Haemophagocytic syndrome and rickettsial diseases

2011 ◽  
Vol 60 (4) ◽  
pp. 537-542 ◽  
Author(s):  
Antonio Cascio ◽  
Salvatore Giordano ◽  
Piera Dones ◽  
Silvia Venezia ◽  
Chiara Iaria ◽  
...  
Keyword(s):  
Systematic Review ◽  
Spotted Fever ◽  
Mediterranean Spotted Fever ◽  
International Literature ◽  
Haemophagocytic Lymphohistiocytosis ◽  
Fatal Disease ◽  
Haemophagocytic Syndrome ◽  
Proliferation Of Lymphocytes ◽  
Rickettsial Diseases

Haemophagocytic lymphohistiocytosis is a rare but potentially fatal disease resulting from dysregulated activation and proliferation of lymphocytes. We present a case of haemophagocytic syndrome occurring in a 5-year-old Italian boy as a complication of Mediterranean spotted fever. The characteristics of this case have been analysed and contextualized among those of another 15 cases of haemophagocytic syndrome associated with rickettsial diseases found through a systematic review of the international literature.

Hepatitis A infection related haemophagocytic syndrome: a case report and systematic review

2019 ◽  
Vol 49 (3) ◽  
pp. 234-238
Author(s):  
Bipadabhanjan Mallick ◽  
Philip Daniel ◽  
Usha Dutta
Keyword(s):  
Systematic Review ◽  
Case Report ◽  
Hepatitis A ◽  
Unusual Case ◽  
Hepatitis A Virus ◽  
Clinical Syndrome ◽  
Haemophagocytic Lymphohistiocytosis ◽  
Tissue Destruction ◽  
Haemophagocytic Syndrome ◽  
Fungal Sepsis

Haemophagocytic lymphohistiocytosis (HLH) is a clinical syndrome of excessive inflammation and tissue destruction owing to abnormal immune activation. We report an unusual case of haemophagocytosis associated with hepatitis A virus (HAV) infection in a 21-year-old man. This was further complicated by haemolysis secondary to G-6-PD deficiency and fungal sepsis. Our patient was treated successfully with intravenous immunoglobulin (IVIg) and supportive care. A systematic review of all reported cases of HAV associated haemophagocytosis is presented.

scholarly journals In Vitro Susceptibilities of 27 Rickettsiae to 13 Antimicrobials

1998 ◽  
Vol 42 (7) ◽  
pp. 1537-1541 ◽  
Author(s):  
J. M. Rolain ◽  
M. Maurin ◽  
G. Vestris ◽  
D. Raoult
Keyword(s):  
Colorimetric Assay ◽  
Spotted Fever ◽  
Plaque Assay ◽  
Mediterranean Spotted Fever ◽  
Spotted Fever Group ◽  
Culture Methods ◽  
Safe Alternative ◽  
Rickettsial Diseases

ABSTRACT The MICs of 13 antibiotics (doxycycline, thiamphenicol, rifampin, amoxicillin, gentamicin, co-trimoxazole, ciprofloxacin, pefloxacin, ofloxacin, erythromycin, josamycin, clarithromycin, and pristinamycin) were determined for 27 available rickettsial species or strains. We used two in vitro cell culture methods described previously: the plaque assay and the microplaque colorimetric assay. Our results confirm the susceptibilities of rickettsiae to doxycycline, thiamphenicol, and fluoroquinolones. Beta-lactams, aminoglycosides, and co-trimoxazole were not active. Typhus group rickettsiae were susceptible to all macrolides tested, whereas the spotted fever group rickettsiae,R. bellii, and R. canada were more resistant, with josamycin, a safe alternative for the treatment of Mediterranean spotted fever, being the most effective compound. Strain Bar 29,R. massiliae, R. montana, R. aeschlimannii, and R. rhipicephali, which are members of the same phylogenetic subgroup, were more resistant to rifampin than the other rickettsiae tested. Heterogeneity in susceptibility to rifampin, which we report for the first time, may explain in vivo discrepancies in the effectiveness of this antibiotic for the treatment of rickettsial diseases. We hypothesize that rifampin resistance and erythromycin susceptibility may reflect a divergence during the evolution of rickettsiae.

scholarly journals Rickettsiosis with Pleural Effusion: A Systematic Review with a Focus on Rickettsiosis in Italy

2022 ◽  
Vol 7 (1) ◽  
pp. 11
Author(s):  
Cristoforo Guccione ◽  
Raffaella Rubino ◽  
Claudia Colomba ◽  
Antonio Anastasia ◽  
Valentina Caputo ◽  
...  
Keyword(s):  
Systematic Review ◽  
Pleural Effusion ◽  
Spotted Fever ◽  
Severe Disease ◽  
Systematic Research ◽  
Rickettsia Conorii ◽  
Mediterranean Spotted Fever ◽  
Atypical Pneumonia ◽  
Clinical Presentations ◽  
Meta Analyses

Background: Motivated by a case finding of Mediterranean spotted fever (MSF) associated with atypical pneumonia and pleural effusion in which Rickettsia conorii subsp. israelensis was identified by molecular methods in the pleural fluid, we wanted to summarize the clinical presentations of rickettsiosis in Italy by systematic research and to make a systematic review of all the global cases of rickettsiosis associated with pleural effusion. Methods: For the literature search, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology was followed. We chose to select only the studies published in last 25 years and confirmed both with serological and molecular assays. Results: Human cases of rickettsiosis in Italy were reported in 48 papers describing 2831 patients with very different clinical presentations; the majority was MSF accounted to R. conorii and was reported in Sicily. Pleural effusion associated with infection with microorganisms belonging to Rickettsiales was described in 487 patients. It was rarely associated with microorganisms different from O. tsutsugamushi; also rarely, cases of scrub typhus were reported outside Southeast Asia and in the largest majority, the diagnosis was achieved with serology. Conclusions: MSF, especially when caused by R. conorii subsp. israelensis, may be a severe disease. A high index of suspicion is required to promptly start life-saving therapy. Pleural effusion and interstitial pneumonia may be part of the clinical picture of severe rickettsial disease and should not lead the physician away from this diagnosis

Chemotherapy-sparing treatment of haemophagocytic lymphohistiocytosis with intravenous immunoglobulins and corticosteroids

2020 ◽  
Vol 13 (5) ◽  
pp. e234490
Author(s):  
Evan C Chen ◽  
Jonathan A Stefely ◽  
Bimalangshu R Dey ◽  
Walter H Dzik
Keyword(s):  
Effective Treatment ◽  
Disease Severity ◽  
Critically Ill ◽  
Intravenous Immunoglobulins ◽  
Current Treatment ◽  
Haemophagocytic Lymphohistiocytosis ◽  
Tailored Therapy ◽  
Fatal Disease ◽  
Therapeutic Challenge

Haemophagocytic lymphohistiocytosis (HLH) can be a rapidly fatal disease. Current treatment in adults is extrapolated from the HLH-2004 protocol that specifies a regimen of etoposide, dexamethasone and cyclosporine. However, HLH presents as a spectrum of disease severity. A therapeutic challenge arises for milder cases where the harms of potent chemotherapy such as etoposide may outweigh its benefit. We present a case of an adult with HLH who developed significant pancytopenia but was otherwise not critically ill and who responded to treatment with a chemotherapy-sparing approach consisting of intravenous immunoglobulins and corticosteroids alone. The case illustrates that tailored therapy may allow effective treatment of the disorder while minimising therapy-related toxicities.

scholarly journals Mediterranean Spotted Fever in Central Tunisia

1994 ◽  
Vol 1 (2) ◽  
pp. 106-108 ◽  
Author(s):  
Letaïef Jemni ◽  
Houssem Hmouda ◽  
Mohamed Chakroun ◽  
Moez Ernez ◽  
Mezri May
Keyword(s):  
Spotted Fever ◽  
Mediterranean Spotted Fever ◽  
Central Tunisia

IMMUNOLOGICAL STUDIES IN MEDITERRANEAN SPOTTED FEVER

The Lancet ◽  
1982 ◽  
Vol 319 (8283) ◽  
pp. 1249 ◽  
Author(s):  
M.A. Piras ◽  
C. Gakis ◽  
M. Budroni ◽  
G. Andreoni
Keyword(s):  
Spotted Fever ◽  
Mediterranean Spotted Fever

scholarly journals A Brief History of the Major Rickettsioses in the Asia–Australia–Pacific Region: A Capstone Review for the Special Issue of TMID

2020 ◽  
Vol 5 (4) ◽  
pp. 165
Author(s):  
Daniel H. Paris ◽  
Daryl J. Kelly ◽  
Paul A. Fuerst ◽  
Nicholas P. J. Day ◽  
Allen L. Richards
Keyword(s):  
Scrub Typhus ◽  
Spotted Fever ◽  
Specific Antigen ◽  
Far East ◽  
Pacific Region ◽  
Special Issue ◽  
Rickettsial Disease ◽  
History Of ◽  
Rickettsial Diseases ◽  
The Impact

The rickettsioses of the “Far East” or Asia–Australia–Pacific region include but are not limited to endemic typhus, scrub typhus, and more recently, tick typhus or spotted fever. These diseases embody the diversity of rickettsial disease worldwide and allow us to interconnect the various contributions to this special issue of Tropical Medicine and Infectious Disease. The impact of rickettsial diseases—particularly of scrub typhus—was substantial during the wars and “police actions” of the last 80 years. However, the post-World War II arrival of effective antibiotics reduced their impact, when recognized and adequately treated (chloramphenicol and tetracyclines). Presently, however, scrub typhus appears to be emerging and spreading into regions not previously reported. Better diagnostics, or higher population mobility, change in antimicrobial policies, even global warming, have been proposed as possible culprits of this phenomenon. Further, sporadic reports of possible antibiotic resistance have received the attention of clinicians and epidemiologists, raising interest in developing and testing novel diagnostics to facilitate medical diagnosis. We present a brief history of rickettsial diseases, their relative importance within the region, focusing on the so-called “tsutsugamushi triangle”, the past and present impact of these diseases within the region, and indicate how historically, these often-confused diseases were ingeniously distinguished from each another. Moreover, we will discuss the importance of DNA-sequencing efforts for Orientia tsutsugamushi, obtained from patient blood, vector chiggers, and rodent reservoirs, particularly for the dominant 56-kD type-specific antigen gene (tsa56), and whole-genome sequences, which are increasing our knowledge of the diversity of this unique agent. We explore and discuss the potential of sequencing and other effective tools to geographically trace rickettsial disease agents, and develop control strategies to better mitigate the rickettsioses.

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