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Laboratory Diagnostic Tests in the Evaluation of Fever
Published in Benedict Isaac, Serge Kernbaum, Michael Burke, Unexplained Fever, 2019
The species of Borrelia responsible for relapsing fever are generally identified on examination of thick smears of peripheral blood. A small drop of blood is applied to a clean glass slide and spread in a circular manner to a diameter of approximately 1 cm. Giemsa, Wright, Leishman, or other routine stains are adequate. Inoculation of clinical material into chick embryo or suckling rodents is a sensitive test, but rarely performed nowadays.
The Diagnosis of Hemorrhagic Fever
Published in James H. S. Gear, CRC Handbook of Viral and Rickettsial Hemorrhagic Fevers, 2019
Two forms of relapsing fever are recognized: louse-borne relapsing fever caused by Borrelia recurrentis and transmitted by the common human body louse Pediculus humanushumanus; and tick-borne relapsing fever caused by Borrelia duttoni and transmitted by the human tampan tick Ornithodorus moubata and other species of argasid tick in different parts of the world. Both forms are characterized by a relapsing type of fever. The louse-borne variety results in a more serious illness, but with fewer relapses of the fever. The tick-borne variety results in an acute stage, often with many relapses, but each attack being relatively mild, but often followed by more chronic illness. Both forms of the disease commonly present with bleeding from the mucous membranes, particularly with epistaxis, and both forms may involve the liver, sometimes with more severe hemorrhagic manifestations.
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Published in Anton Sebastian, A Dictionary of the History of Medicine, 2018
Borrelia duttonii (Syn. Spironema duttonii) A spirochete transmitted by a tick, causing African relapsing fever. Identified by Joseph Everett Dutton (1876–1905) and John Lancelot Todd (1876–1949) in 1905. It was named after French bacteriologist, A. Borrel and Joseph Dutton. See relapsing fever.
Advances in multiplex nucleic acid diagnostics for blood-borne pathogens: promises and pitfalls - an update
Published in Expert Review of Molecular Diagnostics, 2019
Robert Duncan, Elena Grigorenko, Carolyn Fisher, Donna Hockman, Bryan Lanning
Tick-borne pathogenic agents continue to emerge as blood safety threats. Babesia microti is well characterized and an FDA approved assay is available, however other recently emerged agents transmitted by the deer tick (Ixodes scapularis), increasingly demonstrate expanded geographic ranges, clinical case reports and more evidence of transmission by blood transfusion. During the last five years, several newly described tick-borne viral agents have also emerged and potentially may be transmitted by blood transfusion [2]. Examples of emerging tick-borne agents include the obligate intracellular Gram-negative bacterium, Anaplasma phagocytophilum, causing infections that range from asymptomatic to more severe disease and death in less than 1% of cases [3]; Ehrlichia chaffeensis, which causes human monocytic ehrlichiosis (HME), is primarily found in the southeastern US and is transmitted by the Lone Star tick, Amblyomma americanum [4]; of widespread concern the spirochete, Borrelia burgdorferi (Lyme Disease), is not typically a blood-borne agent due to its unique biology, however Borrelia miyamotoi, the agent of relapsing fever in the Northeast US, has been transfusion transmitted in a murine model [5].
Laboratory diagnosis of Lyme borreliosis: Current state of the art and future perspectives
Published in Critical Reviews in Clinical Laboratory Sciences, 2018
Benedikt Lohr, Volker Fingerle, Douglas E. Norris, Klaus-Peter Hunfeld
Spirochetes that cause LB belong to the B. burgdorferi s.l. complex (Table 2); they are spiral-shaped bacteria of 4–30 µm in length and 0.2–0.3 µm in diameter (Figure 2) in the family Spirochaetaceae and belong to the genus Borrelia that comprises both the so-called relapsing fever borreliae, and the closely related LB agents. Relapsing fever borreliae are transmitted by lice (epidemic relapsing fever, B. recurrentis) and ticks (endemic tick-borne relapsing fever, B. caucasica, B. hispanica, B. hermsii, etc.). Tick-borne relapsing fever is endemic to certain regions around the world and is transmitted in Europe, particularly in Eastern and Southern Europe, by soft ticks belonging to Argasidae [19]. In contrast, epidemic relapsing fever caused by B. recurrentis is louse-borne and occurs worldwide [19–21]. Not long ago, another relapsing fever borrelia, B. miyamotoi, was described in Eurasia and North America. This relapsing fever borrelia is transmitted by the same ixodid ticks as LB agents and causes a mostly mild, flu-like illness, but it may also result in a more severe fever and in neurological disease, especially in immunosuppressed patients [22–25]. For the diagnosis of relapsing fever, detection of borreliae by microscopy, specific serological assays (using GlpQ protein as an antigen, especially for B. miyamotoi), and, when possible, molecular methods, is crucial [26]. The diagnosis of the relapsing fever borreliae is not reviewed here but is discussed in several recent publications on this topic [19,21,24]. A phylogenetic relationship of B. burgdorferi s.l. also exists to treponemes and leptospires that, due to possibly resulting cross-reactivity, can be relevant both for molecular and serological aspects of the laboratory diagnosis of LB [21,27–29].
Q fever presenting as miliary pneumonia: Case imagery and differential diagnosis
Published in Canadian Journal of Respiratory, Critical Care, and Sleep Medicine, 2019
Simon Couillard, Maryse Bélanger, Nicole Bouchard
A 56-year-old immunocompetent male consulted for one month of relapsing fever, dyspnea, nonproductive cough, headaches, and myalgias. Physical examination was noncontributory. This gentleman’s occupation as a renderer involved manipulation of a variety of livestock carcasses. The chest X-ray showed subtle micronodular opacities. A computed tomographic scan revealed innumerable randomly distributed 1–3 mm micronodules compatible with miliary pneumonia (Figure 1).