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.

Establishment of a novel endothelial target mouse model of a typhus group rickettsiosis: evidence for critical roles for gamma interferon and CD8 T lymphocytes.

A mouse model of typhus rickettsiosis that reproduces the hematogenous dissemination to the critical target organs, including brain, lungs, heart, and kidneys, primary endothelial and, to a lesser degree, macrophage intracellular rickettsial infection, and typical vascular-based lesions of louse-borne typhus and murine typhus was established. Intravenous inoculation of C3H/HeN mice with Rickettsia typhi caused disease with a duration of the incubation period and mortality rate that were dependent on the infective dose of rickettsiae. Lethal infection was associated with high concentrations of R. typhi in the lungs and brain, despite a brisker humoral immune response to the rickettsiae than in the sublethal infection. Gamma interferon and CD8 T lymphocytes were demonstrated to be crucial to clearance of the rickettsiae and recovery from infection in experiments in which specific monoclonal antibodies were administered to deplete these components. Death of animals depleted of gamma interferon or CD8 T lymphocytes was associated with overwhelming rickettsial infection demonstrated by titers of infectious rickettsiae and by immunohistochemistry. An effective antirickettsial immune response was associated with elevated serum concentrations of IL-12 on Day 5 and increased secretion of IL-12 by concanavalin-A-stimulated spleen cells on Day 5. Evidence for transient suppression of the immune response consisted of marked reduction in the secretion of IL-2 and IL-12 by concanavalin-A-stimulated spleen cells on Days 10 and 15. This model offers excellent opportunities for study of attenuation and pathogenetic mechanisms of typhus rickettsiae, which are established biologic weapons of potential use in bioterrorism.

Epidemiologic classics.

Epidemiology is the study of the relationships of the various factors determining the frequency and distribution of disease in a human community; the field of medicine concerned with the determination of the specific causes of localized outbreaks such as hepatitis,..., or any other disease of recognized etiology.

A search for the epidemic typhus agent in Ethiopian ticks.

The presence of antibodies to Rickettsia prowazeki in domestic animals from several parts of Africa, and the isolation of this rickettsia from the blood of goats and sheep and from ticks off cattle or camels in Ethiopia, led to the hypothesis that R. prowazeki in nature may occur in an extrahuman cycle involving ticks and domestic animals. This study attempted to recover R. prowazeki from 2 624 ticks (4 genera, 10 species) collected in central and southern Ethiopia. The ticks were examined by the haemolymph test and by the injection of tissues into guineapigs. No strains of typhus rickettsia were received and there was no serologic evidence suggesting the presence of this agent in any of the ticks examined. One Amblyomma cohaerens contained an organism that reacted specifically with fluorescing antibodies against R. prowazeki; attempts to isolate and identify this agent failed. Fifty-seven (2.2%) Amblyomma ticks (26 A. gemma, 17 A. variegatum, 14 A. cohaerens) were infected with rickettsiae of the spotted fever group, and probably represented R. conori or closely related rickettsial agents.