scholarly journals A study on laboratory features of scrub typhus

2018 ◽  
Vol 5 (5) ◽  
pp. 1828
Author(s):  
R. Ramanathan ◽  
E. Yazhini
Keyword(s):  
Scrub Typhus ◽  
Liver Function Tests ◽  
Elisa Test ◽  
Emerging Infections ◽  
Rickettsial Infections ◽  
Laboratory Investigations ◽  
Hematological And Biochemical Parameters ◽  
Wbc Count ◽  
Hematological Changes ◽  
Pediatric Icu

Background: Rickettsial infections are the most common re-emerging infections in the recent times especially Scrub typhus. If untreated, fatality rate is as high as 30-35%. Scrub typhus can cause changes in hematological and biochemical parameters. The need for this study is to correlate the laboratory investigations in patients with scrub typhus, so that early diagnosis and appropriate treatment can be done.Methods: This prospective observational study was carried out in children admitted in the pediatric ward/ pediatric ICU of RMMCH who were diagnosed to have Scrub typhus by positive ELISA test. Their basic laboratory investigations are categorized and correlated.Results: Normal Leukocyte count was seen in 48% (n=24) of the cases, leucocytopenia 30% (n=15), leucocytosis 22% (n=11). Platelets <1.5 lakhs were seen in 72% (n=36) and none of the cases had platelets less than 80000. Hb< 9gm/dl was seen in 44% (n=22). Hyponatremia in 24% (n=12). CRP was positive in 28% (n=14). Hypoalbuminemia was seen in 22% (n=11). Renal function test was normal in all the cases.Conclusions: This study discusses the various biochemical and hematological changes in patients with Scrub typhus. Pancytopenia is rare in patients with Scrub typhus. Abnormalities in renal and liver function tests may indicate the progression to complications. Normal WBC count with hyponatremia and hypoalbuminemia with related symptoms and signs can be used to diagnose the disease at earlier stages.

Pharmacological studies of Pediococcus on performance and some hematological and biochemical parameters in cattle

2019 ◽  
Vol 20 (2) ◽  
pp. 60-69
Author(s):  
Gehad El-Sayed ◽  
Mohamed El-Diasty ◽  
Shaimaa Zayed
Keyword(s):  
Body Weight ◽  
Hemoglobin Concentration ◽  
Liver Function Tests ◽  
Mean Corpuscular Hemoglobin ◽  
Corpuscular Hemoglobin ◽  
Control Groups ◽  
Blood Electrolytes ◽  
Calcium Phosphorus ◽  
Hematological And Biochemical Parameters ◽  
Drinking Milk

The use of Pediococcus (23×106 CFU/calf/day) orally in drinking milk once daily for one month in Holstein calves have highly significant effect on blood picture ,liver function tests, kidney function test ,blood electrolytes and body weight in cow calves. There were a significant increase in total erythrocytes count , hemoglobin content, packed cell volume, mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, thrombocyte count, total leucocytes count, neutrophils counts, eosinophil, basophils, total protein and its fractions, level of alkaline phosphatase (ALP),level of sodium ,calcium ,phosphorus and body weight . On the other hand there were significant decrease in urea and potassium level in groups treated by Pediococcus compared to the control groups. Moreover there were a non-significant changes in lymphocytes, monocytes, creatinine, alanine transaminase (ALT), aspartate transaminase (AST), in the same groups compared to the control groups.

Coeliac disease and the liver: spectrum of liver histology, serology and treatment response at a tertiary referral centre

2017 ◽  
Vol 71 (5) ◽  
pp. 412-419 ◽  
Author(s):  
Kaushik Majumdar ◽  
Puja Sakhuja ◽  
Amarender Singh Puri ◽  
Kavita Gaur ◽  
Aiman Haider ◽  
...  
Keyword(s):  
Liver Disease ◽  
Liver Biopsy ◽  
Coeliac Disease ◽  
Liver Function Tests ◽  
Liver Histology ◽  
Tertiary Referral Centre ◽  
Antigliadin Antibodies ◽  
Gluten Sensitive Enteropathy ◽  
Liver Biopsies ◽  
Laboratory Investigations

BackgroundCoeliac disease (CD) is a gluten-sensitive enteropathy diagnosed on the basis of ESPGHAN criteria and clinical response to gluten-free diet (GFD). Histological abnormalities on liver biopsy have been noted in CD but have seldom been described.AimsTo assess the histological spectrum of ‘coeliac hepatitis’ and possibility of reversal of such features after a GFD.MethodsTwenty-five patients with concomitant CD and hepatic derangement were analysed for clinical profile, laboratory investigations and duodenal and liver biopsy. A histological comparison of pre- and post-GFD duodenal and liver biopsies was carried out, wherever possible.ResultsFifteen patients presenting with CD subsequently developed abnormal liver function tests; 10 patients presenting with liver disease were found to have tissue positive transglutaminase in 70% and antigliadin antibodies in 60%. Serological markers for autoimmune liver disease (AILD) were positive in eight patients. Liver histology ranged from mild reactive hepatitis, chronic hepatitis, steatosis to cirrhosis. Liver biopsies after a GFD were available in six cases, of which five showed a decrease in steatosis, portal and lobular inflammation and fibrosis score.ConclusionCoeliac hepatitis could be a distinct entity and the patients may present with either CD or secondary hepatic derangement. Evaluation for the presence of CD is recommended for patients presenting with AILD, unexplained transaminasaemia or anaemia. This is one of the very few studies demonstrating the continuum of liver histological changes in ‘coeliac hepatitis’. Trial of a GFD may result in clinicopathological improvement of ‘coeliac hepatitis’.

scholarly journals Scrub Typhus and Other Rickettsial Infections

2021 ◽  
Vol 25 (S2) ◽  
pp. S138-S143
Author(s):  
Karthik Gunasekaran ◽  
George M. Varghese ◽  
Deepti Bal
Keyword(s):  
Scrub Typhus ◽  
Rickettsial Infections

scholarly journals A Case Report of Rickettsial Meningitis

2020 ◽  
Vol 7 (2) ◽  
pp. 100-103
Author(s):  
Sadia Islam ◽  
Syed Wahidur Rahman ◽  
Tasrina Shamnaz Samdani
Keyword(s):  
Supportive Therapy ◽  
Neurological Involvement ◽  
High Grade ◽  
High Grade Fever ◽  
Fluid Analysis ◽  
Rickettsial Infections ◽  
Obligate Intracellular Bacteria ◽  
Wbc Count ◽  
Classical Triad ◽  
Persistent Headache

Rickettsial diseases are a group of infections caused by the obligate intracellular bacteria Rickettsia. Rickettsial infections are common in southern Europe. The disease is usually characterized by the classical triad of fever, eschar and rash. Complications including neurological involvement are rarely described. We report an unusual case of meningitis in a 55 years old man presenting with high grade fever for 8 days associated with persistent headache. The patient was suspected to have enteric fever and treated with injection ceftriaxone. Forty-eight hours after admission, the presence of continued high grade fever, conjunctival congestion, headache, cough, low platelet and increased WBC count, and elevated transaminase raised the possibility of a different aetiology. Finally, Rickettsial meningitis was confirmed due to history of field visit, presence of eschar, neck rigidity, raised titre of WF OX-K antigen and the cerebrospinal fluid analysis revealed increased cellularity, hypoglycorrhachia, and hyper proteinorrhachia (106 mg/dL). Patient was treated with capsule doxycycline and other supportive therapy and became afebrile within 48 hours. This uncommon clinical scenario should be taken into account in the management of patients with high grade fever on admission. Delta Med Col J. Jul 2019 7(2): 100-103

Clinical Features of Rickettsial Infection in Children in Tropical Australia—A Report of 15 Cases

2020 ◽  
Vol 66 (6) ◽  
pp. 655-660 ◽  
Author(s):  
Alexandra G A Stewart ◽  
Simon Smith ◽  
Enzo Binotto ◽  
Josh Hanson
Keyword(s):  
Scrub Typhus ◽  
Spotted Fever ◽  
Case Fatality ◽  
Spotted Fever Group ◽  
Tertiary Referral Hospital ◽  
Admission Rates ◽  
Rickettsial Infections ◽  
Retrospective Audit ◽  
Tropical Australia ◽  
The Tropics

Abstract Rickettsial infections are an under-recognized cause of acute, undifferentiated fever in the tropics. In Asia, intensive care unit (ICU) admission rates as high as 21% and case-fatality rates of up to 5% have been reported. This 20-year retrospective audit of children and adults with serologically confirmed scrub typhus or spotted fever group (SFG) infection was performed at a tertiary-referral hospital in tropical Australia. There were 15 paediatric cases during the study period (11 scrub typhus, 3 SFG and 1 undifferentiated). Hypotension [5/15 (33%)], tachycardia [6/15 (40%)] and tachypnoea [6/15 (40%)] were common at presentation. Children were more likely to be hypotensive at admission than adults [5/15 (33%) vs. 5/118 (4%), p = 0.002]. However, no child died or was admitted to ICU, compared with 18/120 (15%) adults who required ICU support during the study period, one of whom died. Paediatric rickettsial infections have a relatively benign clinical course in tropical Australia with serious complications appearing far less frequently than have been reported in the Asian literature.

scholarly journals Clinical Profile and Predictors of Outcome for Pediatric Scrub Typhus at a Tertiary Care Hospital

2020 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Kiruthika Muthukrishnan ◽  
Shruthi Tarikere ◽  
Rajakumar Padur Sivaraman ◽  
Shuba Sankaranarayanan ◽  
Krithika Prabaharan ◽  
...  
Keyword(s):  
Scrub Typhus ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Clinical Profile ◽  
Enzyme Linked Immunosorbent Assay ◽  
Care Hospital ◽  
Emerging Infections ◽  
Predictors Of Outcome ◽  
Altered Sensorium ◽  
Elevated Liver Enzymes

Background: Scrub typhus is an important cause of acute undifferentiated fever. It is currently one of the most covert re-emerging infections and the most common rickettsial infection caused by Orientia tsutsugamushi. Untreated cases can have mortality rates as high as 30-35%. Objectives: This study was done to study demographical data, clinical profile, and predictors of outcome for scrub typhus in children who were admitted to our institution, a tertiary care hospital in south India. Methods: In this retrospective study, children diagnosed with scrub typhus based on IgM enzyme-linked immunosorbent assay (ELISA), between January 2012 and June 2019 were included. Detailed history, clinical examination findings, laboratory profile, complications, and outcome were analyzed. Results: A total of 120 patients were identified, of whom 84 (42 males- and 42 females) cases satisfied the inclusion criteria and were analyzed. About 80 (95%) cases had a complete recovery, whereas 4 patients (5%) died of multiple complications. Hypotension, hypoxia, altered sensorium, hypoalbuminemia, elevated liver enzymes, azotemia, and deranged coagulation on admission were considered as poor predictors of outcome for scrub typhus. Conclusions: Pediatric scrub typhus is a common infection and should be suspected in cases with fever for more than 5 days and non-specific signs and symptoms. Early detection and timely management lead to a higher recovery rate. Hypotension, hypoxia, azotemia, altered sensorium, and bleeding manifestations on admission were associated with unfavorable outcomes.

scholarly journals Systemic evaluation of febrile thrombocytopenia

2018 ◽  
Vol 5 (1) ◽  
pp. 91
Author(s):  
Vivek Katiyar ◽  
Rajesh Khare
Keyword(s):  
Platelet Count ◽  
Viral Infections ◽  
Scrub Typhus ◽  
High Morbidity ◽  
Febrile Patient ◽  
Rapid Improvement ◽  
Clinical Recovery ◽  
Rickettsial Infections ◽  
Fatal Bleeding ◽  
Bleeding Manifestation

Background: Febrile patient with thrombocytopenia is commonly encountered by physicians especially during monsoon and perimonsoon period. Infections with protozoa, bacteria and viruses can cause thrombocytopenia with or without disseminated intravascular coagulation. Commonly dengue, malaria, scrub typhus and other rickettsial infections, meningococci, leptospira and certain viral infections present as fever with thrombocytopenia. Occasionally these patients can go on to develop a stormy course with multiorgan dysfunction requiring intensive care unit admission associated with high morbidity and mortality. Though thrombocytopenia is encountered in various diseases, it is for sure that potentially fatal bleeding due to thrombocytopenia is rare. The study was intended to know the underlying etiology of febrile thrombocytopenia in our community, the various presentations and relationship between platelet level and severity of disease and prognosis.Methods: This study was carried out in 218 adult patients (age above 18 years) presenting with fever having thrombocytopenia (platelet count <1,50,000/mm3) in Dept. of medicine in IIMS and  R Lucknow UP.Results: Dengue was the commonest cause of fever with thrombocytopenia (58.71%) followed by P. falciparum malaria 8.71% and P. vivax malaria 6.88%. Bleeding manifestations were seen in 24.31% of patients. 58.49% of patients had patechie/purpura as the commonest bleeding manifestation followed by hematuria in 16.98 %.Conclusions: Fever with thrombocytopenia consists of occult presentations of common diseases rather than rare disease. Infection is the commonest cause of fever with thrombocytopenia. Among infections, dengue was the commonest cause. Treatment of underlying condition will lead to rapid improvement in platelet count with complete clinical recovery.

scholarly journals Accessing the Hypoglycemic Effects of Seed Extract from Celery (Apium graveolens) in Alloxan-Induced Diabetic Rats

2019 ◽  
pp. 1-10
Author(s):  
Kamal Mans ◽  
Talal Aburjai
Keyword(s):  
Ethanol Extract ◽  
Diabetic Rats ◽  
Seed Extract ◽  
Apium Graveolens ◽  
Control Group ◽  
Mean Values ◽  
Neutrophil Percentage ◽  
The Mean ◽  
Hematological And Biochemical Parameters ◽  
Wbc Count

Aims: The present study is aimed to evaluate the potential mechanism of antidiabetic action of seed extract celery (Apium graveolens) and its effects on some hematological and biochemical parameters in alloxan-induced diabetic rats. Study Design: Laboratory-experimental design was used in this study. Methodology: This study was conducted on fifty experimental animals. Adult albino rats (Sprague-Dawely strain) weighing about 220 g each were used throughout the study. Fifty rats were randomly assigned to five experimental groups of 10 rats each: Group 1 - received normal saline (0.5 ml/kg), and serves as control. Group II - gavaged daily for thirty days with 1ml of the extract at doses of 425 mg/kg body wt and served as control. Group III - Untreated diabetic rats that received two doses of alloxan 150 mg/kg. Group IV - Treated diabetic rats for thirty consecutive days with 1 ml of the extract at a dose of 425 mg/kg body wt.  Group V: Treated diabetic rats for thirty consecutive days with 14.2 mg/kg of metformin. Several hematological and biochemical parameters were assessed. Results: It was found that the administration of ethanol extract of A. graveolens produced significant reduction in blood glucose level in diabetic rats after thirty days of treatment. However, there was a significant (P=.05) increase of insulin secretion. Also, the RBC and WBC count, PCV and neutrophil percentage decreased significantly (P=.05). This study indicated that the ethanol extract increased the RBC and WBC counts, PCV, ESR, and neutrophil percentage in diabetic rats. However, the WBC count of the extract - treated diabetic group was still lower than those of control values. Administration of the extract resulted in a significant reduction in the mean values of serum cholesterol, triglyceride, LDL-C, ESR, urea, uric acid, creatinine accompanied by an increase in the mean values of total protein, albumin, insulin, HDL-C, neutrophile count and PCV in diabetic rats. No significant changes in these parameters were found in the control group. Effects produced by this extract were closely similar to a standard antidiabetic drug, metformin.   (p<0.05) hypoglycemic effects in alloxan-induced diabetic rats, protection against body weight loss of diabetic animals and might alleviate diabetes-induced disturbances of some biochemical and hematological parameters. Conclusion: our study was dedicated to monitoring changes in the lipid profile.

Hospital based serological evidence of rickettsial diseases and assessment diagnostic tests of pyrexia of unknown origin

2019 ◽  
Vol 50 (2) ◽  
pp. 122-124
Author(s):  
Muzaheed ◽  
Amal J Fatani ◽  
Darshan D Divakar ◽  
Sanjay Rathod ◽  
Mustafa S Aloahd
Keyword(s):  
Scrub Typhus ◽  
Spotted Fever ◽  
Unknown Origin ◽  
Molecular Techniques ◽  
Serological Evidence ◽  
Serological Tests ◽  
Pyrexia Of Unknown Origin ◽  
Rickettsial Infections ◽  
Igm Elisa ◽  
Rickettsial Diseases

The present study examined hospital-based serological tests of rickettsial infections and assessment for diagnosis of pyrexia of unknown origin (PUO). Blood samples were tested for Weil Felix antigens, ELISA for scrub typhus group and polymerase chain reaction (PCR) to detect the presence of DNA of spotted and scrub typhus group with the help of specific oligonucleotide. We tested 450 patient samples and found 101 Weil Felix-positive with 15 having ≥320 titres. IgM ELISA identified 32 (7.1%) positive cases. Positive PCR was seen in 13 (2.9%) samples, being only 40.1% of those testing positive for ELISA. Rickettsial infection is predominantly diagnosed through serological evidence in combination with molecular techniques. The Weil Felix test has a number of disadvantages and tends to provide false-positive results in a number of scenarios, especially where scrub typhus and spotted fever are widely distributed.

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