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Eilbert W, Matella A. Tick-Borne Diseases. Emerg Med Clin North Am 2024; 42:287-302. [PMID: 38641392 DOI: 10.1016/j.emc.2024.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/21/2024]
Abstract
Ticks are responsible for the vast majority of vector-borne illnesses in the United States. The number of reported tick-borne disease (TBD) cases has more than doubled in the past 20 years. The majority of TBD cases occur in warm weather months in individuals with recent outdoor activities in wooded areas. The risk of contracting a TBD is also highly dependent on geographic location. Between 24 and 48 hours of tick attachment is required for most disease transmission to occur. Only 50% to 70% of patients with a TBD will recall being bitten by a tick, and TBDs are often initially misdiagnosed as a viral illness. Most TBDs are easily treated when diagnosed early in their course.
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Affiliation(s)
- Wesley Eilbert
- Department of Emergency Medicine, University of Illinois Chicago, College of Medicine, Room 469, COME, 1819 West Polk Street, Chicago, IL 60612, USA.
| | - Andrew Matella
- Department of Emergency Medicine, University of Illinois Chicago, College of Medicine, Room 469, COME, 1819 West Polk Street, Chicago, IL 60612, USA
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2
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Cheng R, Zhou C, Zhao M, Zhang S, Wan W, Yu Y, Wen B, Jiao J, Xiong X, Xu Q, OuYang X. TRIM56-mediated production of type I interferon inhibits intracellular replication of Rickettsia rickettsii. Microbiol Spectr 2024; 12:e0369523. [PMID: 38358243 PMCID: PMC10986528 DOI: 10.1128/spectrum.03695-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 01/18/2024] [Indexed: 02/16/2024] Open
Abstract
Rickettsia rickettsii (R. rickettsii), the causative agent of Rocky Mountain spotted fever (RMSF), is the most pathogenic member among Rickettsia spp. Previous studies have shown that tripartite motif-containing 56 (TRIM56) E3 ligase-induced ubiquitination of STING is important for cytosolic DNA sensing and type I interferon production to induce anti-DNA viral immunity, but whether it affects intracellular replication of R. rickettsii remains uncharacterized. Here, we investigated the effect of TRIM56 on HeLa and THP-1 cells infected with R. rickettsii. We found that the expression of TRIM56 was upregulated in the R. rickettsii-infected cells, and the overexpression of TRIM56 inhibited the intracellular replication of R. rickettsii, while R. rickettsii replication was enhanced in the TRIM56-silenced host cells with the reduced phosphorylation of IRF3 and STING and the increased production of interferon-β. In addition, the mutation of the TRIM56 E3 ligase catalytic site impairs the inhibitory function against R. rickettsii in HeLa cells. Altogether, our study discovers that TRIM56 is a host restriction factor of R. rickettsii by regulating the cGAS-STING-mediated signaling pathway. This study gives new evidence for the role of TRIM56 in the innate immune response against intracellular bacterial infection and provides new therapeutic targets for RMSF. IMPORTANCE Given that Rickettsia rickettsii (R. rickettsii) is the most pathogenic member within the Rickettsia genus and serves as the causative agent of Rocky Mountain spotted fever, there is a growing need to explore host targets. In this study, we examined the impact of host TRIM56 on R. rickettsii infection in HeLa and THP-1 cells. We observed a significant upregulation of TRIM56 expression in R. rickettsii-infected cells. Remarkably, the overexpression of TRIM56 inhibited the intracellular replication of R. rickettsii, while silencing TRIM56 enhanced bacterial replication accompanied by reduced phosphorylation of IRF3 and STING, along with increased interferon-β production. Notably, the mutation of the TRIM56's E3 ligase catalytic site did not impede R. rickettsii replication in HeLa cells. Collectively, our findings provide novel insights into the role of TRIM56 as a host restriction factor against R. rickettsii through the modulation of the cGAS-STING signaling pathway.
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Affiliation(s)
- Ruxi Cheng
- Artemisinin Research Center, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
| | - Chunyu Zhou
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
| | - Mingliang Zhao
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
| | - Shan Zhang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
| | - Weiqiang Wan
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
| | - Yonghui Yu
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
| | - Bohai Wen
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
| | - Jun Jiao
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
| | - Xiaolu Xiong
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
| | - Qin Xu
- Artemisinin Research Center, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Xuan OuYang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
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Gual-Gonzalez L, Self SCW, Meyer M, Cantillo-Barraza O, Torres ME, Nolan MS. Human spotted fever group Rickettsia seroprevalence and associated epidemiologic factors among diverse, marginalized populations in South Carolina. Ticks Tick Borne Dis 2024; 15:102288. [PMID: 38071922 DOI: 10.1016/j.ttbdis.2023.102288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 11/21/2023] [Accepted: 11/27/2023] [Indexed: 02/12/2024]
Abstract
Illness caused by spotted fever group Rickettsia (SFGR) is increasing nationally, with affluent, white residents most likely to be diagnosed. The common under-representativeness of marginalized populations in research studies and these vulnerable populations' health inequities make veritable epidemiologic risk factor profiling challenging, which inhibits equitable public health intervention. The current study leveraged 749 banked sera and associated surveys from a cross-sectional minority-represented COVID-19 study to perform an SFGR seroprevalence investigation. SFGR titers (1:64, 1:128, 1:256, 1:512, and 1:1024) were measured using commercially available indirect fluorescent antibody slides-SFGR positive cases were defined as titers ≥1:128. Multivariable logistic regression and Getis-Ord-Gi* hotspot analyses were used to identify seropositivity-associated factors and determine seropositive clusters. Among a mostly minority and lower socioeconomic population, a 3.4 % SFGR seropositivity was noted at the ≥1:128 titer level. Male gender (Odds Ratio (OR): 3.20; adjusted Odds Ratio (aOR)s: 3.73), age (aOR: 1.05), any frequency of tick bite (OR: 2.29), and spending time working outdoors (OR: 5.05) were associated with SFGR IgG seropositivity. Moreover, the geospatial analysis showed clusters of seropositivity in areas where previous case reports occurred, suggesting potential endemic foci.
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Affiliation(s)
- Lídia Gual-Gonzalez
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, 915 Greene St, Room 327A, Columbia, SC 29201, USA
| | - Stella C W Self
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, 915 Greene St, Room 327A, Columbia, SC 29201, USA
| | - Madeleine Meyer
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, 915 Greene St, Room 327A, Columbia, SC 29201, USA; Department of Environmental Health Sciences, Arnold School of Public Health, University of South Carolina, Columbia, SC 29201, USA
| | - Omar Cantillo-Barraza
- Grupo Biología y Control Enfermedades Infecciosas, Universidad de Antioquia, Medellín 050010, Colombia
| | - Myriam E Torres
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, 915 Greene St, Room 327A, Columbia, SC 29201, USA
| | - Melissa S Nolan
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, 915 Greene St, Room 327A, Columbia, SC 29201, USA.
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Nelson JJ, Buchmiller K, Valentine MJ, Lakshmanan K, Kayastha A, Dhingra JS, Fisher RG, Parry CA, Konrad AK, Mughal A, Kirila CE. An Abnormal Presentation of Rocky Mountain Spotted Fever: A Case Report. Cureus 2024; 16:e57319. [PMID: 38690503 PMCID: PMC11060014 DOI: 10.7759/cureus.57319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/26/2024] [Indexed: 05/02/2024] Open
Abstract
The intracellular coccobacilli Rickettsia rickettsii causes Rocky Mountain Spotted Fever, a potentially fatal illness. This bacterium is transmitted to humans through a tick vector. Patients classically present with a triad of symptoms, including fever, headache, and a rash that begins on the extremities and spreads proximally to the trunk. Diagnosis of this disease can prove difficult when patients have unusual symptoms, such as hypertensive crisis. In this case report, we present a 29-year-old male who arrived at the emergency room with altered mental status and a hypertensive crisis after his family reported one week of changes in his behavior. The patient had no evidence of ticks, tick bites, fever, or rash. Positive findings in the emergency room included a WBC of 14.9 × 109. All other physical exams, imaging, and laboratory findings were non-contributory. The patient was promptly given IV hydralazine to control his blood pressure and empiric IV ceftriaxone for potential infection, and he was admitted for observation. Over the course of three days, WBC levels decreased, and his altered mental status improved. On day 3, the patient remembered a tick crawling across his hand, and this prompted the ordering of immunoglobulin levels for tick-borne illnesses. IgM for RMSF was positive. This case presentation illustrates the need for clinicians to keep the potential diagnosis of RMSF high on the differential, even in the presence of a paucity of symptoms, as prompt treatment with doxycycline can be lifesaving. This case may also be one of the first reported in the literature of hypertension being a symptom of Rocky Mountain Spotted Fever. It is plausible, however, that this patient's hypertension was due to an acute stress response.
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Affiliation(s)
- Joshua J Nelson
- College of Osteopathic Medicine, Kansas City University, Kansas City, USA
| | - Kaedon Buchmiller
- College of Osteopathic Medicine, Kansas City University, Kansas City, USA
| | | | | | - Ankur Kayastha
- College of Osteopathic Medicine, Kansas City University, Kansas City, USA
| | - Jagjot S Dhingra
- College of Osteopathic Medicine, Kansas City University, Kansas City, USA
| | | | - Connor A Parry
- College of Osteopathic Medicine, Kansas City University, Kansas City, USA
| | - Annie K Konrad
- College of Osteopathic Medicine, Kansas City University, Kansas City, USA
| | - Arman Mughal
- College of Osteopathic Medicine, Kansas City University, Kansas City, USA
| | - Carol E Kirila
- Primary Care/Internal Medicine, Kansas City University, Kansas City, USA
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Carvajal-Gamez BI, Olguín-Barrera A, Tinoco-Gracia L, Gordillo-Perez G, Dzul-Rosado K, Aguilar-Tipacamú G, Hidalgo-Ruiz M, Mosqueda J. Development and validation of a novel detection method for Rickettsia rickettsii using a loop-mediated isothermal amplification assay. Front Microbiol 2024; 14:1276809. [PMID: 38260903 PMCID: PMC10800886 DOI: 10.3389/fmicb.2023.1276809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Accepted: 11/17/2023] [Indexed: 01/24/2024] Open
Abstract
Introduction Rickettsia rickettsii is an obligate, intracellular pathogen and the causative agent of Rocky Mountain spotted fever (RMSF). RMSF is an important zoonotic disease due to its high fatal outcome in humans. The difficulty of clinical diagnosis due to the low sensitivity and specificity of current diagnostic methods are a principal setback. We reported the development of a new method for the detection of R. rickettsii in human and tick DNA samples using loop-mediated isothermal amplification (LAMP), as well as the validation of the LAMP test for R. rickettsii in field samples of infected ticks and humans, determining the diagnostic sensitivity and specificity, as well as the reproducibility of the test. Methods This technique uses hydroxy naphthol blue (HNB) as an indicator of the formation of magnesium pyrophosphate, a marker for the presence of DNA. Here, we used a putative R. rickettsii gene as a target for three pairs of primers that specifically amplify R. rickettsii DNA by hairpin-based isothermal amplification technique (LAMP). Results and discussion The sensitivity of the assay was ~1.6-3 pg, which is 10 times more sensitive than PCR. To determine the diagnostics specificity and sensitivity, 103 human DNA samples and 30 tick DNA samples were evaluated. For the human samples, a sensitivity for HNB of 93%, a specificity of 70% and a k of 0.53 were obtained. For electrophoresis the sensitivity was 97% with a specificity of 58% and a k of 0.42. For tick samples, a sensitivity of 80% was obtained, a specificity of 93% for HNB and for electrophoresis the sensitivity and specificity were 87%. The k for both was 0.73. The degree of concordance between HNB and electrophoresis was 0.82 for humans and for ticks, it was 0.87. The result is obtained in shorter time, compared to a PCR protocol, and is visually interpreted by the color change. Therefore, this method could be a reliable tool for the early diagnosis of rickettsiosis.
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Affiliation(s)
- Bertha I. Carvajal-Gamez
- Immunology and Vaccines Laboratory, Natural Sciences College, Autonomous University of Queretaro, Queretaro, Mexico
- Cuerpo Academico, Salud Animal y Microbiologia Ambiental, Natural Sciences College, Autonomous University of Queretaro, Queretaro, Mexico
| | - Aída Olguín-Barrera
- Immunology and Vaccines Laboratory, Natural Sciences College, Autonomous University of Queretaro, Queretaro, Mexico
- Maestria en Salud y Producción Animal Sustentable, Facultad de Ciencias Naturales, Universidad Autónoma de Querétaro, Querétaro, Mexico
| | - Luis Tinoco-Gracia
- Laboratorio de Salud Pública Veterinaria, Instituto de Investigaciones en Ciencias Veterinarias, Universidad Autónoma de Baja California, Baja California, Mexico
| | - Guadalupe Gordillo-Perez
- Unidad de Investigación Médica en Enfermedades Infecciosas, Hospital de Pediatría, Centro Medico Nacional SXXI-Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Karla Dzul-Rosado
- Dr. Hideyo Noguchi Regional Research Center, Autonomous University of Yucatan, Mérida, Mexico
| | - Gabriela Aguilar-Tipacamú
- Cuerpo Academico, Salud Animal y Microbiologia Ambiental, Natural Sciences College, Autonomous University of Queretaro, Queretaro, Mexico
| | - Mario Hidalgo-Ruiz
- Immunology and Vaccines Laboratory, Natural Sciences College, Autonomous University of Queretaro, Queretaro, Mexico
| | - Juan Mosqueda
- Immunology and Vaccines Laboratory, Natural Sciences College, Autonomous University of Queretaro, Queretaro, Mexico
- Cuerpo Academico, Salud Animal y Microbiologia Ambiental, Natural Sciences College, Autonomous University of Queretaro, Queretaro, Mexico
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Araújo Pereira MO, Júnior ÁF, Batista Rodrigues ES, Mulser H, Nascimento de Mello E Silva G, Pio Dos Santos WT, de Souza Gil E. An impedimetric immunosensor for diagnosis of Brazilian spotted fever in blood plasma. ANALYTICAL METHODS : ADVANCING METHODS AND APPLICATIONS 2024; 16:189-195. [PMID: 38098444 DOI: 10.1039/d3ay01308a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
Brazilian spotted fever (BSF) is a serious disease of medical importance due to its rapid evolution and high lethality. The effectiveness of the treatment mainly depends on the rapid diagnosis, which is currently performed by indirect immunofluorescence and PCR tests, which require high costs and laboratory structure. In order to propose an alternative methodology, we sought to develop an impedimetric immunosensor (IM) based on the immobilization of specific IgY antibodies for IgG anti Rickettsia rickettsii, using blood plasma from capybara (Hydrochoerus hydrochaeris), for characterization, validation and applications of the ready IM. IM selectivity was observed when comparing capybara reagent IgG (IgGcr) readings with non-reagent IgG (IgGnr). A reagent IgG calibration curve was obtained, from which the limits of detection (LOD) and quantification (LOQ) of 1.3 ng mL-1 and 4.4 ng mL-1 were calculated, respectively. The accuracy tests showed that different concentrations of IgGcr showed a maximum deviation of 20.0%, with CI between 90.00% and 95.00%. Intermediate precision tests showed a relative standard deviation of 2.09% for researcher 1 and 2.61% for researcher 2, and the F test showed no significant difference between the recovery values found between the two analysts, since Fcal 1.56 < 5.05 and P-value 0.48 > 0, 05. Therefore, an impedimetric immunosensor was developed to detect anti BSF IgG in capybara blood plasma, which greatly contributes to the improvement of diagnostic tests, cost reduction and ease of execution.
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Affiliation(s)
| | | | | | - Helena Mulser
- School of Pharmacy, Federal University of Goiás, Brazil.
| | | | - Wallans Torres Pio Dos Santos
- Chemistry Department, Federal University of Vales do Jequitinhonha e Mucuri, Campus JK, 39100000, Diamantina, Minas Gerais, Brazil
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Rowan S, Mohseni N, Chang M, Burger H, Peters M, Mir S. From Tick to Test: A Comprehensive Review of Tick-Borne Disease Diagnostics and Surveillance Methods in the United States. Life (Basel) 2023; 13:2048. [PMID: 37895430 PMCID: PMC10608558 DOI: 10.3390/life13102048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 10/08/2023] [Accepted: 10/11/2023] [Indexed: 10/29/2023] Open
Abstract
Tick-borne diseases (TBDs) have become a significant public health concern in the United States over the past few decades. The increasing incidence and geographical spread of these diseases have prompted the implementation of robust surveillance systems to monitor their prevalence, distribution, and impact on human health. This comprehensive review describes key disease features with the geographical distribution of all known tick-borne pathogens in the United States, along with examining disease surveillance efforts, focusing on strategies, challenges, and advancements. Surveillance methods include passive and active surveillance, laboratory-based surveillance, sentinel surveillance, and a One Health approach. Key surveillance systems, such as the National Notifiable Diseases Surveillance System (NNDSS), TickNET, and the Tick-Borne Disease Laboratory Network (TBDLN), are discussed. Data collection and reporting challenges, such as underreporting and misdiagnosis, are highlighted. The review addresses challenges, including lack of standardization, surveillance in non-human hosts, and data integration. Innovations encompass molecular techniques, syndromic surveillance, and tick surveillance programs. Implications for public health cover prevention strategies, early detection, treatment, and public education. Future directions emphasize enhanced surveillance networks, integrated vector management, research priorities, and policy implications. This review enhances understanding of TBD surveillance, aiding in informed decision-making for effective disease prevention and control. By understanding the current surveillance landscape, public health officials, researchers, and policymakers can make informed decisions to mitigate the burden of (TBDs).
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Affiliation(s)
| | | | | | | | | | - Sheema Mir
- College of Veterinary Medicine, Western University of Health Sciences, Pomona, CA 91766, USA; (S.R.)
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Aneela A, Almutairi MM, Alouffi A, Ahmed H, Tanaka T, da Silva Vaz I, Chang SC, Chen CC, Ali A. Molecular Detection of Rickettsia hoogstraalii in Hyalomma anatolicum and Haemaphysalis sulcata: Updated Knowledge on the Epidemiology of Tick-Borne Rickettsia hoogstraalii. Vet Sci 2023; 10:605. [PMID: 37888557 PMCID: PMC10611279 DOI: 10.3390/vetsci10100605] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 09/23/2023] [Accepted: 10/01/2023] [Indexed: 10/28/2023] Open
Abstract
Ticks are hematophagous ectoparasites that transmit pathogens to animals and humans. Updated knowledge regarding the global epidemiology of tick-borne Rickettsia hoogstraalii is dispersed, and its molecular detection and genetic characterization are missing in Pakistan. The current study objectives were to molecularly detect and genetically characterize Rickettsia species, especially R. hoogstraalii, in hard ticks infesting livestock in Pakistan, and to provide updated knowledge regarding their global epidemiology. Ticks were collected from livestock, including goats, sheep, and cattle, in six districts of Khyber Pakhtunkhwa (KP) Pakistan. Overall, 183 hosts were examined, of which 134 (73.2%), including goats (number = 39/54, 72.2%), sheep (23/40, 57.5%), and cattle (71/89, 80%) were infested by 823 ticks. The most prevalent tick species was Rhipicephalus microplus (number = 283, 34.3%), followed by Hyalomma anatolicum (223, 27.0%), Rhipicephalus turanicus (122, 14.8%), Haemaphysalis sulcata (104, 12.6%), Haemaphysalis montgomeryi (66, 8.0%), and Haemaphysalis bispinosa (25, 3.03%). A subset of 210 ticks was selected and screened for Rickettsia spp. using PCR-based amplification and subsequent sequencing of rickettsial gltA and ompB fragments. The overall occurrence rate of R. hoogstraalii was 4.3% (number = 9/210). The DNA of Rickettsia was detected in Hy. anatolicum (3/35, 8.5%) and Ha. sulcata (6/49, 12.2%). However, no rickettsial DNA was detected in Rh. microplus (35), Rh. turanicus (35), Ha. montgomeryi (42), and Ha. bispinosa (14). The gltA and ompB fragments showed 99-100% identity with R. hoogstraalii and clustered phylogenetically with the corresponding species from Pakistan, Italy, Georgia, and China. R. hoogstraalii was genetically characterized for the first time in Pakistan and Hy. anatolicum globally. Further studies should be encouraged to determine the role of ticks in the maintenance and transmission of R. hoogstraalii in different hosts.
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Affiliation(s)
- Aneela Aneela
- Department of Zoology, Abdul Wali Khan University Mardan, Mardan 23200, Pakistan
| | - Mashal M. Almutairi
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia;
| | - Abdulaziz Alouffi
- King Abdulaziz City for Science and Technology, Riyadh 12354, Saudi Arabia;
| | - Haroon Ahmed
- Department of Biosciences, COMSATS University Islamabad (CUI), Park Road, Chak Shahzad, Islamabad 45550, Pakistan;
| | - Tetsuya Tanaka
- Laboratory of Infectious Diseases, Joint Faculty of Veterinary Medicine, Kagoshima University, Kagoshima 890-0065, Japan;
| | - Itabajara da Silva Vaz
- Centro de Biotecnologia and Faculdade de Veterinária, Universidade Federal do Rio Grande do Sul, Porto Alegre 90050-170, RS, Brazil;
| | - Shun-Chung Chang
- Department of Emergency Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi 60002, Taiwan
| | - Chien-Chin Chen
- Department of Pathology, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi 60002, Taiwan;
- Department of Cosmetic Science, Chia Nan University of Pharmacy and Science, Tainan 71710, Taiwan
- Ph.D. Program in Translational Medicine, Rong Hsing Research Center for Translational Medicine, National Chung Hsing University, Taichung 40227, Taiwan
- Department of Biotechnology and Bioindustry Sciences, College of Bioscience and Biotechnology, National Cheng Kung University, Tainan 70101, Taiwan
| | - Abid Ali
- Department of Zoology, Abdul Wali Khan University Mardan, Mardan 23200, Pakistan
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Silva-Ramos CR, Faccini-Martínez ÁA, Serna-Rivera CC, Mattar S, Hidalgo M. Etiologies of Zoonotic Tropical Febrile Illnesses That Are Not Part of the Notifiable Diseases in Colombia. Microorganisms 2023; 11:2154. [PMID: 37763998 PMCID: PMC10535066 DOI: 10.3390/microorganisms11092154] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 06/15/2023] [Accepted: 06/15/2023] [Indexed: 09/29/2023] Open
Abstract
In Colombia, tropical febrile illnesses represent one of the most important causes of clinical attention. Febrile illnesses in the tropics are mainly zoonotic and have a broad etiology. The Colombian surveillance system monitors some notifiable diseases. However, several etiologies are not monitored by this system. In the present review, we describe eleven different etiologies of zoonotic tropical febrile illnesses that are not monitored by the Colombian surveillance system but have scientific, historical, and contemporary data that confirm or suggest their presence in different regions of the country: Anaplasma, Arenavirus, Bartonella, relapsing fever group Borrelia, Coxiella burnetii, Ehrlichia, Hantavirus, Mayaro virus, Orientia, Oropouche virus, and Rickettsia. These could generate a risk for the local population, travelers, and immigrants, due to which they should be included in the mandatory notification system, considering their importance for Colombian public health.
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Affiliation(s)
- Carlos Ramiro Silva-Ramos
- Grupo de Enfermedades Infecciosas, Departamento de Microbiología, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogotá 110231, Colombia;
| | - Álvaro A. Faccini-Martínez
- Servicio de Infectología, Hospital Militar Central, Bogotá 110110, Colombia;
- Servicios y Asesorías en Infectología—SAI, Bogotá 110110, Colombia
| | - Cristian C. Serna-Rivera
- Grupo de Investigación en Ciencias Veterinarias (CENTAURO), Línea de Investigación Zoonosis Emergentes y Re-Emergentes, Facultad de Ciencias Agrarias, Universidad de Antioquia, Medellín 050034, Colombia;
- Grupo de Investigación en Genética, Biodiversidad y Manejo de Ecosistemas (GEBIOME), Departamento de Ciencias Biológicas, Facultad de Ciencias Exactas y Naturales, Universidad de Caldas, Manizales 170004, Colombia
| | - Salim Mattar
- Instituto de Investigaciones Biológicas del Trópico, Universidad de Córdoba, Montería 230001, Colombia;
| | - Marylin Hidalgo
- Grupo de Enfermedades Infecciosas, Departamento de Microbiología, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogotá 110231, Colombia;
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10
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Dumic I, Person E, Igandan O, Adetimehin O, Nordstrom CW, Williams C, Shweta F. Anaplasma phagocytophilum Community-Acquired Pneumonia: Case Report and Literature Review. Microorganisms 2023; 11:1483. [PMID: 37374985 DOI: 10.3390/microorganisms11061483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 05/21/2023] [Accepted: 05/29/2023] [Indexed: 06/29/2023] Open
Abstract
Anaplasma phagocytophilum is an emerging, Gram-negative, and obligate intracellular pathogen that is infrequently implicated as a causative agent of community-acquired pneumonia. In this paper, we report about an immunocompetent patient from the community who presented with fever, cough, and shortness of breath. Chest X-ray and CT showed bilateral lung infiltrates. Extensive workup for other common and uncommon causes of pneumonia was positive for anaplasmosis. The patient recovered completely with doxycycline therapy. In our literature review, we find that in 80% of reported cases of anaplasmosis pneumonia, empiric treatment did not contain doxycycline, which in some cases led to acute respiratory distress syndrome. Clinicians in tick-borne disease endemic regions should be aware of this unusual presentation of anaplasmosis in order to be able to select appropriate antimicrobial regimens and initiate timely management.
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Affiliation(s)
- Igor Dumic
- Mayo Clinic Alix School of Medicine, Rochester, MN 55905, USA
- Department of Hospital Medicine, Mayo Clinic Health System, Eau Claire, WI 54703, USA
| | - Emily Person
- Department of Emergency Medicine, Mayo Clinic, Rochester, MN 55905, USA
| | - Oladapo Igandan
- Mayo Clinic Alix School of Medicine, Rochester, MN 55905, USA
- Department of Hospital Medicine, Mayo Clinic Health System, Eau Claire, WI 54703, USA
| | - Omobolanle Adetimehin
- Mayo Clinic Alix School of Medicine, Rochester, MN 55905, USA
- Department of Hospital Medicine, Mayo Clinic Health System, Eau Claire, WI 54703, USA
| | - Charles W Nordstrom
- Mayo Clinic Alix School of Medicine, Rochester, MN 55905, USA
- Department of Hospital Medicine, Mayo Clinic Health System, Eau Claire, WI 54703, USA
| | - Christopher Williams
- Mayo Clinic Alix School of Medicine, Rochester, MN 55905, USA
- Department of Pulmonary Medicine, Mayo Clinic Health System, Eau Claire, WI 54703, USA
| | - Fnu Shweta
- Mayo Clinic Alix School of Medicine, Rochester, MN 55905, USA
- Department of Infectious Disease, Mayo Clinic Health System, Eau Claire, WI 54703, USA
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11
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Cente M, Danchenko M, Skultety L, Filipcik P, Sekeyova Z. Rickettsia Deregulates Genes Coding for the Neurotoxic Cell Response Pathways in Cerebrocortical Neurons In Vitro. Cells 2023; 12:cells12091235. [PMID: 37174635 PMCID: PMC10177168 DOI: 10.3390/cells12091235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 04/20/2023] [Accepted: 04/21/2023] [Indexed: 05/15/2023] Open
Abstract
Rickettsial infections of the central nervous system (CNS) are manifested by severe neurological symptoms and represent a serious life-threatening condition. Despite the considerable health danger, only a few studies have been conducted focusing on the pathogenesis induced by Rickettsia sp. in CNS. To investigate the signaling pathways associated with the neurotoxic effects of rickettsiae, we employed an experimental model of cerebrocortical neurons combined with molecular profiling and comprehensive bioinformatic analysis. The cytopathic effect induced by Rickettsia akari and Rickettsia slovaca was demonstrated by decreased neuronal viability, structural changes in cell morphology, and extensive fragmentation of neurites in vitro. Targeted profiling revealed the deregulation of genes involved in the neuroinflammatory and neurotoxic cell response pathways. Although quantitative analysis showed differences in gene expression response, functional annotation revealed that the biological processes are largely shared between both Rickettsia species. The identified enriched pathways are associated with cytokine signaling, chemotaxis of immune cells, responses to infectious agents, interactions between neurons, endothelial and glial cells, and regulation of neuronal apoptotic processes. The findings of our study provide new insight into the etiopathogenesis of CNS infection and further expand the understanding of molecular signaling associated with neuroinvasive Rickettsia species.
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Affiliation(s)
- Martin Cente
- Institute of Neuroimmunology, Slovak Academy of Sciences, Dubravska cesta 9, 845 10 Bratislava, Slovakia
| | - Monika Danchenko
- Department of Rickettsiology, Biomedical Research Center, Slovak Academy of Sciences, Dubravska cesta 9, 845 05 Bratislava, Slovakia
| | - Ludovit Skultety
- Department of Rickettsiology, Biomedical Research Center, Slovak Academy of Sciences, Dubravska cesta 9, 845 05 Bratislava, Slovakia
| | - Peter Filipcik
- Institute of Neuroimmunology, Slovak Academy of Sciences, Dubravska cesta 9, 845 10 Bratislava, Slovakia
| | - Zuzana Sekeyova
- Department of Rickettsiology, Biomedical Research Center, Slovak Academy of Sciences, Dubravska cesta 9, 845 05 Bratislava, Slovakia
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12
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Kim Y, Clemens EG, Farner JM, Londono-Barbaran A, Grab DJ, Dumler JS. Spotted fever rickettsia-induced microvascular endothelial barrier dysfunction is delayed by the calcium channel blocker benidipine. Biochem Biophys Res Commun 2023; 663:96-103. [PMID: 37121130 PMCID: PMC10362780 DOI: 10.1016/j.bbrc.2023.04.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 04/17/2023] [Indexed: 05/02/2023]
Abstract
The tick-borne bacterium Rickettsia parkeri is an obligate intracellular pathogen that belongs to spotted fever group rickettsia (SFGR). The SFG pathogens are characterized by their ability to infect and rapidly proliferate inside host vascular endothelial cells that eventually result in impairment of vascular endothelium barrier functions. Benidipine, a wide range dihydropyridine calcium channel blocker, is used to prevent and treat cardiovascular diseases. In this study, we tested whether benidipine has protective effects against rickettsia-induced microvascular endothelial cell barrier dysfunction in vitro. We utilized an in vitro vascular model consisting of transformed human brain microvascular endothelial cells (tHBMECs) and continuously monitored transendothelial electric resistance (TEER) across the cell monolayer. We found that during the late stages of infection when we observed TEER decrease and when there was a gradual increase of the cytoplasmic [Ca2+], benidipine prevented these rickettsia-induced effects. In contrast, nifedipine, another cardiovascular dihydropyridine channel blocker specific for L-type Ca2+ channels, did not prevent R. parkeri-induced drop of TEER. Additionally, neither drug was bactericidal. These data suggest that growth of R. parkeri inside endothelial cells is associated with impairment of endothelial cell monolayer integrity due to Ca2+ flooding through specific, benidipine-sensitive T- or N/Q-type Ca2+ channels but not through nifedipine-sensitive L-type Ca2+ channels. Further study will be required to discern the exact nature of the Ca2+ channels and Ca2+ transporting system(s) involved, any contributions of the pathogen toward this process, as well as the suitability of benidipine and new dihydropyridine derivatives as complimentary therapeutic drugs against Rickettsia-induced vascular failure.
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Affiliation(s)
- Yuri Kim
- Henry M. Jackson Foundation for the Advancement of Military Medicine, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA; Uniformed Services of the Health Sciences, Department of Pathology, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA.
| | - Emily G Clemens
- Uniformed Services of the Health Sciences, Department of Pathology, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA.
| | - Jennifer M Farner
- Henry M. Jackson Foundation for the Advancement of Military Medicine, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA; Uniformed Services of the Health Sciences, Department of Pathology, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA.
| | - Andres Londono-Barbaran
- Henry M. Jackson Foundation for the Advancement of Military Medicine, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA; Uniformed Services of the Health Sciences, Department of Pathology, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA.
| | - Dennis J Grab
- Uniformed Services of the Health Sciences, Department of Pathology, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA.
| | - J Stephen Dumler
- Uniformed Services of the Health Sciences, Department of Pathology, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA.
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13
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Richmond A, Nelson B. 16-Year-Old Male With 1-Month History of Pruritic Rash and 10 Days of Fever. J Nurse Pract 2023. [DOI: 10.1016/j.nurpra.2022.11.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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14
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Lu M, Meng C, Li Y, Zhou G, Wang L, Xu X, Li N, Ji Y, Tian J, Wang W, Li K. Rickettsia sp. and Anaplasma spp. in Haemaphysalis longicornis from Shandong province of China, with evidence of a novel species "Candidatus Anaplasma Shandongensis". Ticks Tick Borne Dis 2023; 14:102082. [PMID: 36403321 DOI: 10.1016/j.ttbdis.2022.102082] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 10/31/2022] [Accepted: 11/07/2022] [Indexed: 11/17/2022]
Abstract
Haemaphysalis longicornis is one of the most dominant and widespread tick species in China. This species mainly infests wild animals and occasionally attacks humans, and has been associated with the transmission of a variety of zoonotic pathogens including spotted fever group Rickettsia (SFGR), severe fever with thrombocytopenia syndrome virus (SFTSV), Anaplasma phagocytophilum, Babesia spp. and Theileria spp.. Although there are increasing reports of various pathogens associated with H. longicornis, some neglected pathogens in certain areas still need to be studied. In this study, a total of 171 H. longicornis ticks were collected from goats in three locations of Shandong Province, Eastern China (Zibo, Linyi, and Qingdao cities), and subsequently screened for the presence of Rickettsia, Anaplasma, and Ehrlichia bacteria. A total of four bacterial species were identified and characterized. "Candidatus Rickettsia jingxinensis" was detected in one tick specimen from Zibo city. Of 98 ticks from Linyi city, 63.27% (62/98) were tested positive for Anaplasma capra and 5.10% (5/98) were positive for Anaplasma bovis. Interestingly, a novel Anaplasma species was detected and characterized in one tick specimen from Zibo and one other from Linyi, respectively. Genetic and phylogenetic analysis based on the 16S, gltA, groEL, and msp4 genes indicated that it was divergent from all known Anaplasma species but mostly related to A. phagocytophilum and "Cadidatus Anaplasma boleense". Based on where it was first detected, we named it "Candidatus Anaplasma shandongensis".
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Affiliation(s)
- Miao Lu
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 102206, Changping District, Beijing city, China
| | - Chao Meng
- College of life sciences, Shandong First Medical University & Shandong Academy of Medical Sciences, 271016, Taian city, Shandong Province, China
| | - Yilin Li
- College of life sciences, Shandong First Medical University & Shandong Academy of Medical Sciences, 271016, Taian city, Shandong Province, China
| | - Guangyi Zhou
- College of life sciences, Shandong First Medical University & Shandong Academy of Medical Sciences, 271016, Taian city, Shandong Province, China
| | - Lin Wang
- Laoshan No.3 middle school, 266061, Qingdao city, Shandong Province, China
| | - Xiaoyu Xu
- College of life sciences, Shandong First Medical University & Shandong Academy of Medical Sciences, 271016, Taian city, Shandong Province, China
| | - Na Li
- College of life sciences, Shandong First Medical University & Shandong Academy of Medical Sciences, 271016, Taian city, Shandong Province, China
| | - Yuqi Ji
- College of life sciences, Shandong First Medical University & Shandong Academy of Medical Sciences, 271016, Taian city, Shandong Province, China
| | - Junhua Tian
- Wuhan Center for Disease Control and Prevention, 430024, Wuhan city, Hubei Province, China
| | - Wen Wang
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 102206, Changping District, Beijing city, China
| | - Kun Li
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 102206, Changping District, Beijing city, China; Tianjin Key Laboratory of Food and Biotechnology, Tianjin University of Commerce, 300134, Beichen District, Tianjin City, China.
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15
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Gao S, Li L, Zhou X, Dai X, Lu L, Chen Y, Han J, Huang X, Xiao Q, He H, Liu Q. Fatal Rickettsia Japonica Infection Complicating Disseminated Intravascular Coagulation in Yichang, China. Infect Drug Resist 2022; 15:6613-6623. [DOI: 10.2147/idr.s383917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 10/18/2022] [Indexed: 11/12/2022] Open
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16
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Kidd L. Emerging Spotted Fever Rickettsioses in the United States. Vet Clin North Am Small Anim Pract 2022; 52:1305-1317. [DOI: 10.1016/j.cvsm.2022.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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17
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Drexler NA, Close R, Yaglom HD, Traeger M, Parker K, Venkat H, Villarroel L, Brislan J, Pastula DM, Armstrong PA. Morbidity and Functional Outcomes Following Rocky Mountain Spotted Fever Hospitalization-Arizona, 2002-2017. Open Forum Infect Dis 2022; 9:ofac506. [PMID: 36324320 PMCID: PMC9605701 DOI: 10.1093/ofid/ofac506] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 09/30/2022] [Indexed: 10/07/2023] Open
Abstract
Background Rocky Mountain spotted fever (RMSF) is a deadly tickborne disease disproportionately affecting Arizona tribal communities. While the acute clinical effects of RMSF are well-documented, more complete understanding of the long-term health consequences is needed to provide guidance for providers and patients in highly impacted areas. Methods We performed a retrospective review of hospitalized RMSF cases from 2 tribal communities in Arizona during 2002-2017. Medical records from acute illness were abstracted for information on clinical presentation, treatment, and status at discharge. Surviving patients were interviewed about disease recovery, and patients reporting incomplete recovery were eligible for a neurologic examination. Results Eighty hospitalized cases of RMSF met our inclusion criteria and were reviewed. Of these, 17 (21%) resulted in a fatal outcome. Among surviving cases who were interviewed, most (62%) reported full recovery, 15 (38%) reported ongoing symptoms or reduced function following RMSF illness, and 9 (23%) had evidence of neurologic sequelae at the time of examination. Sequelae included impaired cognition, weakness, decreased deep tendon reflexes, seizures, and cranial nerve dysfunction. Longer hospitalization (25.5 days vs 6.2 days, P < .001), a higher degree of disability at discharge (median modified Rankin score 1 vs 0, P = .03), and delayed doxycycline administration (6.2 days vs 4.1 days, P = .12) were associated with long-term sequelae by logistic regression. Conclusions Although the etiology of sequelae is not able to be determined using this study design, life-altering sequelae were common among patients surviving severe RMSF illness. Delayed administration of the antibiotic doxycycline after day 5 was the strongest predictor of morbidity.
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Affiliation(s)
- Naomi A Drexler
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Ryan Close
- Whiteriver Indian Hospital, Indian Health Service, Whiteriver, Arizona, USA
| | - Hayley D Yaglom
- Pathogen and Microbiome Division, Translational Genomics Research Institute, Flagstaff, Arizona, USA
- Office of Infectious Disease Services, Arizona Department of Health Services, Phoenix, Arizona, USA
| | - Marc Traeger
- Whiteriver Indian Hospital, Indian Health Service, Whiteriver, Arizona, USA
| | - Kristen Parker
- Whiteriver Indian Hospital, Indian Health Service, Whiteriver, Arizona, USA
| | - Heather Venkat
- Office of Infectious Disease Services, Arizona Department of Health Services, Phoenix, Arizona, USA
- Center for Preparedness and Response, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Lisa Villarroel
- Office of Infectious Disease Services, Arizona Department of Health Services, Phoenix, Arizona, USA
| | - Jeanette Brislan
- Gila River Healthcare Public Health Nursing, Sacaton, Arizona, USA
| | - Daniel M Pastula
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- University of Colorado School of Medicine and Colorado School of Public Health, Aurora, Colorado, USA
| | - Paige A Armstrong
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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18
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Borgo GM, Burke TP, Tran CJ, Lo NTN, Engström P, Welch MD. A patatin-like phospholipase mediates Rickettsia parkeri escape from host membranes. Nat Commun 2022; 13:3656. [PMID: 35760786 PMCID: PMC9237051 DOI: 10.1038/s41467-022-31351-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 06/15/2022] [Indexed: 12/25/2022] Open
Abstract
Rickettsia species of the spotted fever group are arthropod-borne obligate intracellular bacteria that can cause mild to severe human disease. These bacteria invade host cells, replicate in the cell cytosol, and spread from cell to cell. To access the host cytosol and avoid immune detection, they escape membrane-bound vacuoles by expressing factors that disrupt host membranes. Here, we show that a patatin-like phospholipase A2 enzyme (Pat1) facilitates Rickettsia parkeri infection by promoting escape from host membranes and cell-cell spread. Pat1 is important for infection in a mouse model and, at the cellular level, is crucial for efficiently escaping from single and double membrane-bound vacuoles into the host cytosol, and for avoiding host galectins that mark damaged membranes. Pat1 is also important for avoiding host polyubiquitin, preventing recruitment of autophagy receptor p62, and promoting actin-based motility and cell-cell spread. Pathogenic Rickettsia species are arthropod-borne, obligate intracellular bacteria that invade host cells, replicate in the cell cytosol, and spread from cell to cell. Here, Borgo et al. identify a Rickettsia phospholipase enzyme that is important for infection by helping the bacteria escape from host cell vacuoles into the host cytosol, preventing targeting by autophagy, and promoting bacterial motility and spread to other cells.
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Affiliation(s)
- Gina M Borgo
- Division of Infectious Disease and Vaccinology, School of Public Health, University of California, Berkeley, Berkeley, CA, USA.,Department of Molecular and Cell Biology, University of California, Berkeley, Berkeley, CA, USA
| | - Thomas P Burke
- Department of Molecular and Cell Biology, University of California, Berkeley, Berkeley, CA, USA.,Department of Microbiology & Molecular Genetics, School of Medicine, University of California, Irvine, Irvine, CA, USA
| | - Cuong J Tran
- Division of Infectious Disease and Vaccinology, School of Public Health, University of California, Berkeley, Berkeley, CA, USA.,Department of Molecular and Cell Biology, University of California, Berkeley, Berkeley, CA, USA
| | - Nicholas T N Lo
- Division of Infectious Disease and Vaccinology, School of Public Health, University of California, Berkeley, Berkeley, CA, USA
| | - Patrik Engström
- Department of Molecular and Cell Biology, University of California, Berkeley, Berkeley, CA, USA.,Primordial Genetics, San Diego, CA, USA
| | - Matthew D Welch
- Department of Molecular and Cell Biology, University of California, Berkeley, Berkeley, CA, USA.
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19
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Unger MD, Palmer JL, Thorsvik NM. Incidence Rate of Somatic Dysfunction in Previously Undiagnosed Spotted Fever Rickettsiosis: A Case Report. Cureus 2022; 14:e24416. [PMID: 35619858 PMCID: PMC9126417 DOI: 10.7759/cureus.24416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 04/23/2022] [Indexed: 12/05/2022] Open
Abstract
Spotted Fever Rickettsiosis (SFR) is a systemic vasculopathy due to tick-borne rickettsial infection. Presenting symptoms and signs may be nonspecific or include the triad of fever, headache, and a rash. Established long-term complications of SFR include debilitating neuromusculoskeletal sequelae; however, no reports describe the incidence of somatic dysfunction (SD) in SFR. We present the first description of SD in previously undiagnosed SFR. Incidence of SD before diagnosis and after antibiotic therapy was assessed every seven weeks throughout 28 weeks of Osteopathic Neuromusculoskeletal Medicine (ONMM) care, including osteopathic manipulative treatment (OMT) administered twice a month on average. The patient presented with the chief complaint of worsening neck and back pain interfering with sleep. Other symptoms included blurry vision, right-hand weakness, a truncal rash, and absence of fevers. A 14-week trial of OMT failed to significantly decrease the incidence of SD compared to baseline. Extensive workup for an underlying condition revealed moderate axonal sensorimotor polyneuropathy and elevated rickettsial IgG titers. Doxycycline therapy was initiated alongside ongoing ONMM care. Incidence of SD over the 14-week post-antibiotic OMT period was significantly less than that assessed at baseline and during the OMT-only period. This case highlights the utility of periodic graphical assessment for monitoring SD response to OMT.
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Affiliation(s)
- Mark D Unger
- Osteopathic Neuromusculoskeletal Medicine, Liberty Mountain Medical Group, Lynchburg, USA
| | - Joy L Palmer
- Osteopathic Neuromusculoskeletal Medicine, Liberty Mountain Medical Group, Lynchburg, USA
| | - Nichole M Thorsvik
- Osteopathic Neuromusculoskeletal Medicine, Liberty Mountain Medical Group, Lynchburg, USA
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20
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Molecular Evidence for Flea-Borne Rickettsiosis in Febrile Patients from Madagascar. Pathogens 2021; 10:pathogens10111482. [PMID: 34832637 PMCID: PMC8621948 DOI: 10.3390/pathogens10111482] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 11/02/2021] [Accepted: 11/09/2021] [Indexed: 11/16/2022] Open
Abstract
Rickettsiae may cause febrile infections in humans in tropical and subtropical regions. From Madagascar, no molecular data on the role of rickettsioses in febrile patients are available. Blood samples from patients presenting with fever in the area of the capital Antananarivo were screened for the presence of rickettsial DNA. EDTA (ethylenediaminetetraacetic acid) blood from 1020 patients presenting with pyrexia > 38.5 °C was analyzed by gltA-specific qPCR. Positive samples were confirmed by ompB-specific qPCR. From confirmed samples, the gltA amplicons were sequenced and subjected to phylogenetic analysis. From five gltA-reactive samples, two were confirmed by ompB-specific qPCR. The gltA sequence in the sample taken from a 38-year-old female showed 100% homology with R. typhi. The other sample taken from a 1.5-year-old infant was 100% homologous to R. felis. Tick-borne rickettsiae were not identified. The overall rate of febrile patients with molecular evidence for a rickettsial infection from the Madagascan study site was 0.2% (2/1020 patients). Flea-borne rickettsiosis is a rare but neglected cause of infection in Madagascar. Accurate diagnosis may prompt adequate antimicrobial treatment.
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