First Identification and Description of Rickettsioses and Q Fever as Causes of Acute Febrile Illness in Nicaragua

IntroductionIn rural and difficult-to-access settings, early and accurate recognition of febrile children at risk of progressing to serious illness could contribute to improved patient outcomes and better resource allocation. This study aims to develop a prognostic clinical prediction tool to assist community healthcare providers identify febrile children who might benefit from referral or admission for facility-based medical care.Methods and analysisThis prospective observational study will recruit at least 4900 paediatric inpatients and outpatients under the age of 5 years presenting with an acute febrile illness to seven hospitals in six countries across Asia. A venous blood sample and nasopharyngeal swab is collected from each participant and detailed clinical data recorded at presentation, and each day for the first 48 hours of admission for inpatients. Multianalyte assays are performed at reference laboratories to measure a panel of host biomarkers, as well as targeted aetiological investigations for common bacterial and viral pathogens. Clinical outcome is ascertained on day 2 and day 28.Presenting syndromes, clinical outcomes and aetiology of acute febrile illness will be described and compared across sites. Following the latest guidance in prediction model building, a prognostic clinical prediction model, combining simple clinical features and measurements of host biomarkers, will be derived and geographically externally validated. The performance of the model will be evaluated in specific presenting clinical syndromes and fever aetiologies.Ethics and disseminationThe study has received approval from all relevant international, national and institutional ethics committees. Written informed consent is provided by the caretaker of all participants. Results will be shared with local and national stakeholders, and disseminated via peer-reviewed open-access journals and scientific meetings.Trial registration numberNCT04285021.

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Differential Laboratory Diagnosis of Acute Fever in Guinea: Preparedness for the Threat of Hemorrhagic Fevers

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18116022 ◽

2021 ◽

Vol 18 (11) ◽

pp. 6022

Author(s):

Vladimir G. Dedkov ◽

N’Faly Magassouba ◽

Olga A. Stukolova ◽

Victoria A. Savina ◽

Jakob Camara ◽

...

Keyword(s):

Ebola Virus ◽

Febrile Illness ◽

Laboratory Diagnosis ◽

Acute Febrile Illness ◽

Causative Pathogen ◽

Hemorrhagic Fevers ◽

Wide Range ◽

Causative Agents ◽

Pathognomonic Sign

Acute febrile illnesses occur frequently in Guinea. Acute fever itself is not a unique, hallmark indication (pathognomonic sign) of any one illness or disease. In the infectious disease context, fever’s underlying cause can be a wide range of viral or bacterial pathogens, including the Ebola virus. In this study, molecular and serological methods were used to analyze samples from patients hospitalized with acute febrile illness in various regions of Guinea. This analysis was undertaken with the goal of accomplishing differential diagnosis (determination of causative pathogen) in such cases. As a result, a number of pathogens, both viral and bacterial, were identified in Guinea as causative agents behind acute febrile illness. In approximately 60% of the studied samples, however, a definitive determination could not be made.

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Scrub Typhus and Molecular Characterization of Orientia tsutsugamushi from Central Nepal

Pathogens ◽

10.3390/pathogens10040422 ◽

2021 ◽

Vol 10 (4) ◽

pp. 422

Author(s):

Rajendra Gautam ◽

Keshab Parajuli ◽

Mythili Tadepalli ◽

Stephen Graves ◽

John Stenos ◽

...

Keyword(s):

Genetic Diversity ◽

Scrub Typhus ◽

Febrile Illness ◽

Acute Febrile Illness ◽

Limited Information ◽

Orientia Tsutsugamushi ◽

Health Measures ◽

Central Nepal ◽

Vector Borne

Scrub typhus is a vector-borne, acute febrile illness caused by Orientia tsutsugamushi. Scrub typhus continues to be an important but neglected tropical disease in Nepal. Information on this pathogen in Nepal is limited to serological surveys with little information available on molecular methods to detect O. tsutsugamushi. Limited information exists on the genetic diversity of this pathogen. A total of 282 blood samples were obtained from patients with suspected scrub typhus from central Nepal and 84 (30%) were positive for O. tsutsugamushi by 16S rRNA qPCR. Positive samples were further subjected to 56 kDa and 47 kDa molecular typing and molecularly compared to other O. tsutsugamushi strains. Phylogenetic analysis revealed that Nepalese O. tsutsugamushi strains largely cluster together and cluster away from other O. tsutsugamushi strains from Asia and elsewhere. One exception was the sample of Nepal_1, with its partial 56 kDa sequence clustering more closely with non-Nepalese O. tsutsugamushi 56 kDa sequences, potentially indicating that homologous recombination may influence the genetic diversity of strains in this region. Knowledge on the circulating strains in Nepal is important to the development of diagnostic tests and vaccines to support public health measures to control scrub typhus in this country.

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Respiratory Symptoms and Farming Practices in Farmers Associated With an Acute Febrile Illness After Organic Dust Exposure

CHEST Journal ◽

10.1378/chest.116.5.1452 ◽

1999 ◽

Vol 116 (5) ◽

pp. 1452-1458 ◽

Cited By ~ 35

Author(s):

Susanna Von Essen ◽

Jon Fryzek ◽

Bogdan Nowakowski ◽

Mary Wampler

Keyword(s):

Respiratory Symptoms ◽

Febrile Illness ◽

Dust Exposure ◽

Acute Febrile Illness ◽

Organic Dust ◽

Farming Practices

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Polymyositis Complicating Staphylococcal Septicaemia

Scottish Medical Journal ◽

10.1177/003693308703200510 ◽

1987 ◽

Vol 32 (5) ◽

pp. 149-150

Author(s):

J. Hamilton ◽

R.A. Sharp ◽

J. M. Anderson ◽

M. R. Kerr

Keyword(s):

Inflammatory Myopathy ◽

Febrile Illness ◽

Acute Febrile Illness ◽

Viral Origin ◽

Similar Association

Inflammatory polymyositis can be precipitated by acute febrile illness of viral origin1, but similar association with pyogenic bacterial illness is not recognised. We describe two cases in which recovery from staphylococcal septicaemia was complicated by a widespread inflammatory myopathy.

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High fluorescent lymphocyte cell count and scattergram patterns on the Sysmex XN series cell counters—Novel parameters in early and reliable diagnosis of dengue on a background of acute febrile illness

International Journal of Laboratory Hematology ◽

10.1111/ijlh.13478 ◽

2021 ◽

Author(s):

Ananthvikas Jayaram ◽

Nitty S. Mathews ◽

Sukesh C. Nair ◽

Tulasi Geevar ◽

Winsley Rose ◽

...

Keyword(s):

Cell Count ◽

Febrile Illness ◽

Acute Febrile Illness ◽

Reliable Diagnosis ◽

Lymphocyte Cell

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Lymphadenitis as the Dominant Manifestation of Kawasaki Disease

PEDIATRICS ◽

10.1542/peds.93.3.525 ◽

1994 ◽

Vol 93 (3) ◽

pp. 525-528

Author(s):

Julie Kim Stamos ◽

Kathleen Corydon ◽

James Donaldson ◽

Stanford T. Shulman

Keyword(s):

Kawasaki Disease ◽

Cervical Lymphadenopathy ◽

Febrile Illness ◽

The United States ◽

Acute Febrile Illness ◽

Conjunctival Injection ◽

Coronary Abnormalities ◽

Acquired Heart Disease ◽

Mucosal Changes ◽

Infants And Young Children

Kawasaki disease (KD) is an acute febrile illness primarily affecting infants and young children. Its importance relates to the fact that 20% to 25% of untreated patients develop coronary abnormalities that can lead to myocardial infarction or even to death.1 KD is a leading cause of acquired heart disease in children in many regions, including the United States.2 Because there are no specific diagnostic tests for KD, the diagnosis is established by the presence of fever and four of five criteria without other explanation for the illness: (1) nonexudative conjunctival injection; (2) oral mucosal changes; (3) changes of the peripheral extremities; (4) rash, primarily truncal; and (5) cervical lymphadenopathy.

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Questing one Brazilian query: reporting 16 cases of Q fever from Minas Gerais, Brazil

Revista do Instituto de Medicina Tropical de São Paulo ◽

10.1590/s0036-46652006000100002 ◽

2006 ◽

Vol 48 (1) ◽

pp. 5-9 ◽

Cited By ~ 18

Author(s):

Paulo Sérgio Gonçalves da Costa ◽

Marco Emilio Brigatte ◽

Dirceu Bartolomeu Greco

Keyword(s):

Phase I ◽

Phase Ii ◽

Fever Of Unknown Origin ◽

Q Fever ◽

Acute Infection ◽

Case Series ◽

Febrile Illness ◽

Unknown Origin ◽

Clinical Form ◽

Chronic Q Fever

Q fever has been considered non-existing in Brazil where reports of clinical cases still cannot be found. This case-series of 16 patients is a result of a systematic search for such illness by means of clinical and serologic criteria. Serologic testing was performed by the indirect microimmunofluorescence technique using phase I/II C. burnetii antigens. Influenza-like syndrome was the most frequent clinical form (eight cases - 50%), followed by pneumonia, FUO (fever of unknown origin), mono-like syndrome (two cases - 12.5% each), lymphadenitis (one case - 6.3%) and spondylodiscitis associated with osteomyelitis (one case - 6.3%). The ages varied from four to 67 years old with a median of 43.5. All but one patient had positive serologic tests for phase II IgG whether or not associated with IgM positivity compatible with acute infection. One patient had both phase I and phase II IgG antibodies compatible with chronic Q fever. Seroconvertion was detected in 10 patients. Despite the known limitations of serologic diagnosis, the cases here reported should encourage Brazilian doctors to include Q fever as an indigenous cause of febrile illness.

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