Epidemiologic, Clinical, and Laboratory Findings of Human Ehrlichiosis in the United States, 1988

AbstractKikuchi–Fujimoto's disease (KFD), alternatively termed histiocytic necrotizing lymphadenitis, was first described in 1972. KFD is rare in children, with most of the cases occurring between the ages of 20 and 30 years with a female-to-male ratio of 4:1. The etiology is unknown, although infectious and autoimmune mechanisms have been proposed. KFD manifests with a spectrum of nonspecific clinical symptoms and laboratory findings. KFD is without a definitive diagnostic test and is a diagnosis of exclusion, which must be differentiated from other disease processes with associated lymphadenopathy. Significant overlap in both clinical presentation and histological features with other diseases, such as non-Hodgkin lymphoma, systemic lupus erythematosus, and active tuberculosis (TB), presents challenges in diagnosis. A small number of case reports have been published describing the coexistence of KFD and active TB. Most reported cases occur in TB endemic areas. In the largest analysis of KFD, TB infection was concurrent in 2% of cases. Most of the cases occurred in adult patients. To our knowledge, there have been no pediatric cases of KFD with concurrent TB infection reported in the United States. This study describes a case of KFD with concurrent Mycobacterium tuberculosis infection in a young male from the United States.

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Human Ehrlichiosis in the United States

Ehrlichiosis ◽

10.1007/978-94-009-1998-3_9 ◽

1990 ◽

pp. 100-111 ◽

Cited By ~ 2

Author(s):

Daniel B. Fishbein

Keyword(s):

United States ◽

The United States ◽

Human Ehrlichiosis

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Coupled laboratory and field investigations resolve microbial interactions that underpin persistence in hydraulically fractured shales

Proceedings of the National Academy of Sciences ◽

10.1073/pnas.1800155115 ◽

2018 ◽

Vol 115 (28) ◽

pp. E6585-E6594 ◽

Cited By ~ 25

Author(s):

Mikayla A. Borton ◽

David W. Hoyt ◽

Simon Roux ◽

Rebecca A. Daly ◽

Susan A. Welch ◽

...

Keyword(s):

United States ◽

Microbial Communities ◽

Management Practices ◽

The United States ◽

Microbial Interactions ◽

Competitive Interactions ◽

Industrial Processes ◽

Laboratory Findings ◽

Microbial Ecosystem ◽

Field Investigations

Hydraulic fracturing is one of the industrial processes behind the surging natural gas output in the United States. This technology inadvertently creates an engineered microbial ecosystem thousands of meters below Earth’s surface. Here, we used laboratory reactors to perform manipulations of persisting shale microbial communities that are currently not feasible in field scenarios. Metaproteomic and metabolite findings from the laboratory were then corroborated using regression-based modeling performed on metagenomic and metabolite data from more than 40 produced fluids from five hydraulically fractured shale wells. Collectively, our findings show thatHalanaerobium,Geotoga, andMethanohalophilusstrain abundances predict a significant fraction of nitrogen and carbon metabolites in the field. Our laboratory findings also exposed cryptic predatory, cooperative, and competitive interactions that impact microorganisms across fractured shales. Scaling these results from the laboratory to the field identified mechanisms underpinning biogeochemical reactions, yielding knowledge that can be harnessed to potentially increase energy yields and inform management practices in hydraulically fractured shales.

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Clinical and Laboratory Findings of the First Imported Case of Middle East Respiratory Syndrome Coronavirus to the United States

Clinical Infectious Diseases ◽

10.1093/cid/ciu635 ◽

2014 ◽

Vol 59 (11) ◽

pp. 1511-1518 ◽

Cited By ~ 53

Author(s):

Minal Kapoor ◽

Kimberly Pringle ◽

Alan Kumar ◽

Stephanie Dearth ◽

Lixia Liu ◽

...

Keyword(s):

United States ◽

Middle East ◽

The United States ◽

Middle East Respiratory Syndrome ◽

Laboratory Findings ◽

Imported Case

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Limitations and Confusing Aspects of Diagnostic Testing for Neurologic Lyme Disease in the United States

Journal of Clinical Microbiology ◽

10.1128/jcm.01406-18 ◽

2018 ◽

Vol 57 (1) ◽

Cited By ~ 1

Author(s):

Elitza S. Theel ◽

Maria E. Aguero-Rosenfeld ◽

Bobbi Pritt ◽

Patricia V. Adem ◽

Gary P. Wormser

Keyword(s):

United States ◽

Lyme Disease ◽

Diagnostic Testing ◽

The United States ◽

Passive Diffusion ◽

Serum Antibodies ◽

Laboratory Findings ◽

Content Type ◽

Paired Serum ◽

Positive Results

ABSTRACTIn the United States, laboratories frequently offer multiple different assays for testing of cerebrospinal fluid (CSF) samples to provide laboratory support for the diagnosis of central nervous system Lyme disease (CNSLD). Often included among these diagnostic tests are the same enzyme immunoassays and immunoblots that are routinely used to detect the presence of antibodies toBorrelia burgdorferiin serum. However, performing these assays on CSF alone may yield positive results simply from passive diffusion of serum antibodies into the CSF. In addition, such tests are only U.S. Food and Drug Administration cleared and well validated for testing serum, not CSF. When performed using CSF, positive results from these assays do not establish the presence of intrathecal antibody production toB. burgdorferiand therefore should not be offered. The preferred test to detect intrathecal production of antibodies toB. burgdorferiis the antibody index assay, which corrects for passive diffusion of serum antibodies into CSF and requires testing of paired serum and CSF collected at approximately the same time. However, this assay also has limitations and should only be used to establish a diagnosis of CNSLD in conjunction with patient exposure history, clinical presentation, and other laboratory findings.

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Distribution of Serogroups ofNeisseria meningitidisand Antigenic Characterization of Serogroup Y Meningococci in Canada, January 1, 1999 to June 30, 2001

Canadian Journal of Infectious Diseases ◽

10.1155/2002/891673 ◽

2002 ◽

Vol 13 (6) ◽

pp. 391-396 ◽

Cited By ~ 9

Author(s):

Raymond SW Tsang ◽

Susan G Squires ◽

Wendell D Zollinger ◽

Fraser E Ashton

Keyword(s):

United States ◽

Meningococcal Disease ◽

Relative Frequency ◽

The United States ◽

Antigenic Analysis ◽

Laboratory Findings ◽

Clinical Specimens ◽

Antigenic Characterization ◽

Common Serotypes

The relative frequency of serogroups ofNeisseria meningitidisassociated with meningococcal disease in Canada during the period January 1, 1999 to June 30, 2001 was examined. Of the 552 strains ofN meningitidiscollected from clinical specimens of normally sterile sites, 191 (34.6%), 276 (50.0%), 61 (11.1%) and 23 (4.2%) were identified by serological and molecular methods as serogroups B, C, Y and W135, respectively. About half (50.8%) of the serogroup Y isolates were isolated in the province of Ontario. The two most common serotypes found were 2c and 14. Most of the serogroup Y strains isolated from patients in Ontario were serotype 2c, while serotype 14 was the most common serotype associated with disease in the province of Quebec. The two most common serosubtypes found among the serogroup Y meningococci were P1.5 and P1.2,5. Laboratory findings, based on antigenic analysis, did not suggest that these serogroup Y strains arise by capsule switching from serogroups B and C strains. This study documented a higher incidence of finding serogroup Y meningococci in clinical specimens from patients in Ontario compared to the rest of Canada, and parallels the increase in serogroup Y meningococcal disease reported in some parts of the United States.

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