Laboratory diagnosis of rickettsioses: current approaches to diagnosis of old and new rickettsial diseases

This paper describes the epidemiological and clinical features of a tick-borne disease differing somewhat from other tick-borne diseases found previously in Spain. All patients were bitten by Dermacentor marginatus or a large tick. The clinical features include a crustaceous or necrotic lesion at the site of the tick's attachment, surrounded by an erythema (erythema migrans-like) and painful regional lymphadenopathies. The probable aetiological agent is Rickettsia slovaca. Similar cases have been reported in other European countries.

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“…was not considered to be a reason for exclusion, because there is a serological cross-reaction between the two Rickettsia spp. [8].…”

Section: P a T I E N T S A N D M E T H O D S Study Sitementioning

confidence: 99%

Dermacentor-borne necrosis erythema and lymphadenopathy: clinical and epidemiological features of a new tick-borne disease

Oteo

Ibarra

Blanco

et al. 2004

Clinical Microbiology and Infection

102

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“…The sera were assayed by microimmunofluorescence for IgM, IgG and, sometimes, IgA against a large panel of antigens, comprising Rickettsia typhi, C. burnetii, Rickettsia felis, R. helvetica, R. conorii, Rickettsia israeli, R. africae, Rickettsia sibirica mongolotimonae, Rickettsia massiliae, R. slovaca, F. tularensis, Bartonella henselae, and Bartonella quintana, at the WHO Collaborative Centre for Rickettsial Research (Marseille, France), as described previously [9]. When cross-reacting antibodies with a titre > 1:64 prevented identification of the infecting agent, cross-adsorption was performed using either R. helvetica or R. conori antigens.…”

Section: Introductionmentioning

confidence: 99%

Serological evidence of Rickettsia infections in forestry rangers in north-eastern Italy

Cinco

Luzzati

Mascioli

et al. 2006

Clinical Microbiology and Infection

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The prevalence of antibodies to Rickettsiae and other tick-borne microrganisms in the sera of 181 forestry rangers from Friuli-Venezia-Giulia, Italy, was examined. Seven (3.9%) sera were positive for Rickettsia conorii and Rickettsia helvetica, as single or dual infections; four of these sera had been found previously to be positive for Borrelia burgdorferi. Antibodies to Coxiella burnetii were detected in five (2.8%) sera, four of which were also positive for B. burgdorferi. These findings indicate that patients in this north-eastern Italian region with fever subsequent to tick-bite should be investigated for Rickettsia and Coxiella infections.

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“…Criteria for the diagnosis of rickettsial infections (scrub typhus and murine typhus) were either at least a four-fold rise in specific anti-rickettsial IgG or IgM (using an immunofluorescent antibody test.) titre between paired serum samples to a titre of at least 1 : 200, or a single titer or stable IFA titre of 1:400 or greater [16].…”

Section: Confirmation Of Leptospirosismentioning

confidence: 99%

An open randomized controlled trial of desmopressin and pulse dexamethasone as adjunct therapy in patients with pulmonary involvement associated with severe leptospirosis

Niwattayakul

Kaewtasi

Chueasuwanchai

et al. 2010

Clinical Microbiology and Infection

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Pulmonary involvement in leptospirosis is emerging as a common complication of severe leptospirosis. A prospective randomized controlled trial of desmopressin or high-dose (pulse) dexamethasone as adjunctive therapy in 68 patients with pulmonary involvement associated with severe leptospirosis was conducted between July 2003 and October 2006 at five hospitals in Thailand. There were 23 patients in the desmopressin group, 22 in the pulse dexamethasone group, and 23 in a control group who received standard critical care alone. The diagnosis of leptospirosis was confirmed in 52 patients (77%). There were 15 deaths (22%), of which eight patients received desmopressin, four patients received pulse dexamethasone, and three patients received critical care alone (p 0.19). Eight patients with confirmed leptospirosis died (five patients in the desmopressin group, one in the pulse dexamethasone group and two in the control group). The mortality was not significantly different in the desmopressin group or pulse dexamethasone group compared to the control group in both intention-to-treat patients, and in patients with confirmed leptospirosis. There were no serious events associated with desmopressin treatment, although pulse dexamethasone treatment was associated with a significant increase in nosocomial infection. The results of logistic regression analysis revealed that serum bilirubin level was the only significant risk factor associated with mortality (OR 0.759, 95% CI 0.598-0.965, p 0.024). The results obtained in the present study do not support the use of either pulse dexamethasone or desmopressin as adjunct therapy for pulmonary involvement associated with severe leptospirosis.

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Laboratory diagnosis of rickettsioses: current approaches to diagnosis of old and new rickettsial diseases

Cited by 421 publications

References 163 publications

Dermacentor-borne necrosis erythema and lymphadenopathy: clinical and epidemiological features of a new tick-borne disease

Dermacentor-borne necrosis erythema and lymphadenopathy: clinical and epidemiological features of a new tick-borne disease

Serological evidence of Rickettsia infections in forestry rangers in north-eastern Italy

An open randomized controlled trial of desmopressin and pulse dexamethasone as adjunct therapy in patients with pulmonary involvement associated with severe leptospirosis

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