Factors contributing to emergence of Ehrlichia and Anaplasma spp. as human pathogens.

Ehrlichioses and anaplasmoses are caused by alpha-proteobacteria within the family of Anaplasmataceae. These diseases have been known for a long time in veterinary medicine and recently in human medicine. These tick-borne zoonoses are considered as emerging diseases. The first case of human monocytotropic ehrlichiosis occurred in 1986. Human granulocytic anaplasmosis was described as a separate entity in 1994 and ehrlichiosis caused by Ehrlichia ewingii was reported in humans in 1999. The number of cases has been rising steadily due to better diagnostic techniques and better surveillance worldwide. In this review, we will present human and animal ehrlichioses and anaplasmoses as emerging diseases and present candidate(s) for the future.

[Ticks and human tick-borne diseases in Africa]. / Tiques et maladies transmises à l'homme en Afrique.

Ticks are obligate hematophagous arthropod parasites that feed on the blood of every class of vertebrates in almost every region of the world. Tick bites can transmit bacterial, viral and parasitic diseases to humans. In this review we describe ticks and human tick-borne diseases in Africa. The first part of this article presents elements linking the morphology and biology of these acarians as well as various aspects of their taxonomy and phylogeny. The next part of the article describes the main human tick borne diseases in Africa with particular focus on spotted fever group rickettsioses, relapsing fever borrelioses, and Crimean-Congo fever. Information is also provided on Q fever and other tick-borne diseases as ehrlichioses, anaplasmoses, Lyme disease, and babesiosis that can and do occur in Africa. Finally this article describes methods used for the collection and identification of ticks and for control and prevention of tick bites as well as essential points for early diagnosis and management of patients who have been bitten by ticks.

Bickerstaff's brainstem encephalitis: a case report.

Bickerstaff's brainstem encephalitis (BBE) is a rare diagnosis different from meningoencephalitis with ophthalmoplegia, ataxia and confusion. Less than 100 cases have been described in the literature. We described the fatal case of a 69-year-old man who presented a severe consciousness disorders, distal weakness in the four limbs, and the BBE triad a few days after his admission for pneumonia.

Prognostic factors associated with severe leptospirosis.

Leptospirosis is an anthropozoonosis caused by Leptospira interrogans. It occurs worldwide and is endemic in French Polynesia. Leptospirosis is associated with a large variety of clinical symptoms. Most infections caused by leptospires are either sub-clinical or of very mild severity, but 5-10% of infections result in multiple organ damage, including kidney, liver and lung lesions. Among 71 patients hospitalised in Papeete for severe leptospirosis during a period of 2 years, the main risk-factors for a severe outcome were hypotension, oliguria and an abnormal chest auscultation at the first physical examination. Survival depends on rapid diagnosis and early appropriate management. Well-defined criteria may help physicians to improve the timely treatment of high-risk patients.

Schistosomiasis as an unusual cause of appendicitis.

Millions of people originating from tropical areas now live outside the country of their birth. As a consequence, the number of cases of diseases imported from the tropics and being seen by European physicians in immigrants is growing. As an example of such diseases, schistosomal appendicitis is a specific trait of infection with Schistosoma haematobium and is an uncommon cause of appendicitis in non-endemic areas. Treatment requires anti-schistomal medication in addition to surgery. Physicians, including surgeons, need to be aware of the possibility of seeing atypical presentations of parasitic diseases in immigrant patients.