Impact of C-Reactive Protein Levels on Differentiating of Severe Fever With Thrombocytopenia Syndrome From Japanese Spotted Fever

Abstract Background Severe fever with thrombocytopenia syndrome (SFTS) is an emerging viral hemorrhagic fever in China, Korea, and Japan. Japanese spotted fever (JSF), which belongs to spotted fever group rickettsioses, is also endemic to Western Japan. Patients with SFTS and those with JSF display many of the same clinical manifestations. Sudden fever, rash, tick bite, and neurological and gastrointestinal symptoms may be seen in both infections, but the frequency and severity of each disease have not been compared and studied. Because laboratory confirmation of pathogens takes time, it is important to predict diagnosis of SFTS vs JSF based on the features of the clinical characteristics at the initial presentation, particularly in primary care settings. Methods We conducted a case series review at 4 medical facilities in Miyazaki, Japan. Based on the medical records, clinical and laboratory characteristics were compared between patients with SFTS and those with JSF. Results Eighty-one patients were enrolled in this study, including 41 with SFTS and 40 with JSF. The absence of rash (P < .001), leukopenia (P < .001), and normal C-reactive protein (CRP) levels (P < .001) were the variables distinguishing SFTS from JSF. Normal CRP levels (≤1.0 mg/dL) had a 95% sensitivity (84%–99%) and 97% specificity (87%–100%) for SFTS, with a positive likelihood ratio of 37.1 (5.35–257). Conclusions Normal serum CRP levels were shown to differentiate SFTS from JSF with a very high probability.

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Classification of Tick Species and Detection of Tick-borne Pathogens in Yanbian, China

10.21203/rs.3.rs-127287/v1 ◽

2020 ◽

Author(s):

Jixu Li ◽

Shuang Zhang ◽

Wanfeng Liang ◽

Shaowei Zhao ◽

Hao Wang ◽

...

Keyword(s):

Polymerase Chain Reaction ◽

North Korea ◽

Tick Species ◽

Spotted Fever ◽

Ixodes Persulcatus ◽

Spotted Fever Group ◽

Haemaphysalis Longicornis ◽

Chain Reaction ◽

Polymerase Chain ◽

Severe Fever

Abstract BackgroundYanbian is located at the junction between China, Russia, and North Korea. We aimed to determine the species distribution and pathogens carried by ticks in Yanbian.MethodsA total of 2673 unattached ticks were collected from eight counties and cities in Yanbian and classified morphologically. Candidatus Rickettsia tarasevichiae (CRT), spotted fever group Rickettsia (SFGR), severe fever thrombocytopenia syndrome virus (SFTSV), Theileria, and other pathogens were detected using polymerase chain reaction (PCR) and real-time quantitative polymerase chain reaction followed by phylogenetic and genotypic analyses.ResultsAccording to the morphological classification, the main tick species in Yanbian were Haemaphysalis longicornis, Ixodes persulcatus, Dermacentor silvarum, Haemaphysalis japonica, and Haemaphysalis concinna. Candidatus Rickettsia tarasevichiae, spotted fever group Rickettsia, severe fever thrombocytopenia syndrome virus, and Theileria orientalis were detected in H. longicornis, Candidatus Rickettsia tarasevichiae, spotted fever group Rickettsia, and severe fever thrombocytopenia syndrome virus were detected in I. persulcatus, H. japonica, and D. silvarum, but only severe fever thrombocytopenia syndrome virus was detected in H. concinna. Mixed infection with Candidatus Rickettsia tarasevichiae and severe fever thrombocytopenia syndrome virus was found in I. persulcatus and H. japonica. The gene sequences of all tested pathogens exhibited 95.7%–100% homology with sequences registered in GenBank. Phylogenetic analysis showed that different spotted fever group Rickettsia and severe fever thrombocytopenia syndrome virus genotypes were closely related to the Korean strains. We provide the first evidence for the presence of the spotted fever group Rickettsia genotypes of Candidatus Rickettsia longicornii, ompA, ompB, sca4, and rrs, in Haemaphysalis longicornis in Yanbian. ConclusionsThese results provide epidemiological data to support the prevention and control of ticks and tick-borne diseases in the border areas of China, North Korea, and Russia.

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Spotted fever rickettsiosis in Coronel Fabriciano, Minas Gerais State

Revista da Sociedade Brasileira de Medicina Tropical ◽

10.1590/s0037-86822003000400008 ◽

2003 ◽

Vol 36 (4) ◽

pp. 479-481 ◽

Cited By ~ 12

Author(s):

Márcio Antônio Moreira Galvão ◽

Simone Berger Calic ◽

Chequer Buffe Chamone ◽

Cláudio Lísias Mafra S. ◽

Gracco Cesarino Filho ◽

...

Keyword(s):

Differential Diagnosis ◽

Spotted Fever ◽

Clinical Manifestations ◽

Minas Gerais ◽

Spotted Fever Group ◽

Minas Gerais State ◽

Brazilian Spotted Fever ◽

Spotted Fever Group Rickettsia ◽

Rickettsial Diseases

We report cases of spotted fever rickettsiosis in Coronel Fabriciano Municipality of Minas Gerais State, Brazil. The cases occurred in May and June of 2000. During this period there were two deaths among children from an area named Pedreira in a periurban area of this municipality. In a boy who died with clinical manifestations of Brazilian spotted fever, a necropsy revealed the presence of a spotted fever group Rickettsia. The serological results confirm the difficulty in the differential diagnosis of patients with symptoms of rickettsial diseases.

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Low Albumin Levels Are Associated with Poorer Outcomes in a Case Series of COVID-19 Patients in Spain: A Retrospective Cohort Study

Microorganisms ◽

10.3390/microorganisms8081106 ◽

2020 ◽

Vol 8 (8) ◽

pp. 1106 ◽

Cited By ~ 3

Author(s):

Roberto de la Rica ◽

Marcio Borges ◽

Maria Aranda ◽

Alberto del Castillo ◽

Antonia Socias ◽

...

Keyword(s):

Retrospective Cohort ◽

Poor Prognosis ◽

Case Series ◽

Hospital Length ◽

Limited Information ◽

C Reactive Protein ◽

Icu Patients ◽

Reactive Protein ◽

Epidemiological Features ◽

Initial Symptoms

There is limited information available describing the clinical and epidemiological features of Spanish patients requiring hospitalization for coronavirus disease 2019 (COVID-19). In this observational study, we aimed to describe the clinical characteristics and epidemiological features of severe (non-ICU) and critically patients (ICU) with COVID-19 at triage, prior to hospitalization. Forty-eight patients (27 non-ICU and 21 ICU) with positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection were analyzed (mean age, 66 years, [range, 33–88 years]; 67% males). There were no differences in age or sex among groups. Initial symptoms included fever (100%), coughing (85%), dyspnea (76%), diarrhea (42%) and asthenia (21%). ICU patients had a higher prevalence of dyspnea compared to non-ICU patients (95% vs. 61%, p = 0.022). ICU-patients had lymphopenia as well as hypoalbuminemia. Lactate dehydrogenase (LDH), C-reactive protein (CRP), and procalcitonin were significantly higher in ICU patients compared to non-ICU (p < 0.001). Lower albumin levels were associated with poor prognosis measured as longer hospital length (r = −0.472, p < 0.001) and mortality (r = −0.424, p = 0.003). As of 28 April 2020, 10 patients (8 ICU and 2 non-ICU) have died (21% mortality), and while 100% of the non-ICU patients have been discharged, 33% of the ICU patients still remained hospitalized (5 in ICU and 2 had been transferred to ward). Critically ill patients with COVID-19 present lymphopenia, hypoalbuminemia and high levels of inflammation.

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Rickettsial Infections around the World, Part 1: Pathophysiology and the Spotted Fever Group

Journal of Cutaneous Medicine and Surgery ◽

10.1177/120347540500900203 ◽

2005 ◽

Vol 9 (2) ◽

pp. 54-62

Author(s):

Jashin J. Wu ◽

David B. Huang ◽

Katie R. Pang ◽

Stephen K. Tyring

Keyword(s):

Spotted Fever ◽

Clinical Manifestations ◽

Review Article ◽

Learning Activity ◽

Clinical Aspects ◽

Spotted Fever Group ◽

Infectious Agents ◽

Important Group ◽

Rickettsial Infections ◽

Rickettsial Diseases

Background: The rickettsial diseases are an important group of infectious agents that have dermatological manifestations. These diseases are important to consider in endemic areas, but in certain suspicious cases, possible acts of bioterrorism should warrant prompt notification of the appropriate authorities. Objective: In this two part review article, we review these diverse diseases by examining established and up-to-date information about the pathophysiology, epidemiology, clinical manifestations, and treatment of the ricksettsiae. Methods: Using PubMed to search for relevant articles, we browsed over 500 articles to compose a clinically based review article. Results: Part one focuses on pathophysiology of the rickettsial diseases and the clinical aspects of the spotted fever group. Conclusions: At the completion of part one of this learning activity, participants should be able to discuss all of the clinical manifestations and treatments of the sported fever group. Participants should also be familiar with the pathophysiology of the rickettsial diseases.

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Pseudo paralysis of the shoulder and increased C-reactive protein are predictive factors for septic shoulder in children superior to other clinical symptoms: a retrospective case series of 25 patients

Journal of Children s Orthopaedics ◽

10.1302/1863-2548.14.190126 ◽

2020 ◽

Vol 14 (1) ◽

pp. 85-90 ◽

Cited By ~ 1

Author(s):

Cezara Danilov ◽

Christoph Ihle ◽

Francisco F. Fernandez ◽

Gunnar Blumenstock ◽

Thomas Wirth ◽

...

Keyword(s):

Septic Arthritis ◽

Clinical Symptoms ◽

Case Series ◽

Diagnostic Procedures ◽

White Blood Count ◽

C Reactive Protein ◽

Retrospective Case ◽

Level Of Evidence ◽

Reactive Protein ◽

Shoulder Arthritis

Purpose The aim of the study was to evaluate predictable parameters with the highest sensitivity used in the diagnosis of children septic shoulder arthritis. Methods All children treated in our paediatric orthopaedic hospital between 2000 and 2017 with intraoperative verified septic arthritis of the shoulder were included in this retrospective study. Diagnostic procedures e.g. ultrasound, MRI, radiograph or blood samples as well as typical clinical symptoms were evaluated as predictable parameters for septic shoulder arthritis in paediatric patients. Descriptive statistics as well as sensitivity analysis were performed. Results In all, 25 children, 20 boys and five girls, aged from eight days to 15 years, were included for further statistical analysis. All parameters included were tested for sensitivity with binomial confidence intervals (Cis) of 95%. Predictive parameters with highest sensitivity were pseudo paralysis (100%, CI 0.86 to 1.00) and C-reactive protein (CRP) (96%, CI 0.79 to 0.99) superior to temperature (52%, CI 0.3 to 0.73), white blood count (11%, CI 0.01 to 0.34), radiograph (21%, CI 0.04 to 0.50), ultrasound (71%, CI 0.47 to 0.88) or MRI (100%, CI 0.78 to 1.00). Conclusion The diagnosis of a septic arthritis of the shoulder in children can be challenging for the clinician and especially for the resident doctor. Clinical symptoms such as pseudo paralysis and increased CRP level must be considered as predictive markers not to delay further diagnostics and treatment. Level of Evidence IV

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Serum peptidyl-prolyl cis-trans isomerase NIMA-interacting 1 in combination with C-reactive protein and white blood cell as novel predictors for infants with community-acquired pneumonia

European Journal of Inflammation ◽

10.1177/2058739220942343 ◽

2020 ◽

Vol 18 ◽

pp. 205873922094234

Author(s):

Heng Xue ◽

Hui Liu ◽

Liangpu Xu ◽

Qiaoling Liu ◽

Bimin Zhuo ◽

...

Keyword(s):

Blood Cell ◽

White Blood Cell ◽

Roc Curve ◽

Predictive Value ◽

Clinical Manifestations ◽

Community Acquired Pneumonia ◽

Enzyme Linked Immunosorbent Assay ◽

C Reactive Protein ◽

Roc Curve Analysis ◽

Reactive Protein

The aim of this study was to investigate the predictive value of peptidyl-prolyl cis-trans isomerase NIMA-interacting 1 (Pin1) with C-reactive protein (CRP) and white blood cell (WBC) count for community-acquired pneumonia (CAP) in infants. A total of 84 hospitalized infants with CAP and 69 healthy infants were included in this study. The clinical manifestations and laboratory assay results of infants were recorded. Serum Pin1 level was estimated by enzyme-linked immunosorbent assay. The median serum Pin1 concentration in infants with CAP was significantly higher than that in controls (1.44 vs. 0.21 ng/mL, P < 0.0001). Receiver operating characteristic (ROC) curve analysis showed that the area under the ROC curve (AUC) of the combination Pin1, CRP and WBC (Pin1 + CRP + WBC, 0.943) was higher than Pin1, CRP, WBC alone or the combination of Pin1 and CRP ( P < 0.05). The sensitivity of Pin1 + CRP + WBC (94.0%) was higher than that of Pin1, CRP, WBC alone, or any two combined ( P < 0.05). Pin1 + CRP + WBC also had a high negative predictive value (91.4%). Moreover, serum Pin1 alone had a high specificity (97.0%) and excellent positive predictive value (96.6%) for infants with CAP, which were higher than WBC, Pin1 and WBC in combination, CRP and WBC in combination, and Pin1 + CRP + WBC ( P < 0.05). Therefore, serum Pin 1 was highly expressed in infants with CAP and can singly or in combination with CRP and WBC represent promising novel predictors for infants with CAP.

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Retrospective analysis of clinical characteristics of 405 patients with COVID-19

Journal of International Medical Research ◽

10.1177/0300060520949039 ◽

2020 ◽

Vol 48 (8) ◽

pp. 030006052094903 ◽

Cited By ~ 1

Author(s):

Ting Zhan ◽

Meng Liu ◽

Yalin Tang ◽

Zheng Han ◽

Xueting Cheng ◽

...

Keyword(s):

Clinical Characteristics ◽

Severe Disease ◽

Clinical Manifestations ◽

Gastrointestinal Symptoms ◽

Circulatory System ◽

Respiratory Illnesses ◽

Reactive Protein ◽

Circulatory System Diseases ◽

History Of ◽

Abnormal Lymphocyte

Objective This study was performed to investigate the clinical characteristics of patients with coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Methods We analyzed the electronic medical records of 405 hospitalized patients with laboratory-confirmed COVID-19 in the Third Hospital of Wuhan. Results The patients’ median age was 56 years, 54.1% were female, 11.4% had a history of smoking, and 10.6% had a history of drinking. All cases of COVID-19 were community-acquired. Fever (76.8%) and cough (53.3%) were the most common clinical manifestations, and circulatory system diseases were the most common comorbidities. Gastrointestinal symptoms were present in 61.2% of the patients, and 2.9% of the patients were asymptomatic. Computed tomography showed ground-glass opacities in most patients (72.6%) and consolidation in 30.9%. Lymphopenia (72.3%) and hypoproteinemia (71.6%) were observed in most patients. About 20% of patients had abnormal liver function. Patients with severe disease had significantly more prominent laboratory abnormalities, including an abnormal lymphocyte count and abnormal C-reactive protein, procalcitonin, alanine aminotransferase, aspartate aminotransferase, D-dimer, and albumin levels. Conclusion SARS-CoV-2 causes a variety of severe respiratory illnesses similar to those caused by SARS-CoV-1. Older age, chronic comorbidities, and laboratory abnormalities are associated with disease severity.

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Combined Imaging and Serum Bioinformatics Analysis for Neonatal Infectious Pneumonia

Journal of Medical Imaging and Health Informatics ◽

10.1166/jmihi.2020.3022 ◽

2020 ◽

Vol 10 (6) ◽

pp. 1385-1388

Author(s):

Yalin Li

Keyword(s):

Neonatal Jaundice ◽

Bioinformatics Analysis ◽

Clinical Manifestations ◽

Control Group ◽

Imaging Features ◽

Imaging Analysis ◽

C Reactive Protein ◽

Infection Group ◽

Reactive Protein ◽

Combined Imaging

Objective: The morbidity and mortality of neonatal pneumonia are high, and the clinical manifestations are often lack of specificity. The aim of this study was to analyze the combined imaging and serum bioinformatics characteristic in neonatal infectious pneumonia, in order to provided a useful early diagnosis methods. Methods: A total of 38 patients with neonatal infectious pneumonia and 20 children with neonatal jaundice (control group) was analyzed respectively. The imaging and serum bioinformatics characteristic, including the white blood cell (WBC), and C-reactive protein (CRP), was used to diagnosis disease. Results: The imaging features of neonatal infectious pneumonia are complex and variable, ranging from slight thickening of lung texture to obstructive emphysema. Compared with control group, the WBC, and CRP in pneumonia group is significantly higher. The sensitivity of WBC, and CRP in infection group was 67.4%, 80.4.4%, individually, and increased to 96.7% in combination. Conclusion: The specificity of simple imaging analysis is not enough. Combined imaging and serum bioinformatics characteristic are good indicator for differential diagnosis of neonatal infectious pneumonia.

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Epidemiological and Clinical Characteristics of Patients with COVID-19 in Arak, Iran

The Open Public Health Journal ◽

10.2174/1874944502013010712 ◽

2020 ◽

Vol 13 (1) ◽

pp. 712-717

Author(s):

Morteza Mousavi-Hasanzadeh ◽

Hossein Sarmadian ◽

Fatemeh Safi ◽

Mohammad Jamalian ◽

Amir Almasi-Hashiani

Keyword(s):

Clinical Characteristics ◽

Clinical Signs ◽

Clinical Manifestations ◽

Case Fatality ◽

C Reactive Protein ◽

Reactive Protein ◽

The Mean ◽

Mixed Ground ◽

Taste And Smell ◽

Muscle Ache

Background: The number of confirmed cases of COVID-19 is increasing. Here we present the clinical characteristics and outcomes of COVID-19 in Arak, Iran. Methods: In this study, 139 COVID-19 confirmed cases from 15 February to 15 March 2020 in Arak, Iran, were investigated. The clinical signs, symptoms, laboratory and radiological findings and outcomes were analyzed. Results: The mean age of the patients was 55.41 years (S.D.: 17.11) and 55.40% of them were males. 26.81% of patients had recently traveled to other epidemic cities. The most common clinical manifestations were fever (71.64%), cough (67.16%), shortness of breath (55.22%), muscle ache (50.00%) and the most prevalent complications were taste and smell disruption (29.5%), weakness (22.3%), anorexia (20.1%) and acute respiratory distress syndrome (ARDS) (15.8%). Almost half of the patients had lymphopenia, an elevated level of erythrocyte sedimentation rate (ESR) and C - reactive protein (CRP). In terms of outcome, 9.3% of patients needed an ICU admission as a result of ARDS in which 15.32% were directly admitted to the ICU. 43.2% of patients have been discharged and the case fatality rate (CFR) was estimated as 11.5%. Conclusion: COVID-19 pneumonia usually occurred at an age older than 50 years and in the male gender. The most common initial clinical laboratories and radiological presentations are fever, cough, lymphopenia with elevated CRP and ESR and Bilateral mixed ground-glass opacities with consolidation.

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Clinical effects of hemoadsorption with CytoSorb® in patients with severe acute pancreatitis: A case series

The International Journal of Artificial Organs ◽

10.1177/0391398818823762 ◽

2019 ◽

Vol 42 (4) ◽

pp. 190-193 ◽

Cited By ~ 6

Author(s):

Dana Tomescu ◽

Mihai Popescu ◽

Corina David ◽

Simona Dima

Keyword(s):

Acute Pancreatitis ◽

Severe Acute Pancreatitis ◽

Case Series ◽

Clinical Effects ◽

C Reactive Protein ◽

Reactive Protein ◽

Continuous Venovenous Hemodiafiltration ◽

Vasopressor Support ◽

Before And After ◽

Organ Dysfunctions

Hemoadsorption using CytoSorb® has recently gained attention as a new therapy aimed at modulating the inflammatory response syndrome in critically ill patients. The aim of our study was to assess the clinical effects of CytoSorb in patients with severe acute pancreatitis. We prospectively included 12 patients admitted to the intensive care unit for severe acute pancreatitis. After inclusion, continuous venovenous hemodiafiltration in conjunction with CytoSorb was applied. Clinical data, number of organ dysfunctions, paraclinical data, and vasopressor support were collected before and after the treatment. The use of CytoSorb was associated with a decrease in C-reactive protein from 242 (30, 300) to 180 (20, 252) mg/L (p = 0.04) and procalcitonin from 2.21 (0.01, 15.02) to 1.10 (0.01, 3.79) ng/mL (p = 0.02). The median vasopressor support was 0.1 (0, 0.9) mg/h at the beginning of the treatment and it was discontinued in all cases after the treatment. In conclusion, the use of CytoSorb in patients with severe acute pancreatitis was associated with improved hemodynamics and decreased inflammatory markers.

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