Coagulation and Complement Studies in Rocky Mountain Spotted Fever

Fine, Douglas P.; Mosher, Deane F.; Yamada, Tadataka; Burke, Donald S.; Kenyon, Richard H.

doi:10.1001/archinte.1978.03630290043016

Cited by 6 publications

(2 citation statements)

References 36 publications

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“…Experimental evidence indicates that hostmediated pathogenic mechanisms, such as immunopathology (2,3,10,11,18), Shwartzman phenomenon-like blood coagulation (2,3,10,11,21), and inflammation, are not the primary mechanisms of injury in infection by Rickettsia rickettsii. Localized effects of kallikrein are probably events secondary to the primary pathogenic mechanism(s) (25).…”

mentioning

confidence: 99%

Human endothelial cell culture plaques induced by Rickettsia rickettsii

Walker¹,

Firth²,

Edgell³

1982

Infect Immun

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Primary cultures of human umbilical vein endothelial cells were inoculated with plaque-purified Rickettsia rickettsii. After adsorption of rickettsiae, monolayers were overlaid with medium containing 0.5% agarose. Small plaques appeared on day 4 postinoculation, and distinct 1to 2-mm plaques were observed on day 5. Plaquing efficiency was less than that of primary chicken embryo cells in the same medium. Human endothelial cell monolayers were susceptible to infection by R. rickettsii and underwent necrosis as demonstrated by supravital staining. The topographic association of endothelial cell necrosis and rickettsial infection in the plaque model confirmed the direct cytopathic effect of R. rickettsii on human endothelium. Uninfected cells appeared normal by supravital staining and transmission electron microscopy. This model offers the possibility of investigating rickettsial pathogenesis and mechanisms of enhanced severity of Rocky Mountain spotted fever in specific genetically determined conditions.

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mentioning

confidence: 99%

Human endothelial cell culture plaques induced by Rickettsia rickettsii

Walker¹,

Firth²,

Edgell³

1982

Infect Immun

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“…24,26 Endothelial activation may lead to widespread platelet adhesion and microvascular thrombosis, exacerbating the systemic microvascular dysfunction and increasing the likelihood of multiorgan failure. 27,28 FIGURE 2. (A) Digital necrosis complicating histologically proven purpura fulminans in a 69-year-old woman without comorbidity.…”

Section: Discussionmentioning

confidence: 99%

The Characteristics and Clinical Course of Patients with Scrub Typhus and Queensland Tick Typhus Infection Requiring Intensive Care Unit Admission: A 23-year Case Series from Queensland, Tropical Australia

Bagshaw

Stewart

Smith

et al. 2020

The American Journal of Tropical Medicine and Hygiene

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Scrub typhus and Queensland tick typhus (QTT)-rickettsial infections endemic to tropical Australia-can cause life-threatening disease. This retrospective study examined the clinical course of all patients with laboratoryconfirmed scrub typhus or QTT admitted to the intensive care unit (ICU) of a tertiary referral hospital in tropical Australia between 1997 and 2019. Of the 22 patients, 13 had scrub typhus and nine had QTT. The patients' median (interquartile range [IQR]) age was 50 (38-67) years; 14/22 (64%) had no comorbidity. Patients presented a median (IQR) of seven (5-10) days after symptom onset. Median (IQR) Acute Physiology and Chronic Health Evaluation II scores were 13 (9-17) for scrub typhus and 13 (10-15) for QTT cases (P = 0.61). Following hospital admission, the median (IQR) time to ICU admission was five (2-19) hours. The median (IQR, range) length of ICU stay was 4.4 (2.9-15.9, 0.8-33.8) days. Multi-organ support was required in 11/22 (50%), 5/22 (22%) required only vasopressor support, 2/22 (9%) required only invasive ventilation, and 4/22 (18%) were admitted for monitoring. Patients were ventilated using protective lung strategies, and fluid management was conservative. Standard vasopressors were used, indications for renal replacement therapy were conventional, and blood product usage was restrictive; 9/22 (41%) received corticosteroids. One patient with QTT died, and two (8%) additional patients with QTT developed purpura fulminans requiring digital amputation. Death or permanent disability occurred in 3/9 (33%) QTT and 0/13 scrub typhus cases (P = 0.055). Queensland tick typhus and scrub typhus can cause multi-organ failure requiring ICU care in otherwise well individuals. Queensland tick typhus appears to have a more severe clinical phenotype than previously believed.

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Rickettsioses éruptives

Hansmann¹

2009

EMC - Maladies infectieuses

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Coagulation and Complement Studies in Rocky Mountain Spotted Fever

Cited by 6 publications

References 36 publications

Human endothelial cell culture plaques induced by Rickettsia rickettsii

Human endothelial cell culture plaques induced by Rickettsia rickettsii

The Characteristics and Clinical Course of Patients with Scrub Typhus and Queensland Tick Typhus Infection Requiring Intensive Care Unit Admission: A 23-year Case Series from Queensland, Tropical Australia

Rickettsioses éruptives

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