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1.
Ter Arkh ; 89(11): 35-43, 2017.
Artículo en Ruso | MEDLINE | ID: mdl-29260744

RESUMEN

Ixodes tick-borne borreliosis caused by Borrelia miyamotoi (ITBB-BM) is a previously unknown infectious disease discovered in Russia. AIM: The present study continues the investigation of the clinical features of ITBB-BM in the context of an immune system-pathogen interaction. SUBJECTS AND METHODS: The study enrolled 117 patients with ITBB-BM and a comparison group of 71 patients with Lyme disease (LD) that is ITBB with erythema migrans. All the patients were treated at the New Hospital, Yekateringburg. More than 100 clinical, epidemiological and laboratory parameters were obtained from each patient's medical history and included in the general database. A subset of patients hospitalized in 2015 and 2016 underwent additional laboratory examinations. Namely, the levels of B. miyamotoi-specific IgM and IgG antibodies were measured by the protein microarray containing GlpQ protein and four variable major proteins (VMPs): Vlp15/16, Vlp18, Vsp1, and Vlp5. The blood concentration of Borrelia was estimated by quantitative real-time PCR. RESULTS: In contrast to LD, first of all (p<0.001) the following clinical features were typical for ITBB-BM: the absence of erythema migrans (in 95% of patients), fever (93%), fatigue (96%), headache (82%), chill (41%), nausea (28%), lymphopenia (56%), thrombocytopenia (46%), the abnormal levels of alanine aminotransferase (54%) and C-reactive protein (98%), proteinuria (61%). Given the set of these indicators, the course of ITBB-BM was more severe in approximately 70% of patients. At admission, only 13% and 38% of patients had antibodies to GlpQ and VMPs, respectively; at discharge, antibodies to GlpQ and VMPs were detected in 88% of patients. There was no statistically significant association of the antibody response with individual clinical manifestations and laboratory parameters of the disease. However, patients with more severe ITBB-BM produced less IgM antibodies to VMPs and GlpQ at the time of discharge. CONCLUSION: ITBB-BM is a moderate systemic disease accompanied by the production of specific antibodies in virtually all patients.


Asunto(s)
Anticuerpos Antibacterianos/sangre , Proteínas Bacterianas/inmunología , Borrelia/patogenicidad , Ixodes/virología , Enfermedad de Lyme , Fiebre Recurrente , Adulto , Animales , Humanos , Enfermedad de Lyme/sangre , Enfermedad de Lyme/fisiopatología , Enfermedad de Lyme/virología , Hidrolasas Diéster Fosfóricas/inmunología , Fiebre Recurrente/sangre , Fiebre Recurrente/fisiopatología , Fiebre Recurrente/virología
3.
J Exp Med ; 175(5): 1207-12, 1992 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-1569394

RESUMEN

The Jarisch-Herxheimer Reaction (J-HR) is a clinical syndrome occurring soon after the first adequate dose of an antimicrobial drug to treat infectious diseases such as Lyme disease, syphilis, and relapsing fever. Previous attempts to identify factors mediating this reaction, that may cause death, have been unsuccessful. We conducted a prospective trial in Addis Ababa, Ethiopia on 17 patients treated with penicillin for proven louse-borne relapsing fever due to Borrelia recurrentis to evaluate the association of symptoms with plasma levels of tumor necrosis factor (TNF), interleukins 6, and 8 (IL-6 and -8). 14 of the 17 (82%) patients experienced a typical J-HR consisting of rigors, a rise in body temperature (1.06 +/- 0.2 degrees C) peaking at 2 h, leukopenia (7.4 +/- 0.6 x 10(-3) cells/mm3) at 4 h, a slight decrease, and then rise of mean arterial blood pressure. Spirochetes were cleared from blood in 5 +/- 1 h after penicillin. There were no fatalities, but constitutional symptoms were severe during J-HR. Plasma TNF, IL-6, and -8 were raised in several patients on admission, but a seven-, six-, and fourfold elevation of these plasma cytokine concentrations over admission levels was detected, respectively, occurring in transient form coincidental with observed pathophysiological changes of J-HR. Elevated plasma cytokine levels were not detected in the three patients who did not suffer J-HR. We conclude that the severe pathophysiological changes characterizing the J-HR occurring on penicillin treatment of louse-borne relapsing fever are closely associated with transient elevation of plasma TNF, IL-6, and -8 concentrations.


Asunto(s)
Interleucina-6/sangre , Interleucina-8/sangre , Fiebre Recurrente/sangre , Factor de Necrosis Tumoral alfa/metabolismo , Adolescente , Adulto , Humanos , Cinética , Masculino , Fiebre Recurrente/fisiopatología
4.
Trop Doct ; 39(1): 34-6, 2009 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-19211422

RESUMEN

We describe the epidemiological and clinical aspects of louse-borne relapsing fever (LBRF) in a series of children attending in a rural hospital in Ethiopia during 1997-2007. From a total of 249 cases of LBRF, 154 (61.4%) were children (<15 years). The most frequent symptoms were: fever, headache, dizziness and musculoskeletal pains. The overall case fatality rate was 2.4 (10% for patients <1.1 years; 3.4% for 1.1 to 4.0 years; and 0% >4.0 years [P = 0.05]). The mortality in children was less than in adults (13.2%) (P = 0.003).


Asunto(s)
Hospitales Rurales , Fiebre Recurrente , Adolescente , Adulto , Animales , Borrelia/clasificación , Niño , Preescolar , Etiopía/epidemiología , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Phthiraptera/microbiología , Pronóstico , Fiebre Recurrente/epidemiología , Fiebre Recurrente/microbiología , Fiebre Recurrente/mortalidad , Fiebre Recurrente/fisiopatología
5.
Lancet ; 368(9529): 37-43, 2006 Jul 01.
Artículo en Inglés | MEDLINE | ID: mdl-16815378

RESUMEN

BACKGROUND: The ongoing drought in sub-Saharan countries has led to the colonisation of west African Savanna by Ornithodoros sonrai; this tick acts as a vector for Borrelia crocidurae, which causes tick-borne relapsing fever (TBRF). Our aim was to ascertain the incidence of TBRF in west Africa. METHODS: From 1990 to 2003, we monitored the incidence of TBRF in Dielmo, Senegal, by daily clinical surveillance and by blood testing of individuals with a fever. From 2002 to 2005, we investigated the presence of O sonrai in 30 villages in Senegal, Mauritania, and Mali, and measured by PCR the prevalence of B crocidurae. FINDINGS: The average incidence of TBRF over 14 years was 11 per 100 person-years (range from 4 in 1990 to 25 in 1997). All age-groups presented a high incidence of the disease. In addition to relapses, repeated infections in the same individuals were common, with some affected by up to six distinct infections during the study period. Epidemiological studies indicated that 26 of the 30 studied villages (87%) were colonised by the vector tick O sonrai and that the average B crocidurae infection rate of the vector was 31%. INTERPRETATION: The incidence of TBRF at the community level is the highest described in Africa for any bacterial disease. The presence of the vector tick in most villages investigated and its high infection rate suggest that TBRF is a common cause of fever in most rural areas of Senegal, Mauritania, and Mali.


Asunto(s)
Borrelia/aislamiento & purificación , Fiebre Recurrente/epidemiología , Adolescente , Adulto , África Occidental/epidemiología , Animales , Niño , Preescolar , Femenino , Humanos , Incidencia , Lactante , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Embarazo , Fiebre Recurrente/fisiopatología
6.
Physiol Behav ; 90(4): 656-63, 2007 Mar 16.
Artículo en Inglés | MEDLINE | ID: mdl-17275044

RESUMEN

Infection causes fever and suppression of appetite, a combination of effects which threatens normal growth in infected children. We have used an animal model to study the effects on growth of recurrent simulated Gram-positive bacterial infection. After weaning, 10 guinea pig pups underwent surgery under general anaesthesia for the implantation of temperature-sensitive radiotelemeters and thereafter were assigned to receive intramuscular injections of either 50 microg/kg muramyl dipeptide (MDP), or sterile saline. During a 30-day period corresponding to their rapid growth phase, the pups were given eight injections. MDP resulted in fevers of about 1.5 degrees C on each occasion, but no significant change in body temperature occurred after saline injections. Food intake was suppressed during each febrile episode such that 24-h intake was significantly lower on days of injections of MDP, compared to days between MDP injections in the same animals, and compared to that of animals injected with saline. The rate of weight gain of the MDP-injected guinea pigs was significantly lower than that of the control group and failed even to achieve a rate similar to the saline-injected group in their more adult-like growth phase. Plasma zinc concentration was significantly lower in MDP-compared to saline-injected animals sampled 8 days after the last injection. Our results show that recurrent fever during the growth phase of young guinea pigs results in irreversible growth failure, and that reduced food intake on days when the animals were febrile was at least partly responsible for this reduced rate of growth.


Asunto(s)
Temperatura Corporal/fisiología , Peso Corporal/fisiología , Fiebre Recurrente/fisiopatología , Acetilmuramil-Alanil-Isoglutamina , Factores de Edad , Análisis de Varianza , Animales , Animales Recién Nacidos , Temperatura Corporal/efectos de los fármacos , Peso Corporal/efectos de los fármacos , Modelos Animales de Enfermedad , Ingestión de Alimentos/efectos de los fármacos , Ingestión de Alimentos/fisiología , Cobayas , Inyecciones Intramusculares , Distribución Aleatoria , Fiebre Recurrente/inducido químicamente
8.
Arch Intern Med ; 145(5): 871-5, 1985 May.
Artículo en Inglés | MEDLINE | ID: mdl-3994463

RESUMEN

Between 1940 and 1976, two cases of tick-borne relapsing fever were reported in Colorado, but since 1977, 23 confirmed cases have occurred. All patients had fever, with a mean of 2.8 febrile episodes (range, one to six). Complications included thrombocytopenia, endophthalmitis, meningitis, abortion, in utero infection, and erythema multiforme. All treated patients were eventually cured with antibiotics, although two pregnant patients failed to be cured by their initial courses of antibiotics. Seven of 21 treated patients had Jarisch-Herxheimer reactions, three of whom required intensive care. Five of nine patients who received tetracycline at an initial dose of 5 mg/kg or more had reactions v none of four patients treated with lower doses. Possible causes of the recent increased incidence include increased physician awareness and reporting, improved diagnostic techniques, and an actual increase due to a larger population at risk. Because summertime visits to the Rocky Mountains are becoming increasingly popular, physicians elsewhere should know how to recognize and treat this condition.


Asunto(s)
Fiebre Recurrente/epidemiología , Adolescente , Adulto , Antibacterianos/efectos adversos , Antibacterianos/uso terapéutico , Presión Sanguínea/efectos de los fármacos , Niño , Preescolar , Colorado , Femenino , Fiebre/inducido químicamente , Fiebre/prevención & control , Humanos , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Fiebre Recurrente/tratamiento farmacológico , Fiebre Recurrente/fisiopatología
9.
Am J Trop Med Hyg ; 23(5): 957-61, 1974 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-4217570

RESUMEN

Fifteen grivet monkeys, Cercopithecus aethiops, were infected with an Ethiopian strain of Borrelia recurrentis, the causative agent of louse-borne relapsing fever. An initial spirochetemia occurred in all. Inactivity, fever, and leukocytosis accompanied the infections. Eight of the monkeys experienced 1 relapse and 1 monkey had 2 relapses. The relapses tended to be less severe than the initial infections. The only deaths, however, occurred in 2 of the 3 monkeys with severe relapses. The clinical course of the experimental infection in grivet monkeys closely resembles that of natural infections in man.


Asunto(s)
Modelos Animales de Enfermedad , Haplorrinos , Fiebre Recurrente , Fosfatasa Alcalina/sangre , Animales , Temperatura Corporal , Borrelia/aislamiento & purificación , Convalecencia , Femenino , Insectos Vectores , Recuento de Leucocitos , Masculino , Periodicidad , Phthiraptera , Fiebre Recurrente/sangre , Fiebre Recurrente/enzimología , Fiebre Recurrente/microbiología , Fiebre Recurrente/fisiopatología , Fiebre Recurrente/transmisión , Remisión Espontánea
10.
Am J Trop Med Hyg ; 23(5): 969-73, 1974 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-4217572

RESUMEN

Eight grivet monkeys infected with Borrelia recurrentis received tetracycline (12.5mg/kg body weight) on the 3rd or 4th day of spirochetemia. Leukopenia, fever, hyperpnea, and tachycardia developed within 2 hours as spirochete counts fell to undetectable levels. These events closely simulated the crisis in human louse-borne relapsing fever in both timing and extent.


Asunto(s)
Modelos Animales de Enfermedad , Haplorrinos , Fiebre Recurrente/fisiopatología , Animales , Sangre/microbiología , Borrelia/aislamiento & purificación , Femenino , Fiebre , Frecuencia Cardíaca , Insectos Vectores , Recuento de Leucocitos , Leucocitos/microbiología , Leucopenia/etiología , Masculino , Phthiraptera , Fiebre Recurrente/sangre , Fiebre Recurrente/complicaciones , Fiebre Recurrente/tratamiento farmacológico , Fiebre Recurrente/microbiología , Respiración , Taquicardia/sangre , Tetraciclina/uso terapéutico
11.
Trans R Soc Trop Med Hyg ; 71(1): 43-8, 1977.
Artículo en Inglés | MEDLINE | ID: mdl-871032

RESUMEN

Louse-borne relapsing fever seems to have become endemic in the southern Sudan. The epidemic history of the disease in the Sudan is reviewed. We have studied 363 Sudanese patients involved in an outbreak of louse-borne relapsing fever in Khartoum (Sudan) between January and June 1974. 318 of the 363 patients were new immigrants from the soughern Sudan to Khartoum. The clinical presentation varied. The common clinical fetures of the disease were: fever (94%), headache (85%), hepatosplenomegaly (74%), body and joint pains (66%), abdominal pain and tenderness (63%), jaundice (46%) and epistaxis (40%). Thrombocytopenia was common. Biochemical evidence of hepatocellular and renal damage was present in most patients. The mortality rate was 5-5% with treatment. Post-mortem examination was performed on six cases. The organs predominantly involved were the liver, spleen, brain and lungs. The common causes of death were severe hepatic damage, lobar pneumonia, subarachnoid haemorrhage and splenic rupture.


Asunto(s)
Fiebre Recurrente/epidemiología , Adolescente , Adulto , Anciano , Recuento de Células Sanguíneas , Niño , Femenino , Humanos , Riñón/fisiopatología , Hígado/fisiopatología , Masculino , Persona de Mediana Edad , Fiebre Recurrente/mortalidad , Fiebre Recurrente/fisiopatología , Sudán
12.
Trans R Soc Trop Med Hyg ; 79(1): 74-7, 1985.
Artículo en Inglés | MEDLINE | ID: mdl-3887684

RESUMEN

Plasma concentrations of glucose and insulin were measured in ten patients during the Jarisch-Herxheimer reaction of tetracycline-treated louse-borne relapsing fever. Plasma glucose fell significantly in eight of the ten patients associated with the peak of the reaction, but plasma insulin remained low. Glucoregulation by insulin was therefore normal. This evidence questions the role of macrophage mediator-induced pancreatic insulin release in causing hypoglycaemia in borreliosis or bacterial endotoxicosis.


Asunto(s)
Glucemia/metabolismo , Temperatura Corporal , Insulina/sangre , Fiebre Recurrente/sangre , Tetraciclina/uso terapéutico , Adolescente , Adulto , Homeostasis , Humanos , Persona de Mediana Edad , Fiebre Recurrente/tratamiento farmacológico , Fiebre Recurrente/fisiopatología
17.
Clin Microbiol Infect ; 15(5): 407-14, 2009 May.
Artículo en Inglés | MEDLINE | ID: mdl-19489923

RESUMEN

Tick-borne relapsing fever (TBRF) has been reported in Eurasia and attributed mainly to Borrelia persica, although other entities have also been described. Ornithodoros tholozani is the most important tick vector, found in India and Kashmir, the southern countries of the former USSR, Iran, Iraq, Syria, Jordan, Turkey, Israel, Egypt, and Cyprus. It inhabits caves, ruins, and burrows of rodents and small mammals. In the northern countries, O. tholozani also lives in houses and cowsheds. In Israel, 30-60% of caves were found to be infested. PCR studies of Borrelia infection of O. tholozani ticks collected in caves showed very variable rates, ranging from less than 2% to 40%. The number of human cases reported varies among countries, from eight cases per year in Israel to 72 cases per year in Iran. The incubation period is 5-9 days. The fever attacks last from several hours to 4 days, and are accompanied by chills, headache, nausea and vomiting, sweating, abdominal pain, arthralgia, and cough; complications are rare. Other described Borrelia species are Borrelia caucasica, Borrelia latyschewii, Borrelia microtii, and Borrelia baltazardi. The classic taxonomy based on the co-speciation concept is very complex and very confusing. For this reason, 16S rRNA and flaB genes were used for taxonomic clarification. Sequencing of Israeli TBRF flaB genes, from human and tick samples, has demonstrated a third cluster corresponding to the Eurasia strains, in addition to both New World and Old World clusters. Thin and thick blood smears remain the most frequently used methods for laboratory diagnosis, with a sensitivity of 80%. PCR-based diagnosis is the most sensitive method, and has the advantage of allowing species identification.


Asunto(s)
Borrelia/aislamiento & purificación , Fiebre Recurrente/epidemiología , Animales , Asia/epidemiología , Técnicas de Tipificación Bacteriana , Borrelia/clasificación , Borrelia/genética , Manejo de Caso , Análisis por Conglomerados , ADN Bacteriano/química , ADN Bacteriano/genética , Vectores de Enfermedades , Europa (Continente)/epidemiología , Genotipo , Humanos , Incidencia , Ornithodoros/microbiología , Fiebre Recurrente/fisiopatología , Análisis de Secuencia de ADN
18.
J Infect Dis ; 195(11): 1686-93, 2007 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-17471439

RESUMEN

BACKGROUND: Relapsing fever (RF) is a multisystemic spirochetal infection caused by different Borrelia species. Studies in our laboratory have shown that disease severity varies depending on the infecting serotype. However, the relative contribution of each serotype to pathogenesis during mixed infections is not known. To investigate this, we compared the outcome of infection with isogenic serotypes 1 (Bt1) or 2 (Bt2) of the RF agent B. turicatae alone or in combination. METHODS: B cell-deficient mice were used for these experiments, to avoid serotype clearance by the host's variable membrane protein-specific antibodies. Observers masked to infection status examined infected and uninfected control mice for clinical disease and functional impairment for up to 65 days. RESULTS: All mice developed persistent infection with the serotypes with which they were originally inoculated. Severe vestibular dysfunction developed in mice infected with Bt1 alone and was associated with increased morbidity and mortality. However, coinfection with Bt2 significantly reduced the severity of vestibular dysfunction and prevented earlier mortality. In contrast, coinfection with Bt1 had little effect on the severe arthritis caused by Bt2 infection. CONCLUSIONS: The manifestations of infection with B. turicatae are significantly influenced by the combination of serotypes present during mixed infection.


Asunto(s)
Borrelia/clasificación , Borrelia/patogenicidad , Fiebre Recurrente , Enfermedades Vestibulares/fisiopatología , Animales , Artritis/microbiología , Artritis/fisiopatología , Femenino , Humanos , Ratones , Ratones SCID , Fiebre Recurrente/microbiología , Fiebre Recurrente/mortalidad , Fiebre Recurrente/fisiopatología , Serotipificación , Índice de Severidad de la Enfermedad , Enfermedades Vestibulares/microbiología
19.
Am Fam Physician ; 72(10): 2039-44, 2005 Nov 15.
Artículo en Inglés | MEDLINE | ID: mdl-16342834

RESUMEN

Tick-borne relapsing fever is characterized by recurring fevers separated by afebrile periods and is accompanied by nonspecific constitutional symptoms. It occurs after a patient has been bitten by a tick infected with a Borrelia spirochete. The diagnosis of tick-borne relapsing fever requires an accurate characterization of the fever and a thorough medical, social, and travel history of the patient. Findings on physical examination are variable; abdominal pain, vomiting, and altered sensorium are the most common symptoms. Laboratory confirmation of tick-borne relapsing fever is made by detection of spirochetes in thin or thick blood smears obtained during a febrile episode. Treatment with a tetracycline or macrolide antibiotic is effective, and antibiotic resistance is rare. Patients treated for tick-borne relapsing fever should be monitored closely for Jarisch-Herxheimer reactions. Fatalities from tick-borne relapsing fever are rare in treated patients, as are subsequent Jarisch-Herxheimer reactions. Persons in endemic regions should avoid rodent- and tick-infested areas and use insect repellents and protective clothing to prevent tick bites.


Asunto(s)
Ornithodoros/patogenicidad , Fiebre Recurrente , Tetraciclinas/uso terapéutico , Animales , Humanos , Masculino , Persona de Mediana Edad , Fiebre Recurrente/diagnóstico , Fiebre Recurrente/tratamiento farmacológico , Fiebre Recurrente/fisiopatología , Estados Unidos/epidemiología
20.
Eur J Neurol ; 12(6): 449-52, 2005 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-15885049

RESUMEN

The aim of the study was to chart incidence and clinical features of tick-borne relapsing fever in Tanzania. Consecutive patients with fever and spirochetes demonstrated in a thick blood smear at Haydom Lutheran Hospital from 1 January to 31 December 2003 underwent clinical and cerebrospinal fluid (CSF) examination. Forty-four patients were included, making an estimated minimum annual incidence of 11 per 100 000 population in this region. The mortality rate was 2.3% (95% CI = 0-12). The most frequent complaints were generalized malaise (93%), headache (86%), nausea and vomiting (52%). None of the patients [0% (95% CI = 0-8)] had focal neurological symptoms. Cell count in CSF was normal in 22 and slightly elevated (6-12 leukocytes/mm(3)) in 20 patients. Two of three pregnancies had a poor outcome. Jarisch-Herxheimer reactions, bleeding complications and ocular manifestations were infrequent. In conclusion, tick-borne relapsing fever is a common disease in the Northern highland of Tanzania, but in contrast to other parts of the world, neurological involvement is uncommon in this area.


Asunto(s)
Enfermedades del Sistema Nervioso/etiología , Fiebre Recurrente/epidemiología , Fiebre Recurrente/fisiopatología , Adolescente , Adulto , Infecciones por Borrelia/líquido cefalorraquídeo , Infecciones por Borrelia/complicaciones , Infecciones por Borrelia/epidemiología , Niño , Preescolar , Intervalos de Confianza , Demografía , Femenino , Cefalea , Hemorragia , Humanos , Lactante , Masculino , Persona de Mediana Edad , Náusea , Enfermedades del Sistema Nervioso/microbiología , Fiebre Recurrente/virología , Estudios Retrospectivos , Tasa de Supervivencia , Tanzanía/epidemiología
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