The Diagnosis of the Relapsing Fevers

Burgdorfer, Willy

doi:10.1016/b978-0-12-387050-6.50024-4

Cited by 22 publications

(9 citation statements)

References 15 publications

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“…Burgdorfer [130] expects that the immunofluorescence tests will emerge as the method of choice in the serodiagnosis of relapsing fever, as in Lyme disease. Suckling Swiss mice have long been used for the culture of relapsing fever spirochetes [130]. Spirochetes are first detected in smears of tail blood 3-6 days after inoculation.…”

Section: B Recurrentismentioning

confidence: 99%

“…Blood from the patient is examined by direct observation of unstained wet preparations by light-or darkfield microscopy or by examining thick blood films stained by light microscopy. Spirochetes are readily detected under low power because of the organism's characteristic locomotion [130]. The Giemsa stain is most commonly used for demonstration of spirochetes in thick and thin film preparations ( figure 6).…”

Section: B Recurrentismentioning

confidence: 99%

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The Body Louse as a Vector of Reemerging Human Diseases

1999

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The body louse, Pediculus humanus humanus, is a strict human parasite, living and multiplying in clothing. Louse infestation is associated with cold weather and a lack of hygiene. Three pathogenic bacteria are transmitted by the body louse. Borrelia recurrentis is a spirochete, the agent of relapsing fever, recently cultured on axenic medium. Historically, massive outbreaks have occurred in Eurasia and Africa, but currently the disease is found only in Ethiopia and neighboring countries. Bartonella quintana is now recognized as an agent of bacillary angiomatosis bacteremia, trench fever, endocarditis, and chronic lymphadenopathy among the homeless. Rickettsia prowazekii is the agent of epidemic typhus. The most recent outbreak (and the largest since World War II) was observed in Burundi. A small outbreak was also reported in Russia in 1997. Louse infestation appears to become more prevalent worldwide, associated with a decline in social and hygienic conditions provoked by civil unrest and economic instability.

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Section: B Recurrentismentioning

confidence: 99%

Section: B Recurrentismentioning

confidence: 99%

The Body Louse as a Vector of Reemerging Human Diseases

1999

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“…Laboratory confirmation of TBRF is made by the detection or isolation of spirochetes from the patient’s blood during a febrile episode [56]. A thin smear or thick drop of blood is applied to a standard glass microscope slide and stained with Wright or Giemsa stain and examined with a bright-field microscope at 1000× with oil immersion.…”

Section: Laboratory Diagnosismentioning

confidence: 99%

Tick-Borne Relapsing Fever

Dworkin

Schwan

Anderson

et al. 2008

Infectious Disease Clinics of North America

201

175

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“…Despite substantial biological differences among human spirochetes, all spirochetoses share a spirochetemic phase during the early stage of infection (6,17,20,22). Leptospires can cause hepatitis in humans.…”

mentioning

confidence: 99%

Uptake and Killing of Leptospira interrogans and Borrelia burgdorferi , Spirochetes Pathogenic to Humans, by Reticuloendothelial Cells in Perfused Rat Liver

Marangoni¹,

Aldini²,

Sambri³

et al. 2000

Infect Immun

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In situ-perfused rat livers were infused with a single dose of 1.5 ؋ 10 7 radiolabeled cells of Leptospira interrogans serovar icterohaemorrhagiae, the agent of leptospirosis, or with Borrelia burgdorferi IRS, the agent of Lyme disease. Significant (P < 0.0001) differences in the liver uptake of L. interrogans and of B. burgdorferi were observed, the uptakes being 37.4% ؎ 2.3% for L. interrogans and 60.5% ؎ 3.1% for B. burgdorferi. Leptospires, in contrast to borreliae, were recovered from the livers when liver samples were cultured in growth medium. Leptospires but not borreliae were recovered in bile within 30 min of infusion. The association of leptospires and borreliae with reticuloendothelial cells of the liver was demonstrated by immunohistochemistry. Leptospires and borreliae were found to be associated with vimentin-positive cells and not with desminpositive cells. Few leptospires but no borreliae were also seen associated with vimentin-and desmin-negative cells, suggesting the presence of leptospires outside the sinusoidal spaces, in the liver parenchyma.The spirochetes Borrelia burgdorferi and Leptospira interrogans are the etiological agents of Lyme disease and leptospirosis, respectively. Despite substantial biological differences among human spirochetes, all spirochetoses share a spirochetemic phase during the early stage of infection (6,17,20,22). Leptospires can cause hepatitis in humans. This will result in microscopic alteration in the liver, including swelling of parenchymal cells, disruption of the liver cord, enlargement of Kupffer cells, and bile stasis in biliary canaliculi (2). In Lyme disease, liver function test abnormalities are common but mild and are most often not associated with symptoms (12). Lyme disease presenting as hepatitis and jaundice has been also reported (8). The involvement of the hepatic reticuloendothelial system (RES) in host defense by phagocytosis and killing of blood-borne spirochetes has been previously demonstrated in animals. Studies by us (18) have shown significant differences in the rat liver uptake of borreliae causing Lyme disease and of borreliae involved in relapsing fevers and have also indicated that B. burgdorferi is efficiently taken up by hepatic macrophages in the absence of serum factors. Electron microscopy studies by Faine (10) showed that in experimentally infected mice leptospires are found almost entirely in Kupffer cells and also interstitially between or in parenchymal liver cells.The perfused liver has been used several times in the past few decades to study bacterial hepatic phagocytosis (5, 13, 15). We therefore used such a technique to evaluate the uptake and killing of leptospires in comparison with borreliae by the rat hepatic RES in the elimination of circulating bacteria. Although the mouse is a widely used model for experimental infections with borreliae, this study was performed with rats, since they are more suitable for liver perfusion. The applicability of rats for experimental studies on borreliae has also been shown previously...

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The Diagnosis of the Relapsing Fevers

Cited by 22 publications

References 15 publications

The Body Louse as a Vector of Reemerging Human Diseases

The Body Louse as a Vector of Reemerging Human Diseases

Tick-Borne Relapsing Fever

Uptake and Killing of Leptospira interrogans and Borrelia burgdorferi , Spirochetes Pathogenic to Humans, by Reticuloendothelial Cells in Perfused Rat Liver

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