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Infectious disease
Published in Kaji Sritharan, Jonathan Rohrer, Alexandra C Rankin, Sachi Sivananthan, Essential Notes for Medical and Surgical Finals, 2021
Kaji Sritharan, Jonathan Rohrer, Alexandra C Rankin, Sachi Sivananthan
This group includes Rickettsia, Coxiella and Bartonella. Commonly carried by arthropod vectors such as lice, fleas, ticks and mites: Rickettsiae commonly cause typhus, a disease with swinging fever, headache and rash associated with vasculitis and multisystem involvement. Three groups: typhus group (epidemic and endemic typhus), spotted fever group (Rocky Mountain spotted fever, tick typhus, rickettsial pox) and scrub typhus group.Coxiellaburnetii causes an atypical pneumonia (Q fever).Bartonellahenselae causes cat scratch disease; B. quintana causes trench fever.
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Published in Samar Razaq, Difficult Cases in Primary Care, 2021
Lyme disease is caused by the spirochete bacterium Borrelia burgdorferi. B. burgdorferi is transferred to humans via the hard tick Ixodes dammini, which feeds on animals infected with the bacterium. Introduction of the bacterium into the human bloodstream via tick saliva occurs during a tick bite. Patients may recall this tick bite and the resultant macular lesion that appears at the site of the bite. This lesion then expands over the course of a week and develops into the characteristic rash of Lyme disease: erythema chronicum migrans. While this is occurring the patient may suffer from a prodromal phase in which there is fever and general malaise. The appearance of the typical rash should raise suspicions and trigger appropriate investigations that may include serology (to look for antibodies against the bacterium) and culture from appropriate fluid or tissue. Untreated, there is a significant risk of developing the late manifestations of Lyme disease, which include neurological abnormalities (e.g. meningitis, cranial neuropathy, peripheral neuropathy), heart disease (e.g. myocarditis, pericarditis, atrioventricular block) and rheumatological disease such as arthritis and fatigue. Rarely, the eyes, liver, spleen and testicles may also be involved. Doxycycline is the first-choice antibiotic. Summer forest walkers should be advised to cover up well and remove attached ticks promptly. Q fever is another bacterial zoonosis caused by the bacterium Coxiella burnetii.
Acute Infective Endocarditis and Its Mimics in the Critical Care Unit
Published in Cheston B. Cunha, Burke A. Cunha, Infectious Diseases and Antimicrobial Stewardship in Critical Care Medicine, 2020
In total, 90% of Coxiella burnetii IE present with intermittent low-grade fevers and diffuse purpuric rashes caused by immune complex vasculitis. The CHF develops later in its course. Arterial emboli are seen in 20% of patients, with significant splenomegaly in 50%.
Evaluation of post-COVID health status using the EuroQol-5D-5L scale
Published in Pathogens and Global Health, 2022
Siddhi Hegde, Shreya Sreeram, Kaushik R Bhat, Vaishnavi Satish, Sujith Shekar, Mahesh Babu
The current study found that the majority of the individuals reporting ‘any problem’ in the pain/discomfort dimension belonged to the age group of 18–39 years. A significant relationship was found to exist between age and pain/discomfort scores, at 8 weeks. This could be linked to the ubiquitous post-viral syndrome, viral-associated end-organ damage and new-onset pain due to increased sleep disturbance, inactivity, fear, anxiety, depression [69,70]. Post-viral pain/discomfort is also common in other infections like EBV and Coxiella burnetii, which extends into the recovery period[71]. However, its association with COVID-19 goes beyond just the pathological effect of the virus and can be explained by a biopsychosocial model[72]. Ibanez et al found an association between disruption of daily routine and elevated pain intensity and pain sensitivity in COVID-19 survivors[73]. This higher pain sensitivity coupled with their reluctance to rest or premature resumption of pre-COVID activities could explain why younger patients were affected more.
Clinical characteristics and outcomes of infective endocarditis: impact of haemodialysis status, especially vascular access infection on short-term mortality
Published in Infectious Diseases, 2021
Seong Soon Kwon, Se Yoon Park, Duk Won Bang, Min-Ho Lee, Min-Su Hyon, Seong Soo Lee, Sangchul Yun, Dan Song, Byoung-Won Park
A microbiological diagnosis was made by blood culture, valve cultures and especially in the case of Q fever, the measurement of serum antibodies against Coxiella burnetii by molecular techniques [13]. At least two sets of blood cultures (for aerobic and anaerobic incubation) were obtained at the disease onset and whenever needed during the subsequent hospital course. Genus and species confirmation and identification of the antimicrobial susceptibility patterns were evaluated with standardized automated methods. Culture negativity was defined as IE with three or more negative blood cultures despite prolonged incubation. When a patient was diagnosed with IE within the first 24 h of medical assessment by clinicians, they were considered to have early detected IE upon admission.
Molecular diagnosis of Coxiella burnetii in culture negative endocarditis and vascular infection in South Korea
Published in Annals of Medicine, 2021
Moonsuk Bae, Hyo Joo Lee, Joung Ha Park, Seongman Bae, Jiwon Jung, Min Jae Kim, Sang-Oh Lee, Sang-Ho Choi, Yang Soo Kim, Yong Shin, Sung-Han Kim
Culture negative endocarditis is a life-threatening condition associated with significant morbidity and mortality. It accounts for 15–40% of all cases of infective endocarditis [1–3]. There are several causes of culture-negative endocarditis. Of these, infection due to intracellular or non-culturable pathogens remains a diagnostic and therapeutic challenge. Coxiella burnetii is the most common causative pathogen [3,4]. Q fever endocarditis is clinically important because the diagnostic delay and the absence of combination treatment can be associated with mortality and serological monitoring is necessary to monitor relapse [5]. In addition, Q fever vascular infection is a disease entity as well-known as Q fever endocarditis, and it is associated with high mortality and major complications [6–9].