ABSTRACT
Hemophagocytic lymphohistiocytosis is a rare complication in Rickettsia typhi infections. We report the case of a 2-year-old boy with sudden night-onset fever, pallor, neck adenopathy and erythematous macular rash on the thorax, thighs and buttocks. During admission, he developed hyponatremia, hypoalbuminemia, anemia, thrombocytopenia, leukopenia, neutropenia, liver damage, hemorrhages and persistent fever. No hematological improvement was observed after the initial management, neoplastic diseases were discarded by bone marrow aspiration and lymph node biopsy; hemophagocytic lymphohistiocytosis was diagnosed. By immunohistochemistry and indirect immunofluorescence, murine typhus was also diagnosed and doxycycline was started with transitory recovery. Later, the child developed kidney failure and distributive shock that evolved to cardiac arrest and death. This is the first case report in Mexico on a fatal murine typhus associated with hemophagocytic lymphohistiocytosis in which the etiology was evidenced by histopathology.
Subject(s)
Lymphohistiocytosis, Hemophagocytic/diagnosis , Rickettsia typhi/isolation & purification , Typhus, Endemic Flea-Borne/diagnosis , Animals , Bone Marrow , Child, Preschool , Dogs , Fatal Outcome , Humans , Lymphohistiocytosis, Hemophagocytic/complications , Lymphohistiocytosis, Hemophagocytic/mortality , Mexico , Mice , Typhus, Endemic Flea-Borne/complications , Typhus, Endemic Flea-Borne/mortalityABSTRACT
RESUMEN Las rickettsiosis son un grupo de enfermedades zoonóticas causadas por bacterias del género Rickettsia, transmitidas por ectoparásitos hematófagos. Debido a su cuadro clínico inespecífico (fiebre, artralgias, mialgias y exantema) es subdiagnosticada y confundida con otras de mayor prevalencia como son el dengue y Chikunguya. Dada su creciente incidencia, se han estudiado antígenos rickettsiales, así como la respuesta inmune que generan con el fin de poder desarrollar vacunas, de ellos los más destacados son las proteínas OmpA y OmpB; en recientes estudios se muestra una respuesta inmune efectiva contra esta enfermedad, por lo que la presente revisión tiene como objetivo brindar un panorama de los resultados obtenidos en estudios enfocados al desarrollo de vacunas a partir de estas proteínas.
ABSTRACT Rickettsioses are a group of zoonotic diseases caused by bacteria of the genus Rickettsia, transmitted by hematophagous ectoparasites. Due to its non-specific clinical characteristics (fever, arthralgia, myalgias and exanthema) is underdiagnosed and confused with others of greater influence such as Dengue, and Chikunguya. In attention to its increasing incidence, rickettsial antigens have been studied along with the immune response they generate, in order to develop vaccines against rickettsiosis, being OmpA and OmpB the most prominent. Recent studies indicate an effective immune response against this disease, so the present review aims to provide an overview of the results obtained in studies focusing in vaccine development using these two proteins.
ABSTRACT
During the second half of the twentieth century, neurologic sequelae associated with central nervous system impairment caused by Rickettsia rickettsii were studied widely and exclusively in the United States. We present the case of a Mexican pediatric patient with neurologic sequelae 10 years after an acute infection by R. rickettsii.
Subject(s)
Nervous System Diseases/microbiology , Rocky Mountain Spotted Fever/complications , Child , Female , Humans , Mexico , Rickettsia rickettsii , Time FactorsABSTRACT
ABSTRACT During the second half of the twentieth century, neurologic sequelae associated with central nervous system impairment caused by Rickettsia rickettsii were studied widely and exclusively in the United States. We present the case of a Mexican pediatric patient with neurologic sequelae 10 years after an acute infection by R. rickettsii.
Subject(s)
Humans , Female , Child , Rocky Mountain Spotted Fever/complications , Nervous System Diseases/microbiology , Rickettsia rickettsii , Time Factors , MexicoABSTRACT
Fungus from the Aspergillus genus mainly affects lung tissue, occurring when the integrity of the host immunesystem is compromised. The human body uses immunocompetence conditions from mechanical and enzymatic defenses and the action of the innate immune system cells and also uses adaptive responses to control infection. Neutrophils, macrophages, and dendritic cells are critical as antifungal effector cells possess surface receptors that recognize fungal structures and trigger specific responses. TLRs and Dectin-1 the most studied for this interaction. TLRs are responsible for the production and release of cytokines and Dectin-1 is essential in the phagocytosis of theparticle recognition and production of ROS. The best-studied cytokines and its crucial role in the response toAspergillus spp. are TNF-á, IFN-ã, and IL-12. In this work, we reviewed the main mechanisms related to molecularreceptors on phagocytic cells involved in the recognition of Aspergillus spp. Understanding the immune response insituations of immunocompetence and its comparison in immunodeficient organisms could provide alternatives tocontrol invasive aspergillosis.
