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Tick Bites
Published in Charles Theisler, Adjuvant Medical Care, 2023
Ticks get onto the skin, tend to move to a warm moist location, and then bite onto the skin to attach themselves. Next, they burrow into the skin and feed on blood. Ticks are most often found on the head, scalp, or neck. Most tick bites are painless and cause minor redness and swelling. However, some ticks can cause illness or infection such as Lyme disease, anaplasmosis/ehrlichiosis, spotted fever rickettsiosis, babesiosis, tularemia, and Powassan virus. A tick should be removed as soon as it is found to help prevent disease. Symptoms of weakness, paralysis, fever, lethargy, numbness, headache, or rash (especially an expanding rash) are reasons to seek medical care. According to the CDC, tick-borne diseases are increasing nationally.1
Ticks
Published in Jerome Goddard, Public Health Entomology, 2022
Spotted fever group rickettsioses. Ticks may transmit a wide variety of rickettsial organisms, classified by scientists into several distinct groups. One of the main groups, the spotted fever group (SFG), contains rickettsial species related to the agent of Rocky Mountain spotted fever (RMSF), Rickettsia rickettsii. But there are many other rickettsial species in the SFG (Figure 10.10); it contains at least 8 disease agents and 15 others with low or no pathogenicity to humans. RMSF is the most frequently reported rickettsial disease in the United States, with several thousand cases reported each year. In 2018, there were 5,544 cases of spotted fever rickettsiosis reported in the United States.4 At the time of initial presentation, there is often the classic triad of RMSF: fever, headache, and rash (Figure 10.11). Other characteristics are malaise, chills, myalgias, and gastrointestinal symptoms. Sometimes RMSF leads to coma and death, and the mortality rate is about 5% even with treatment.
Sepsis
Published in Miriam Orcutt, Clare Shortall, Sarah Walpole, Aula Abbara, Sylvia Garry, Rita Issa, Alimuddin Zumla, Ibrahim Abubakar, Handbook of Refugee Health, 2021
Any bacterial, fungal, viral or parasitic infection can cause sepsis. Refugees from LMICs are susceptible to the same bacterial infections as populations in high-income countries; however, mycobacteria, parasites and viral infections also need to be considered.Invasive non-typhoidal salmonella is an important cause of bacteraemia in Africa.Melioidosis is the second most common cause of bacteraemia in northeast Thailand and can remain latent for months or years, presenting later in a refugee’s journey.There is a high prevalence of tuberculous mycobacteria among septic patients in Uganda and Malawi.Patients with rickettsiosis can present as sepsis throughout Southeast Asia.Malaria and dengue should be considered in the differential diagnosis given the right epidemiological risk.
Prevalence of Spotted Fever Group Rickettsia in North-Eastern Poland
Published in Infectious Diseases, 2019
Karol Borawski, Justyna Dunaj, Piotr Czupryna, Sławomir Pancewicz, Renata Świerzbińska, Agnieszka Żebrowska, Anna Moniuszko-Malinowska
Rickettsia taxonomy includes four groups: Typhus group, Spotted Fever Group, Rickettsia bellii and Rickettsia canadensis groups. Rickettsia is small (0.3–0.5; 0.8–2.0 μm Gram-negative obligate intracellular bacilli. Spotted Fever Group rickettsiosis belongs to tick-borne diseases. In Poland three species are considered to be the etiological agents of Spotted Fever Group infections: Rickettsia slovaca, Rickettsia raoultii and Rickettsia helvetica. They are transmitted by Ixodes and Dermacentor ticks [5]. Ticks can be infected with Rickettsia spp. transovarially and transstadially [8,9]. The Spotted Fever Group Rickettsia commonly present with non-specific clinical signs and symptoms. Average incubation period is 3–12 d after a tick bite. Symptoms include fever, headache, muscle and articular pain, maculopapular or papulovesicular rash, in some cases – black eschar or ulcerative skin lesion in the bitten area. Lymph nodes enlargement is observed [10].
Emerging and threatening vector-borne zoonoses in the world and in Europe: a brief update
Published in Pathogens and Global Health, 2019
Bacterial order Rickettsiales causes wide range of related diseases spread by ticks, fleas, chiggers and lice. Spreading abilities, morbidity and mortality rates of Rickettsiales are high. Typhus fever caused by Rickettsia prowazekii was classified as the category B on the list of bioterrorism agents [81]. The most common rickettsiosis in Europe is Mediterranean spotted fever caused by Rickettsia conorii. Even though the disease had been endemic to Southern Italy for many years [82], it has been spreading recently [83]. This infection may represent a severe threat, as its mortality rate is about 32% [84]. Anaplasmosis caused by Anaplasma phagophytophila has also a strongly increasing and widespread occurrence in Europe [85,86]. Recently, new human rickettsial infections have been recognized in Europe [82,87]. In general, rickettsioses occurrence increases in northern countries, which had been traditionally Rickettsia free [88]. It is supposed that this increasing occurrence is associated with the rise of temperature and decreasing number of frosty days [83,89,90]. Several rickettsial vaccines were developed; however, they were difficult, expensive and very hazardous to produce [91]. There is still no approved vaccine available yet [92].
Presumed Post-COVID Infection Retinitis – Clinical and Tomographic Features of Retinitis as a Post-COVID Syndrome
Published in Ocular Immunology and Inflammation, 2023
Apoorva Ayachit, Madan Joshi, Guruprasad Ayachit, Shrinivas Joshi, Priya Shah
This was a retrospective chart review including patients with retinitis lesions post-fever, presenting to the retina department of a tertiary eye institute in southern India between May 2020 and March 2021. Written, informed consent was taken from all patients. The study was approved by the institutional review board and adhered to the tenets of declaration of Helsinki. Patients with either a documented positive COVID-19 reverse transcriptase-polymerase chain reaction (RT-PCR) at the time of fever/or increased IgM and/ or IgG titers by rapid ELISA test for SARS-CoV-2 (Vidas, Biomerieux, France) were included in the data analysis. Patients who presented with retinal artery occlusions, retinal vein occlusions, ophthalmic artery occlusions, other anterior segment, and adnexal complications post-COVID infection were excluded. Patients who had received COVID-19 vaccination were excluded. Patients’ demographic data, ocular complaints, symptoms of cough, breathlessness, anosmia, runny nose, history of hospitalization, and reasons for hospitalization were recorded. Serological tests for dengue, chikungunya (IgM and IgG antibodies), and rickettsiosis [(Weil–Felix test (WFT)] were done to rule out other causes of ER. Immunofluorescence assay, the gold-standard test for rickettsiosis, was not done as it is unavailable in our region and expensive. Systemic workup for diabetes, hypertension, and anti- nuclear antibodies profile, c-ANCA, and p-ANCA tests were done to rule out systemic lupus erythematosus, granulomatosis polyangiitis, and polyarteritis nodosa, respectively. Presenting complaints such as diminished vision for both distance and near, metamorphopsia, and floaters were noted. All patients underwent detailed ocular examination including visual acuity (VA), anterior segment examination, and fundus examination. Grading of cells in the anterior chamber and vitreous were done in accordance with standardized uveitis nomenclature classification. Fundus photograph was obtained (Topcon TRC- 50 DX, Tokyo). Optical coherence tomography (OCT) (48 horizontal line scans in ART mode) was done in all eyes on the HRA-2 Spectralis (Heidelberg engineering, Heidelberg, Germany). Fluorescein angiography was done in selected cases (HRA-2 Spectralis, Heidelberg engineering, Heidelberg, Germany). Patients received systemic doxycycline (unless contraindicated) for 2 weeks along with oral steroids started at 1 mg/kg bodyweight, tapered by 10 mg weekly in the following weeks.