Manifestations neurologiques de la fièvre boutonneuse méditerranéenne : à propos de quatre observations

Alioua, Z.; Bourazza, Ahmed; Lamsyah, H.; Erragragui, Y; Boudi, O; Ghfir, M.; Mossedaq, R.; Sedrati, O.

doi:10.1016/j.revmed.2003.08.002

Cited by 14 publications

(4 citation statements)

References 5 publications

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“…Moreover, R. typhi was found to be an important cause of CNS infections in Laos, where endemic typhus is common (97). Furthermore, it has been demonstrated that the CNS is affected in MSF caused by R. conorii (98) and in the late phase of RMSF caused by R. rickettsii (4,99) and other rickettsial infections (100). Symptoms include ataxia, paresis, and paralysis (100) and resemble those observed in R. typhi-infected C57BL/6 RAG1 Ϫ/Ϫ mice.…”

Section: Discussionmentioning

confidence: 99%

Persisting Rickettsia typhi Causes Fatal Central Nervous System Inflammation

et al. 2016

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bRickettsioses are emerging febrile diseases caused by obligate intracellular bacteria belonging to the family Rickettsiaceae. Rickettsia typhi belongs to the typhus group (TG) of this family and is the causative agent of endemic typhus, a disease that can be fatal. In the present study, we analyzed the course of R. typhi infection in C57BL/6 RAG1 ؊/؊ mice. Although these mice lack adaptive immunity, they developed only mild and temporary symptoms of disease and survived R. typhi infection for a long period of time. To our surprise, 3 to 4 months after infection, C57BL/6 RAG1 ؊/؊ mice suddenly developed lethal neurological disorders. Analysis of these mice at the time of death revealed high bacterial loads, predominantly in the brain. This was accompanied by a massive expansion of microglia and by neuronal cell death. Furthermore, high numbers of infiltrating CD11b ؉ macrophages were detectable in the brain. In contrast to the microglia, these cells harbored R. typhi and showed an inflammatory phenotype, as indicated by inducible nitric oxide synthase (iNOS) expression, which was not observed in the periphery. Having shown that R. typhi persists in immunocompromised mice, we finally asked whether the bacteria are also able to persist in resistant C57BL/6 and BALB/c wild-type mice. Indeed, R. typhi could be recultivated from lung, spleen, and brain tissues from both strains even up to 1 year after infection. This is the first report demonstrating persistence and reappearance of R. typhi, mainly restricted to the central nervous system in immunocompromised mice.

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Section: Discussionmentioning

confidence: 99%

Persisting Rickettsia typhi Causes Fatal Central Nervous System Inflammation

et al. 2016

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“…MSF typically follows a benign course, but in about 6 % of the cases it may cause severe illness involving multiple organs, with a mortality of 2?5-5 % (Raoult et al, 1986;Yagupsky & Wolach, 1993). Neurological involvement has been reported in 28 % of patients and constitutes a negative prognostic factor for the outcome of the disease (Alioua et al, 2003).…”

Section: Discussionmentioning

confidence: 99%

Severe case of Mediterranean spotted fever in Greece with predominantly neurological features

Tzavella¹,

Hatzizisis²,

Vakali³

et al. 2006

Journal of Medical Microbiology

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Rickettsia conorii is endemic in Greece, though only a few cases of infection have been published to date. The case of a 58-year-old man from northern Greece with a severe form of Mediterranean spotted fever and rapid neurological deterioration is presented here. The patient received antibiotic treatment with doxycycline, showing immediate clinical and laboratory improvement. Diagnosis was confirmed later, during the second week after disease onset, by detection of elevated titres of IgM and IgG antibodies against R. conorii using an indirect immunofluorescence assay. Case reportA 58-year-old retired and previously healthy man presented himself at a peripheral hospital in northern Greece with a sudden onset of chest pain at rest and headache. Clinical, laboratory and imaging investigation, including electrocardiogram, troponin T test, stress test and echocardiogram, showed no pathological findings; the chest pain receded spontaneously and the patient was released after 2 days. One day later, at home, the patient developed high fever (39 uC) with persisting headache and diffuse myalgia. He received amoxycillin-clavulanic acid orally, and showed only a slight improvement of his symptoms. Additionally, a facial and upper limb maculopapular rash occurred 2 days later, which was considered to be an allergic side effect of the antibiotic therapy. The antibiotics were discontinued and the patient received antihistamines. He still complained of headache, myalgia and subfebrile temperatures. The next day (6 days after disease onset) the patient suddenly developed confusion, for which reason he was transferred to our department immediately. Clinical examination at admission revealed an axillary body temperature of 37?8 uC and a fading diffuse macupapular rash with no signs of lymphadenopathy. Neurological examination of the patient showed confusion, ataxia and dysarthria without neck stiffness or any focal neurological findings. Although a history of tick exposure was denied, a black necrotic scabbed lesion of 5 mm in diameter was found on the patient's left thumb. ). Blood-gas analysis revealed hypoxaemia (pO 2 60 mm Hg, pCO 2 35 mm Hg, pH 7?4). The cerebrospinal fluid showed a slight pleocytosis (12 cells mm 23 , 90 % polymorphonuclear) and an increased level of protein (53 mg dl 21 ). A CT (computed tomography) scan and ultrasound of the abdomen showed mild enlargement of liver and spleen without lymphadenopathy. Chest X-ray, CT scan and magnetic resonance imaging of the head, as well as an encephalogram, were normal.The patient remained haemodynamically stable, but deteriorated neurologically within the first 24 h after admission, in spite of additional intravenous therapy with dexamethasone and mannitol. Due to clinical findings (diffuse macupapular rash, fever, headache, myalgia, inoculation eschar) and laboratory findings (thrombocytopenia, elevated alanine and aspartate aminotransferase) a rickettsial infection was suggested, so antibiotic therapy with doxycycline (200 mg per day, orally) was started on the eighth...

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“…Typical clinical symptoms include high fever, myalgia, cervical lymphadenopathy, headache, and a generalized maculopapular rash. Neurological manifestations have been reported in up to 28% of patients [ 105 ]; however, the effects on the peripheral nervous system are considered extremely rare. Rh.…”

Section: Tick-transmitted Bacteria and Diseases And Associated Tick Speciesmentioning

confidence: 99%

Tick-Borne Pathogens and Diseases in Greece

Efstratiou

Karanis

2021

Microorganisms

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Tick-borne diseases (TBDs) are recognized as a serious and growing public health epidemic in Europe, and are a cause of major losses in livestock production worldwide. This review is an attempt to present a summary of results from studies conducted over the last century until the end of the year 2020 regarding ticks, tick-borne pathogens, and tick-borne diseases in Greece. We provide an overview of the tick species found in Greece, as well as the most important tick-borne pathogens (viruses, bacteria, protozoa) and corresponding diseases in circulation. We also consider prevalence data, as well as geographic and climatic conditions. Knowledge of past and current situations of TBDs, as well as an awareness of (risk) factors affecting future developments will help to find approaches to integrated tick management as part of the ‘One Health Concept’; it will assist in avoiding the possibility of hotspot disease emergencies and intra- and intercontinental transmission. Increased surveillance in Greece is required to ensure clear and effective policies for TBD control.

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Manifestations neurologiques de la fièvre boutonneuse méditerranéenne : à propos de quatre observations

Cited by 14 publications

References 5 publications

Persisting Rickettsia typhi Causes Fatal Central Nervous System Inflammation

Persisting Rickettsia typhi Causes Fatal Central Nervous System Inflammation

Severe case of Mediterranean spotted fever in Greece with predominantly neurological features

Tick-Borne Pathogens and Diseases in Greece

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