Rickettsialpox in a patient with HIV infection

Rickettsialpox in Turkey

“…R. akari was isolated from the blood of a patient suspected of having Mediterranean spotted fever rather than rickettsialpox; this was the first human isolate of R. akari reported in >40 years ( 4 ). Recent reports of a rickettsialpox case in North Carolina ( 3 ), R. akari seropositivity found in HIV-positive intravenous drug users in the inner city of Baltimore, Maryland ( 5 ), and in Central and East Harlem, New York City ( 6 ), as well as rickettsialpox cutaneous eruption in an HIV patient in New York ( 7 ), indicate that R. akari rickettsiosis is more common than previously thought and presents the risk of sporadic outbreaks worldwide.…”

Increased Detection of Rickettsialpox in a New York City Hospital Following the Anthrax Outbreak of 2001

“…1,16 Mild leukopenia and mild thrombocytopenia have been described during the acute phase of the disease 9,11,15,16,20,22 and were seen in approximately one third of the patients we examined. In our series, the most dramatic laboratory abnormalities (a markedly elevated white blood cell count and erythrocyte sedimentation rate) were seen in the youngest patient.…”

“…Immunohistochemical staining for spotted fever group rickettsiae was performed at the Centers for Disease Control and Prevention using a previously described immunoalkaline phosphatase technique. 14,15 Briefly, a rabbit polyclonal anti-R rickettsii antibody was used as the primary antibody; this antibody is known to cross-react with other spotted fever rickettsiae, including R akari. Paired acute and convalescent phase serum specimens were obtained from 9 patients, and a single acute or convalescent phase sample was obtained from 9 patients.…”

“…16 Since the 1960s, only single case reports and small case series have been published, and most of these cases have occurred in New York City. 1,9,11,15,[17][18][19] The largest of these series described 13 patients examined during a 10-year period.…”

“…Direct immunofluorescence testing for R rickettsii in fixed, paraffin-embedded tissue was developed initially as a test for Rocky Mountain spotted fever. 12 Because R rickettsii and R akari belong to the spotted fever group of rickettsiae and their antigens have a high level of cross-reactivity, 13 immunofluorescence testing and, more recently, immunohistochemical (IHC) staining using an anti-R rickettsii antibody 14,15 have been used successfully to diagnose rickettsialpox using paraffinembedded skin biopsy specimens.…”