Case Report: Typhoid Fever and Spotted Fever Group Rickettsiosis Presenting Concomitantly in an Indian Immigrant

Cohen, Regev; Babushkin, Frida; Shapiro, Marc A.; Uda, Martina; Atiya-Nasagi, Yafit; Finn, Talya

doi:10.4269/ajtmh.17-0770

Cited by 4 publications

(4 citation statements)

References 24 publications

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“…In almost 306 cases, diagnostic samples consisted of blood [ 63 ]; occasionally, other samples alone or in conjunction with blood have been used, such as eschar swab [ 64 ], skin biopsy [ 65 ], vesicles swab [ 66 ], CSF [ 67 ], central nervous system biopsy (autoptic) [ 56 ], pleural fluid [ 68 ], liver biopsy [ 62 ] and in vectors found feeding on patients [ 69 ]. On 22 occasions, an infected tick was found while biting the patient’s skin [ 70 ].…”

Section: Resultsmentioning

confidence: 99%

Rickettsiales in the WHO European Region: an update from a One Health perspective

Guccione

Colomba

Iaria³

2023

Parasites Vectors

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Background The availability of molecular techniques has significantly increased our understanding of bacteria of the order Rickettsiales, allowing the identification of distinct species in both vector and host arthropods. However, the literature lacks studies that comprehensively summarize the vast amount of knowledge generated on this topic in recent years. The purpose of this study was to conduct a comprehensive analysis of the distribution of Rickettsiales in arthropod vectors, animals and humans in the WHO European Region in order to provide useful information to predict the emergence of certain diseases in specific geographical areas and to formulate hypotheses regarding the possible pathogenetic role of some rickettsial species in the etiology of human pathological conditions. Methods A systematic review of the literature in the PubMed and EMBASE databases was conducted following the PRISMA methodology using the search terms “Spotted fever” OR “rickettsiosis” OR “ricketts*” AND all the countries of the WHO European Region, from 1 January 2013 to 12 February 2022. Only studies that identified rickettsiae in human, animal or arthropod samples using molecular techniques were included in the review. Results A total of 467 articles considering 61 different species of Rickettsiales with confirmed or suspected human pathogenicity were analyzed in the review. More than 566 identifications of Rickettsiales DNA in human samples were described, of which 89 cases were assessed as importation cases. A total of 55 species of ticks, 17 species of fleas, 10 species of mite and four species of lice were found infected. Twenty-three species of Rickettsiales were detected in wild and domestic animal samples. Conclusion The routine use of molecular methods to search for Rickettsiales DNA in questing ticks and other blood-sucking arthropods that commonly bite humans should be encouraged. Molecular methods specific for Rickettsiales should be used routinely in the diagnostics of fever of unknown origin and in all cases of human diseases secondary to an arthropod bite or animal contact. Graphical Abstract

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Section: Resultsmentioning

confidence: 99%

Rickettsiales in the WHO European Region: an update from a One Health perspective

Guccione

Colomba

Iaria³

2023

Parasites Vectors

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“…Israelensis was diagnosed using the molecular method/PCR on an Indian traveler in Israel [ 58 ]. Another case of SFG rickettsiosis /typhoid co-infection was reported in Israel from an Indian traveler in 2018 [ 59 ]. A case of novel SFG Candidatus R. indica Tenjiku01 was reported in Japan from a traveler returning from Karnataka [ 60 ].…”

Section: Resultsmentioning

confidence: 99%

A Review of Rickettsial Diseases Other Than Scrub Typhus in India

et al. 2023

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Rickettsial diseases (RD) are widely reported all over the world. Scrub typhus (ST) is a major tropical infection which is well documented all over India. Therefore, the index of suspicion of scrub typhus is high among physicians with regard to patients presenting with acute febrile illness (AFI) and acute undifferentiated febrile illness (AUFI) in India. Rickettsial diseases other than ST (non-ST RDs), which include spotted fever group (SFG) rickettsioses and typhus group (TG) rickettsioses are not uncommon in India, but the index of suspicion is not as high as ST unless there is a history of the presence of fever with rashes and/or recent arthropod bites. This review aims to look into the Indian scenario on the epidemiology of non-ST RDs, especially the SFG and TG rickettsioses based on various investigations, spectrum of clinical presentation, challenges and gaps in knowledge to suspect and diagnose these infections.

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“…In India, concomitant infection of Salmonella and Rickettsia have been reported in some recent studies. 16 Cohen et al reported one such dual infected case and suggested that the dual infection must be considered in post-travel patients and in immigrants from developing countries. Seow et al from Singapore also reported Typhoid and Scrub Typhus Coinfection in one India Returned Traveler.…”

Section: Studies By Lin Et Al Suggested Crp [C Reactive Protein]mentioning

confidence: 99%

A prospective study on Rickettsia infections in Central India

Taraphdar,

Hawaldar,

Sodani

2024

IJMR

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Rickettsial infections are under-reported in India. The actual disease burden has been underestimated as non-specific serological tests are mostly used to diagnose these infections. The aim of this study was the detection of Rickettsia infections in clinical specimens by Real-time Polymerase Chain Reaction.A study was established to analyse blood samples taken from pyrexia of unknown origin (PUO) or undifferentiated fever cases. A total of 69 such patients, were referred/walked-in to our diagnostic centre, Indore, India between October 2021 and May 2023. The blood samples were collected in EDTA lavender (purple) top tube.Of the tested samples, 14 patients (20.3%) were positive for Rickettsia infection.Gender wise distribution revealed higher incidence (57%) of Rickettsial infections in male patients. Children were majorly infected (50% of cases); multiple infection was also noted in them, though severity was not high. Severe clinical manifestation including hospitalization was also noted in some patients. Few reports are available from India on molecular diagnosis of Rickettsia infection. Early-stage molecular diagnosis will help to stave off and prevent serious complications.

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Case Report: Typhoid Fever and Spotted Fever Group Rickettsiosis Presenting Concomitantly in an Indian Immigrant

Abstract: We present a rare case of an Indian immigrant suffering from concomitant infection of and spotted fever group. We discuss the scarce reports of dual infections from the developing world and the related diagnostic challenges.

Cited by 4 publications

References 24 publications

Rickettsiales in the WHO European Region: an update from a One Health perspective

Rickettsiales in the WHO European Region: an update from a One Health perspective

A Review of Rickettsial Diseases Other Than Scrub Typhus in India

A prospective study on Rickettsia infections in Central India

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