RESUMEN
Doenças febris agudas são comuns e frequentemente associadas com agentes infecciosos em países tropicais como o Brasil. Com manifestações clínicas inespecíficas de difícil diferenciação com uma série de doenças endêmicas como dengue, leptospirose e outras doenças fatais, a febre maculosa brasileira (FMB) raramente tem sido considerada no diagnóstico, fato que, com o consequente retardo no tratamento antimicrobiano específico, tem determinado a elevada letalidade frequentemente observada em nosso país. A dengue é uma das doenças infecciosas mais importantes e frequentes no Brasil, onde epidemias são relatadas periodicamente no estado do Rio de Janeiro...
Acute febrile diseases are common and often associated with infectious agents in tropical countries such as Brazil. With nonspecific clinical manifestations and hard to differentiate with a number of endemic diseases such as dengue, leptospirosis, and other fatal diseases, Brazilian Spotted Fever (BSF) has rarely been considered in the diagnosis, fact that with the consequent delay in the specific antimicrobial treatment, has determined high lethality often observed in our country. Dengue is one of the most important and frequent infectious diseases in Brazil, where epidemics are reported periodically in the State of Rio de Janeiro.
Asunto(s)
Humanos , Dengue , Fiebre Maculosa de las Montañas Rocosas/diagnóstico , Fiebre Maculosa de las Montañas Rocosas/transmisión , Infecciones por Rickettsiaceae/etiología , Diagnóstico Diferencial , Reacción en Cadena de la PolimerasaRESUMEN
This article is an update and literature review of the clinical and neuroimaging findings of the commonly known rickettsial, spirochetal, and eukaryotic parasitic infections. Being familiar with clinical presentation and imaging findings of these infections is crucial for early diagnosis and treatment especially in patients who live in or have a travel history to endemic regions or are immunocompromised.
Asunto(s)
Infecciones Bacterianas del Sistema Nervioso Central/diagnóstico , Infecciones Parasitarias del Sistema Nervioso Central/diagnóstico , Interpretación de Imagen Asistida por Computador , Imagen por Resonancia Magnética , Infecciones por Rickettsiaceae/diagnóstico , Fiebre Maculosa de las Montañas Rocosas , Infecciones por Spirochaetales/diagnóstico , Tomografía Computarizada por Rayos X , Infecciones Oportunistas Relacionadas con el SIDA/diagnóstico , Infecciones Oportunistas Relacionadas con el SIDA/etiología , Encéfalo/patología , Neoplasias Encefálicas/diagnóstico , Neoplasias Encefálicas/secundario , Infecciones Bacterianas del Sistema Nervioso Central/etiología , Infecciones Parasitarias del Sistema Nervioso Central/etiología , Diagnóstico Diferencial , Diagnóstico Precoz , Humanos , Enfermedad de Lyme/diagnóstico , Enfermedad de Lyme/etiología , Neurosífilis/diagnóstico , Neurosífilis/etiología , Infecciones Oportunistas/diagnóstico , Infecciones Oportunistas/etiología , Fiebre Q/diagnóstico , Fiebre Q/epidemiología , Fiebre Q/etiología , Infecciones por Rickettsiaceae/etiología , Fiebre Maculosa de las Montañas Rocosas/diagnóstico , Fiebre Maculosa de las Montañas Rocosas/etiología , Médula Espinal/patología , Infecciones por Spirochaetales/etiología , Toxoplasmosis Cerebral/diagnóstico , Toxoplasmosis Cerebral/etiología , Tifus Epidémico Transmitido por Piojos/diagnóstico , Tifus Epidémico Transmitido por Piojos/etiologíaRESUMEN
The vascular endothelium is the main target of a limited number of infectious agents, Rickettsia, Ehrlichia ruminantium, and Orientia tsutsugamushi are among them. These arthropod-transmitted obligately-intracellular bacteria cause serious systemic diseases that are not infrequently lethal. In this review, we discuss the bacterial biology, vector biology, and clinical aspects of these conditions with particular emphasis on the interactions of these bacteria with the vascular endothelium and how it responds to intracellular infection. The study of these bacteria in relevant in vivo models is likely to offer new insights into the physiology of the endothelium that have not been revealed by other models.
Asunto(s)
Endotelio Vascular/microbiología , Infecciones por Rickettsiaceae/etiología , Infecciones por Rickettsiaceae/microbiología , Rickettsiaceae/patogenicidad , Animales , Vectores Artrópodos/microbiología , Quimiocinas/biosíntesis , Citocinas/biosíntesis , Endotelio Vascular/inmunología , Endotelio Vascular/fisiopatología , Interacciones Huésped-Patógeno , Humanos , Rickettsiaceae/inmunología , Infecciones por Rickettsiaceae/transmisiónRESUMEN
Las rickettsiosis son un grupo de enfermedades producidas por bacterias pleomorfas que se comportan como parásitos intracelulares. Aunque estas enfermedades son raras en nuestro medio, la proliferación de viajes internacionales a zonas endémicas suponen un riesgo de aparición en nuestro país1. Las características generales de estas enfermedades, así como las rickettsiosis más importantes transmitidas por piojos, pulgas y ácaros, han sido descritas en un trabajo anterior. En esta revisión se exponen las características más importantes, en especial aspectos epidemiológicos y clínicos, tanto en adultos como en niños, de las rickettsiosis más frecuentes transmitidas por garrapatas, como son la fiebre de las Montañas Rocosas, la fiebre botonosa mediterránea, la fiebre Q y la ehrlichiosis (AU)
Asunto(s)
Humanos , Infecciones por Rickettsiaceae/diagnóstico , Infecciones por Rickettsiaceae/etiología , Infecciones por Rickettsiaceae/tratamiento farmacológico , Fiebre Maculosa de las Montañas Rocosas/diagnóstico , Fiebre Maculosa de las Montañas Rocosas/etiología , Fiebre Maculosa de las Montañas Rocosas/tratamiento farmacológico , Fiebre Botonosa/diagnóstico , Fiebre Botonosa/etiología , Fiebre Botonosa/tratamiento farmacológico , Fiebre Q/diagnóstico , Fiebre Q/etiología , Fiebre Q/tratamiento farmacológico , Ehrlichiosis/diagnóstico , Ehrlichiosis/etiología , Ehrlichiosis/tratamiento farmacológicoRESUMEN
Polymerase chain reaction (PCR) primers derived from a variable region of the 16S rRNA gene sequence were used to amplify DNA specifically from Ehrlichia chaffeensis (the recently proposed name for the etiologic agent of human ehrlichiosis). The 389-bp product defined by the specific primers was not detected when DNA samples from any of the other recognized species of Ehrlichia were used as amplification templates. When the PCR was applied to five suitable blood specimens obtained from patients subsequently shown to be serologically positive for E. chaffeensis, all five were positive. The same technique was applied to a total of six control blood specimens, three from febrile patients who had no serologic evidence of infection with Ehrlichia or Rickettsia species and three from patients diagnosed with Rocky Mountain spotted fever, and all six were negative. A chemiluminescent, group-specific oligonucleotide probe was shown to hybridize only with the PCR products obtained upon amplification of the five blood specimens from patients serologically diagnosed as having human ehrlichiosis. The results indicate that PCR, coupled with a nonisotopic method of confirming the identity of the PCR product, is a highly specific and efficient method of detecting the agent of human ehrlichiosis in blood. The results also suggest that E. chaffeensis is the sole etiologic agent of human ehrlichiosis in the United States. The technique was also applied to four ticks that were positive by direct immunofluorescence for Ehrlichia species, and one tick was PCR positive, indicating that E. chaffeensis DNA can be detected in ticks harboring this organism, although the sensitivity may be low.
Asunto(s)
Ehrlichia/genética , Reacción en Cadena de la Polimerasa/métodos , Infecciones por Rickettsiaceae/etiología , Animales , Secuencia de Bases , Sondas de ADN , ADN Bacteriano/sangre , ADN Bacteriano/genética , Humanos , Datos de Secuencia Molecular , ARN Bacteriano/genética , ARN Ribosómico 16S/genética , Infecciones por Rickettsiaceae/microbiología , Garrapatas/microbiologíaRESUMEN
Two previously healthy, immunocompetent men had persistent Rochalimaea henselae bacteremia with clinical relapses after courses of antibiotics to which the isolates were ultimately demonstrated susceptible in vitro. Both had sustained tick bites prior to their illnesses, thus demonstrating an association not previously identified, although suspected. The first patient had relapsing fever, constitutional symptoms, and an episode of aseptic meningitis despite therapy with amoxicillin, then with doxycycline, and then with ceftriaxone. Thereafter, he spontaneously became asymptomatic during a span of 2 months of persistent bacteremia. Finally, after 2 weeks of therapy with ceftriaxone plus gentamicin, followed by 4 weeks of therapy with oral ciprofloxacin, his bacteremia was cured. The second man had relapsing fever and constitutional symptoms after courses of tetracycline, then of chloramphenicol, and then of doxycycline. He became permanently asymptomatic after serial 2-week courses of chloramphenicol and erythromycin. The greater efficacy of lysis-centrifugation blood cultures in the recovery of R. henselae was noted.
Asunto(s)
Inmunocompetencia , Infecciones por Rickettsiaceae/microbiología , Rickettsieae/aislamiento & purificación , Adulto , Animales , Antibacterianos/farmacología , Antibacterianos/uso terapéutico , Vectores Arácnidos , Secuencia de Bases , ADN Bacteriano/análisis , Humanos , Masculino , Datos de Secuencia Molecular , Reacción en Cadena de la Polimerasa , ARN Ribosómico 16S/química , Recurrencia , Mapeo Restrictivo , Infecciones por Rickettsiaceae/tratamiento farmacológico , Infecciones por Rickettsiaceae/etiología , Rickettsieae/efectos de los fármacos , Rickettsieae/genética , GarrapatasRESUMEN
Se informa sobre tres nuevos casos de Fiebre Manchada de las Monta¿as Rocosas ocurridos en Costa Rica, dos en El Bosque, Limón y el otro en la Virgen, Sarapiquí, Heredia. Se incluyen, además, algunas consideraciones de orden epidemiológico que han caracterizado a esta rickettsiosis en Costa Rica tales como distribución geográfica, clínica, patología, diagnóstico de laboratorio y vectores
Asunto(s)
Humanos , Femenino , Infecciones por Rickettsiaceae/etiología , Costa Rica , Infecciones por Rickettsiaceae/etnologíaRESUMEN
After being passaged through 3 generations of Amblyomma hebraeum, an Ehrlichia-like agent isolated from an adult Hyalomma truncatum female became more pathogenic and elicited a disease in sheep indistinguishable from heartwater. Cross-immunity between this agent and several stocks of Cowdria ruminantium and high levels of antibody elicited by the agent against 2 stocks of C. ruminantium in the indirect fluorescent antibody test, confirmed its close relationship to Cowdria.
Asunto(s)
Enfermedades de los Bovinos/etiología , Ehrlichia/patogenicidad , Infecciones por Rickettsiaceae/veterinaria , Enfermedades de las Ovejas/etiología , Garrapatas/microbiología , Animales , Bovinos , Reacciones Cruzadas , Ehrlichia/inmunología , Rickettsia/inmunología , Infecciones por Rickettsiaceae/etiología , Pase Seriado , OvinosRESUMEN
The first case of canine ehrlichiosis in Connecticut is reported. A female Brittany spaniel from Milford presented with lethargy, anorexia, fever, petechiae, splenomegaly, thrombocytopenia, anemia, elevated serum alkaline phosphatase, lymphopenia, and hypoalbuminemia. Serologic analysis revealed antibodies to Ehrlichia canis (titer, 1:2,560). This documents a more northern geographic distribution in the United States for this infectious agent than had previously been suspected.
Asunto(s)
Enfermedades de los Perros/etiología , Infecciones por Rickettsiaceae/veterinaria , Animales , Vectores Arácnidos , Connecticut , Enfermedades de los Perros/transmisión , Perros , Ehrlichia , Femenino , Infecciones por Rickettsiaceae/etiología , Infecciones por Rickettsiaceae/transmisión , Garrapatas/microbiologíaAsunto(s)
Ehrlichia , Meningitis Aséptica/etiología , Meningitis/etiología , Infecciones por Rickettsiaceae/etiología , Rickettsiaceae , Animales , Animales Domésticos , Preescolar , Cloranfenicol/uso terapéutico , Humanos , Masculino , Meningitis Aséptica/tratamiento farmacológico , Infecciones por Rickettsiaceae/tratamiento farmacológico , Tetraciclina/uso terapéutico , ZoonosisAsunto(s)
Infecciones por Rickettsiaceae/parasitología , Infestaciones por Garrapatas/complicaciones , Animales , Niño , Preescolar , Diagnóstico Diferencial , Ehrlichia/aislamiento & purificación , Humanos , Linfopenia/etiología , Linfopenia/parasitología , Masculino , Infecciones por Rickettsiaceae/etiologíaRESUMEN
Three dogs admitted for evaluation of lameness were determined to be infected with a neutrophilic strain of Ehrlichia. Ehrlichia morulae were detected in low numbers in both synovial fluid and blood neutrophils. The dogs had rapid clinical improvement after appropriate antibiotic therapy. A diagnosis of canine ehrlichiosis easily could have been missed if morulae had not been identified. Ehrlichiosis should be considered in acutely lame dogs residing in areas enzootic for ehrlichiosis. A careful search for Ehrlichia morulae within synovial fluid and blood neutrophils should be performed. An E canis titer determination also may be helpful.
Asunto(s)
Artritis Infecciosa/veterinaria , Enfermedades de los Perros/etiología , Cojera Animal/etiología , Infecciones por Rickettsiaceae/veterinaria , Animales , Artritis Infecciosa/tratamiento farmacológico , Artritis Infecciosa/etiología , Enfermedades de los Perros/tratamiento farmacológico , Perros , Ehrlichia/aislamiento & purificación , Femenino , Cojera Animal/tratamiento farmacológico , Masculino , Infecciones por Rickettsiaceae/tratamiento farmacológico , Infecciones por Rickettsiaceae/etiologíaRESUMEN
The Ehrlichia are tick-borne rickettsial organisms that cause disease in animals throughout the world but that have been previously recognized as human pathogens only in Asia. We have identified six patients with serological evidence of recent infection with an Ehrlichia: a fourfold or greater rise or fall in titer to Ehrlichia canis. All of the patients reported recent tick bites. Rigors, myalgia, headache, nausea, and anorexia were each reported by five patients. Fever was present in all patients and was accompanied by relative bradycardia and leukopenia in five patients, thrombocytopenia and abnormal liver function test results in four, and anemia in three. Five of the six patients were treated with tetracycline hydrochloride, and all recovered. Infection with Ehrlichia should be considered in patients with unexplained febrile illnesses after tick exposure.
Asunto(s)
Mordeduras y Picaduras/complicaciones , Fiebre de Origen Desconocido/etiología , Infecciones por Rickettsiaceae/etiología , Garrapatas , Adulto , Ehrlichia , Femenino , Fiebre de Origen Desconocido/sangre , Fiebre de Origen Desconocido/fisiopatología , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Pruebas SerológicasRESUMEN
Potomac horse fever, a recently recognized disease of equines, characterized by high fever, leukopenia, and a profuse diarrhea, was studied for its etiology. An Ehrlichia organism was isolated in equine macrophage-fibroblast cell cultures and mouse macrophage cell cultures from the mononuclear cells of blood of infected horses. The agent was continuously propagated in mouse macrophage cell cultures. The organism multiplied in the cytoplasm of mouse macrophage cells and was identified by Giemsa staining, acridine orange staining, and by indirect immunofluorescence with convalescent sera from infected horses. The disease was experimentally reproduced in horses inoculated with Ehrlichia-infected cell culture material. The Ehrlichia organism was reisolated from the blood of these infected horses during the course of the disease. Antibody against the organism was detected in the sera of experimentally infected horses. This study confirmed that the new Ehrlichia organism is the etiological agent of Potomac horse fever.
Asunto(s)
Ehrlichia/aislamiento & purificación , Enfermedades de los Caballos/microbiología , Infecciones por Rickettsiaceae/veterinaria , Rickettsiaceae/aislamiento & purificación , Animales , Anticuerpos Antibacterianos/aislamiento & purificación , Células Cultivadas , Modelos Animales de Enfermedad , Ehrlichia/inmunología , Enfermedades de los Caballos/etiología , Caballos , Ratones , Infecciones por Rickettsiaceae/etiología , Infecciones por Rickettsiaceae/microbiologíaRESUMEN
The literature on tick-borne fever is reviewed. Tick-borne fever is a rickettsial disease of sheep and cattle characterised by high fever and severe leucopaenia. The causative agent, Cytoecetes phagocytophila invades the neutrophils and monocytes and is transmitted by the tick Ixodes ricinus. There is very little information on the pathogenesis and immunogenesis of the disease but there is ample evidence that infected animals are predisposed to other diseases. Animals infected with tick-borne fever resist reinfection for a variable period of time. The organisms may persist in the blood of recovered animals for up to two years. Humoral antibodies are produced two weeks after infection and continue to be detected for many months but their significance on protective immunity is not clearly established.
Asunto(s)
Enfermedades de los Bovinos/etiología , Infecciones por Rickettsiaceae/veterinaria , Enfermedades de las Ovejas/etiología , Garrapatas , Animales , Animales Salvajes/microbiología , Anticuerpos Antibacterianos/análisis , Formación de Anticuerpos , Vectores Arácnidos/microbiología , Bovinos , Enfermedades de los Bovinos/inmunología , Enfermedades de los Bovinos/transmisión , Ehrlichia/inmunología , Ehrlichia/aislamiento & purificación , Leucopenia/etiología , Leucopenia/veterinaria , Infecciones por Rickettsiaceae/etiología , Infecciones por Rickettsiaceae/inmunología , Infecciones por Rickettsiaceae/transmisión , Ovinos , Enfermedades de las Ovejas/inmunología , Enfermedades de las Ovejas/transmisión , Garrapatas/microbiologíaRESUMEN
Rhipicephalus simus Koch was removed from a human upon his return to Connecticut, U.S.A. from Kenya, Africa. This person became ill in Africa, exhibited clinical manifestations of boutonneuse fever and had a significant rise (greater than or equal to 8-fold) in IgM titer against spotted fever-group rickettsiae. Rickettsia conorii was probably the infectious agent.