scholarly journals Neglected human Rickettsia felis infection in Taiwan: A retrospective seroepidemiological survey of patients with suspected rickettsioses

2021 ◽  
Vol 15 (4) ◽  
pp. e0009355
Author(s):  
Wan-Hsiu Yang ◽  
Meng-Shiuan Hsu ◽  
Pei-Yun Shu ◽  
Kun-Hsien Tsai ◽  
Chi-Tai Fang
Keyword(s):  
Scrub Typhus ◽  
Q Fever ◽  
Current Knowledge ◽  
Medical Center ◽  
Case Reports ◽  
Clinical Manifestations ◽  
Murine Typhus ◽  
Rickettsia Felis ◽  
Elevated Liver Enzymes ◽  
Life Threatening

Background Current knowledge on Rickettsia felis infection in humans is based on sporadic case reports. Here we conducted a retrospective seroepidemiological survey of R. felis infection among febrile patients visiting a medical center in Taipei. Methodology/Principal findings A total of 122 patients with suspected rickettsioses presenting with fever of unknown origin (FUO) but tested negative for scrub typhus, murine typhus, or Q fever were retrospectively identified during 2009 to 2010. The archived serum samples were examined for the presence of antibodies against R. felis, Rickettsia japonica, and Rickettsia typhi using microimmunofluorescence (MIF) assay. Serological evidence of Rickettsia exposure was found in 23 (19%, 23/122) patients. Eight patients had antibodies reactive to R. felis, including four with current infection (a ≥4-fold increase in IgG titer between acute and convalescent sera). The clinical presentations of these four patients included fever, skin rash, lymphadenopathy, as well as more severe conditions such as pancytopenia, hepatomegaly, elevated liver enzymes/bilirubin, and life-threatening acute respiratory distress syndrome. One of the patients died after doxycycline was stopped after being tested negative for scrub typhus, Q fever, and murine typhus. Conclusions Rickettsia felis is a neglected flea-borne pathogen in Taiwan, and its infection can be life-threatening. Further prospective studies of the prevalence of R. felis among patients with FUO and compatible clinical manifestations are warranted.

scholarly journals Atypical presentations of malignant otitis externa

2010 ◽  
Vol 124 (11) ◽  
pp. 1205-1208 ◽  
Author(s):  
Z Vourexakis ◽  
M-I Kos ◽  
J-P Guyot
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Skull Base ◽  
Diagnostic Criteria ◽  
Otitis Externa ◽  
Case Reports ◽  
Clinical Manifestations ◽  
Diabetic Patients ◽  
Malignant Otitis Externa ◽  
Life Threatening ◽  
Atypical Presentations

AbstractIntroduction:Malignant otitis externa is a life-threatening infection of the skull base. Its presentation is not always typical.Case reports:We report three cases of malignant otitis externa which illustrate the diversity of its clinical manifestations and the difficulties in its diagnosis.Discussion:The perception of malignant otitis externa as an infection caused by Pseudomonas aeruginosa in diabetic patients is not always correct. The adoption of diagnostic criteria could be helpful in identifying atypical cases.

BK virus: microbiology, epidemiology, pathogenesis, clinical manifestations and treatment

2010 ◽  
Vol 4 (1) ◽  
pp. 3-18 ◽  
Author(s):  
Chakrapol Sriaroon ◽  
John N. Greene ◽  
Albert L. Vincent ◽  
Veronica T. Tucci ◽  
Mohamed A. Kharfan-Dabaja ◽  
...  
Keyword(s):  
Virus Infection ◽  
Treatment Guidelines ◽  
Current Knowledge ◽  
Virus Disease ◽  
Hemorrhagic Cystitis ◽  
Clinical Manifestations ◽  
Bk Virus ◽  
Molecular Diagnostic ◽  
Sufficient Information ◽  
Life Threatening

Abstract Background: BK virus infection is common but is usually asymptomatic. However, it can become life threatening as severe hemorrhagic cystitis (HC) or the polyomavirus-associated nephropathy (PVAN) particularly in immune compromised and transplant recipients. Some investigators have studied the pathophysiology and there are anecdotal and uncontrolled studies of therapy with few conclusions allowing treatment guidelines. Objectives: Summarize literature review of current knowledge concerning the nature, epidemiology, pathophysiology, diagnosis and treatment of this common virus infection. Results: HC is a not uncommon and often misdiagnosed infection from BK virus. It is usually self limited but can become life threatening in immune compromised patients. PVAN threatens survival of transplanted kidneys and is difficult to differentiate from rejection without sophisticated molecular diagnostic technology. We have sufficient information for making a diagnosis of BK virus disease by using clinical, serological and molecular technology. Studies using manipulation of immunosuppression and a variety of antiviral agents, including cidofovir, leflunomide, intravenous immunoglobulin, vidarabine, fluroquinolones, have been published but most were uncontrolled reports of few cases. Cidofovir offers some promise but more must be learned before there is hope for evidence-based treatment guidelines.

Clinical Characteristics of Acute Q Fever, Scrub Typhus, and Murine Typhus with Delayed Defervescence Despite Doxycycline Treatment

2008 ◽  
Vol 79 (3) ◽  
pp. 441-446 ◽  
Author(s):  
Chung-Hsu Lai ◽  
Hui-Ching Weng ◽  
Hsing-Chun Chung ◽  
Chih-Wen Lin ◽  
Shiou-Haur Liang ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Scrub Typhus ◽  
Q Fever ◽  
Murine Typhus ◽  
Doxycycline Treatment ◽  
Acute Q Fever

scholarly journals Serum C-reactive protein and procalcitonin values in acute Q fever, scrub typhus, and murine typhus

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
I-Fan Lin ◽  
Jiun-Nong Lin ◽  
Chia-Ta Tsai ◽  
Yu-Ying Wu ◽  
Yen-Hsu Chen ◽  
...  
Keyword(s):  
Scrub Typhus ◽  
Q Fever ◽  
C Reactive Protein ◽  
Murine Typhus ◽  
Reactive Protein ◽  
Acute Q Fever

scholarly journals Epidemiology of Acute Q Fever, Scrub Typhus, and Murine Typhus, and Identification of Their Clinical Characteristics Compared to Patients with Acute Febrile Illness in Southern Taiwan

2009 ◽  
Vol 108 (5) ◽  
pp. 367-376 ◽  
Author(s):  
Chung-Hsu Lai ◽  
Chun-Kai Huang ◽  
Yen-Hsu Chen ◽  
Lin-Li Chang ◽  
Hui-Ching Weng ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Scrub Typhus ◽  
Q Fever ◽  
Febrile Illness ◽  
Acute Febrile Illness ◽  
Murine Typhus ◽  
Southern Taiwan ◽  
Acute Q Fever

scholarly journals Characteristics of scrub typhus, murine typhus, and Q fever among elderly patients: Prolonged prothrombin time as a predictor for severity

2019 ◽  
Vol 52 (1) ◽  
pp. 54-61 ◽  
Author(s):  
Ko Chang ◽  
Nan-Yao Lee ◽  
Wen-Chien Ko ◽  
Wei-Ru Lin ◽  
Yen-Hsu Chen ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Prothrombin Time ◽  
Scrub Typhus ◽  
Q Fever ◽  
Murine Typhus ◽  
Prolonged Prothrombin Time

scholarly journals Cardiotoxicity of Novel Targeted Hematological Therapies

Life ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. 344
Author(s):  
Valentina Giudice ◽  
Carmine Vecchione ◽  
Carmine Selleri
Keyword(s):  
Targeted Therapies ◽  
Current Knowledge ◽  
Clinical Manifestations ◽  
Standard Chemotherapy ◽  
Life Threatening ◽  
Myocardial Structure ◽  
Phosphoinositide 3 Kinase ◽  
Btk Inhibitors ◽  
Target Effects

Chemotherapy-related cardiac dysfunction, also known as cardiotoxicity, is a group of drug-related adverse events negatively affecting myocardial structure and functions in patients who received chemotherapy for cancer treatment. Clinical manifestations can vary from life-threatening arrythmias to chronic conditions, such as heart failure or hypertension, which dramatically reduce quality of life of cancer survivors. Standard chemotherapy exerts its toxic effect mainly by inducing oxidative stress and genomic instability, while new targeted therapies work by interfering with signaling pathways important not only in cancer cells but also in myocytes. For example, Bruton’s tyrosine kinase (BTK) inhibitors interfere with class I phosphoinositide 3-kinase isoforms involved in cardiac hypertrophy, contractility, and regulation of various channel forming proteins; thus, off-target effects of BTK inhibitors are associated with increased frequency of arrhythmias, such as atrial fibrillation, compared to standard chemotherapy. In this review, we summarize current knowledge of cardiotoxic effects of targeted therapies used in hematology.

Guillain–Barre syndrome: a rare complication of leptospirosis and scrub typhus co-infection

2019 ◽  
Vol 49 (3) ◽  
pp. 248-249 ◽  
Author(s):  
Nishant Dev ◽  
Rahul Kumar ◽  
Dilip Kumar
Keyword(s):  
Scrub Typhus ◽  
Case Reports ◽  
Rare Complication ◽  
Nerve Conduction Studies ◽  
Guillain Barre Syndrome ◽  
First Case ◽  
Immune Mediated ◽  
Guillain Barré Syndrome ◽  
Life Threatening ◽  
Guillain Barré

Guillain–Barré syndrome (GBS) is a potentially life-threatening immune-mediated acute inflammatory polyneuropathy associated with several antecedent infections. We report a 20-year-old man with GBS associated with concurrent leptospirosis and scrub typhus infection. GBS was confirmed with clinical examination and nerve conduction studies. There have been case reports of GBS in association with Leptospira and Orienta tsusugamushi separately. However, this may be the first case report of GBS associated with concurrent diseases.

scholarly journals Pituitary metastasis: a rare condition

2018 ◽  
Vol 7 (10) ◽  
pp. 1049-1057 ◽  
Author(s):  
Aida Javanbakht ◽  
Massimo D’Apuzzo ◽  
Behnam Badie ◽  
Behrouz Salehian
Keyword(s):  
Breast Cancer ◽  
Primary Tumor ◽  
Medical Center ◽  
Clinical Manifestations ◽  
Posterior Part ◽  
Rare Condition ◽  
National Medical ◽  
Threatening Condition ◽  
Life Threatening ◽  
Pituitary Metastasis

Tumor metastasis to the pituitary gland is a rare, not well-documented and life-threatening condition associated with a shortened life span. A better understanding of its clinical manifestations could lead to earlier diagnosis, appropriate therapy and potentially improving quality of life. Therefore, we retrospectively studied the charts of patients with pituitary metastases who were treated at the City of Hope National Medical Center (Duarte, CA) from 1984 to 2018. We reviewed and analyzed tumor origin, primary pituitary clinical manifestation, duration between primary tumor diagnosis and pituitary metastasis, type of treatment and patient survival. A total of 11 patients were identified with a mean age of 59.2 years and median survival following the diagnosis of metastasis of 10 months. Breast cancer and lymphoma were the most common primary origins in these cases, and diabetes insipidus and panhypopituitarism were the most common clinical manifestations of their metastasis. We also compared our results with reports in the literature published between 1957 and 2018. A total 289 patients with pituitary metastasis have been reported in the literature. Breast cancer was the most frequent primary origin of the metastasis, and visual symptoms were the most common primary manifestation. The posterior part of the pituitary is more susceptible than the anterior to metastasis. Pituitary metastasis may occur as a consequence of successful primary tumor treatment prolonging the chance of seeding. Future studies are needed to determine the molecular mechanism of metastasis to the pituitary.

Cystic Fibrosis: Pathophysiology of Lung Disease

2019 ◽  
Vol 40 (06) ◽  
pp. 715-726 ◽  
Author(s):  
Christelle Bergeron ◽  
André M. Cantin
Keyword(s):  
Cystic Fibrosis ◽  
Mucociliary Clearance ◽  
Current Knowledge ◽  
Clinical Manifestations ◽  
Autosomal Recessive Disorder ◽  
Cftr Gene ◽  
Susceptibility To Infection ◽  
Life Threatening ◽  
Cftr Protein ◽  
And Function

AbstractCystic fibrosis (CF) is a common, life-threatening, multisystemic, autosomal recessive disorder. In the last few years, giant steps have been made with regard to the understanding of CF pathophysiology, allowing the scientific community to propose mechanisms that cause the myriad of CF clinical manifestations. Following the discovery of the cystic fibrosis transmembrane conductance regulator (CFTR) gene in 1989, the structure and function of the CFTR protein were described. Since then, more than 2,000 variants of the CFTR gene and their impact on the amount and function of the CFTR protein have been reported. The role of the CFTR protein as an ion channel transporting chloride and bicarbonate and its repercussions on different epithelial cell-lined organs and mucus are now better understood. Mechanisms behind susceptibility to infection in CF have also been proposed and include abnormalities in the composition, volume and acidity of the airway surface liquid, changes in the submucosal gland's anatomy and function, and deficiencies in the mucociliary clearance system. Numerous hypotheses explaining the excessive inflammatory response in CF are also debated and involve impaired mucociliary clearance, persistent hypoxia, lipid abnormalities, protease and antiprotease disproportion, and oxidant and antioxidant imbalance. The purpose of this review is to summarize our current knowledge of CF pathophysiology, including significant historic discoveries and most recent breakthroughs, and to improve understanding and awareness of this fatal disease.

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