infestation is associated with cold weather and a lack of hygiene. Three pathogenic bacteria are transmitted by the body louse. Borrelia recurrentis is a spirochete, the agent of relapsing fever, recently cultured on axenic medium. Historically, massive outbreaks have occurred in Eurasia and Africa, but currently the disease is found only in Ethiopia and neighboring countries. Bartonella quintana is now recognized as an agent of bacillary angiomatosis bacteremia, trench fever, endocarditis, and chronic lymphadenopathy among the homeless. Rickettsia prowazekii is the agent of epidemic typhus. The most recent outbreak (and the largest since World War II) was observed in Burundi. A small outbreak was also reported in Russia in 1997. Louse infestation appears to become more prevalent worldwide, associated with a decline in social and hygienic conditions provoked by civil unrest and economic instability.

Adenosine deaminase isoenzymes in typhoid fever.

The activity of serum adenosine deaminase and its isoenzymes (ADA1 and ADA2) was measured in the sera of 55 patients with clinically diagnosed typhoid fever, 46 of whom were seropositive for Salmonella typhi infection. At presentation 95% of the serologically positive patients had increased serum adenosine deaminase activity. The increase in activity was greater than that of other frequently measured enzymes. Isoenzyme ADA2 accounted for 84% of the activity, indicating a monocyte/macrophage origin. Results show that in patients with typhoid fever, serum adenosine deaminase, particularly its isoenzyme ADA2, may be regarded as a marker for monocyte/macrophage activation and could be valuable in diagnosis.

Comparative evaluation of a commercial enzyme immunoassay for the detection of human antibody to Rickettsia typhi.

A commercial enzyme immunoassay kit called the Dip-S-Ticks (DS) for the detection of total immunoglobulin (Ig) G and IgM human antibodies to Rickettsia typhi was evaluated. In tests with 340 serum samples from patients with diagnosed cases of rickettsial diseases, patients suffering from other febrile illnesses, and normal subjects, the DS compared favorably with the standard indirect fluorescent-antibody (IFA) test. At IFA cutoff titers of > or = 1.64 and > or = 1:128, the DS showed sensitivities of 88.2 and 91.4% and specificities of 91.8 and 87.7%, respectively. The DS test correlated significantly with both the IFA IgG (r = 0.84, P < 0.0005) and IgM (r = 0.63, P < 0.0005) titers. Only 80% of IgG and 82% of IgM IFA readings determined by two technicians were within one dilution, while the DS was more reliable, with 100% within one dot. The rapidity, reliability, and simplicity of the DS suggest that it is a suitable test for use in clinical laboratories unable to perform the IFA test.

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.

A typhus-like illness caused by acute HIV seroconversion.

A patient is described in whom an acute human immunodeficiency virus seroconversion illness occurred following a trip to southern Africa. The presentation was strikingly similar to that of African tick typhus and could only be distinguished by serological testing.

PIP: Physicians admitted a 27-year-old man to the Hospital for Tropical Diseases in London, England because he had had a fever for 2 days (39 degrees Celsius) and a generalized erythematous maculo-papular rash for 1 day. These symptoms appeared soon after returning from a 5-month visit to Botswana, South Africa, and Zimbabwe. Much of his visit included visits to rural areas where insects bit him frequently. He experienced vaginal intercourse with some women, but did use condoms each time. He had his last sexual experience 10 days before becoming ill. When the physicians examined the patient, they noted many small palatal ulcers, bilateral inguinal lymphadenopathy, and a 5 mm diameter nontender ulcer of the glans penis. At this point, they believed he suffered from tick typhus and primary syphilis. Laboratory tests showed 29% of his white blood cells to be lymphocytes and Treponema pallidum in the penile ulcer exudate. The physicians then prescribed daily intramuscular injections of 600 mg procaine penicillin for 10 days. The rash vanished 2 days and the fever and ulcers vanished 5 days after treatment began. Blood tests later done while still in the hospital revealed him to be HIV-I p24 antigen positive, but anti-HIV-I and -II negative. 2 months later, however, he tested HIV-I positive, but negative for rickettsiae, arboviruses, cytomegalovirus, and enteroviruses. Since he later tested HIV positive and negative for pathogens causing typhus, it was concluded that his typhuslike illness was a result of acute HIV seroconversion. Other physicians have also noted similar manifestations of seroconversion in HIV positive patients. They recommended that physicians should consider HIV seroconversion illness when a patient who recently traveled to the tropics or is sexually active exhibits an acute febrile condition with maculo-papular rash.

Fiebre tifoidea en Cartagena / Typhoid fever in Cartagena

Se revisaron 92 historias con diagnostico de fiebre tifoidea comprobada bacteriologicamente que se presentaron en el Hospital Universitario de Cartagena en el periodo comprendido entre enero de 1976 y diciembre de 1987. Se describen los hallazgos epidemiologicos, sintomas, signos, examenes de laboratorio y tratamiento. Se comparan estos resultados ( de una forma endemica de la enfermedad) con otros tres estudios colombianos, encontrando diferencias entre las formas epidemicas y endemicas. Se dicuten nuevos metodos diagnosticos (serologicos) y modalidades terapeuticas prometedoras

[An indirect solid-phase immunoenzyme method in diagnosing rickettsial infections]. / Nepriamoi tverdofaznyi immunofermentnyi metodom (iTIFM) v diagnostike rikketsiozov.

Sera of Brill-Zinsser disease patients (70 samples) Q fever patients (12 samples) and healthy persons from Q fever enzootic areas (99 samples) were studied in indirect solid phase enzyme immunoassay (ELISA), indirect immunofluorescent antibody test (IFA) and indirect passive hemahglutination test. ELISA and IFA have been proved as most sensitive tests for detection of rickettsial antibodies in both clinical and retrospective diagnosis of Rickettsial diseases.