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Chronic erythematous rash and lesions on trunk and limbs
Published in Richard Ashton, Barbara Leppard, Differential Diagnosis in Dermatology, 2021
Richard Ashton, Barbara Leppard
If treatment is delayed, patients can go on to develop arthritis (initially intermittent swelling of large joints and later a chronic erosive arthritis), meningoencephalitis, facial nerve palsy and heart problems (conduction defects, myocarditis and pericarditis) weeks or months later. If suspected, the diagnosis can be confirmed by finding antibodies to the spirochaete in the patient's serum. There should be a fourfold rise in antibody titre over 2–3 weeks. The antibody (ELISA) test can be done at your local hospital.
Skin disorders in AIDS, immunodeficiency, and venereal disease
Published in Rashmi Sarkar, Anupam Das, Sumit Sethi, Concise Dermatology, 2021
Indrashis Podder, Rashmi Sarkar
Diagnosis is made by identification of the spirochaete from wet preparations of the chancre or moist secondary-stage lesions (dark ground illumination microscopy) and by serological tests detecting either lipoidal substance liberated by infected tissues (non-treponemal tests) or the presence of antibodies to the microorganism (treponemal tests).
The liver, gallbladder and pancreas
Published in C. Simon Herrington, Muir's Textbook of Pathology, 2020
Dina G. Tiniakos, Alastair D. Burt
Caused by the spirochaete Leptospira icterohaemorrhagica, Weil disease is typically contracted from water contaminated by the urine of infected rats. The spirochaete penetrates the skin, particularly through skin defects such as unhealed wounds, and may cause liver cell necrosis, presenting as jaundice and an increased tendency to bleed.
Epidemiology of sepsis and risk factors for mortality in intensive care unit: a hospital based prospective study in South India
Published in Infectious Diseases, 2022
Rahul Garg, Chaitanya Tellapragada, Tushar Shaw, Vandana Kalwaje Eshwara, Vishal Shanbhag, Shwethapriya Rao, Harjeet S. Virk, Muralidhar Varma, Chiranjay Mukhopadhyay
Adult patients of both genders admitted to the study ICUs were considered eligible if they fulfilled our inclusion criteria. Inclusion criteria were: (1) Suspected or documented infection as a primary diagnosis by the attending clinician, (2) blood culture draws within 24 h of admission in the ICU, and (3) a quick sequential organ failure assessment (qSOFA) score ≥2 at the time of ICU admission. Definitions of infection in accordance with the International Sepsis Forum Consensus are routinely used by the clinicians at the study hospital and the same definitions were used in the present study cohort [12]. Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated response to infection and was objectively defined in the present study as an increase in the Sequential Organ Failure Assessment (SOFA) score of two points or more with infection [1]. Pregnant women, patients staying in the ICU ≤24 h for routine postoperative care, and patients with severe burns (total surface area burnt ≥30%) were excluded from the study. We also excluded patients with sepsis that had viral, fungal, parasite, spirochaete, and rickettsial aetiologies. Besides qSOFA, other common criteria for ICU admission in our centre are the need for assisted ventilation with SpO2 <90% despite supportive oxygen therapy.
Lyme Neuroborreliosis Presenting as Multiple Cranial Neuropathies
Published in Neuro-Ophthalmology, 2022
Aishwarya Sriram, Samantha Lessen, Kevin Hsu, Cheng Zhang
With regard to neuroborreliosis, approximately 20% of patients with Lyme disease have some degree of neurological involvement, and this tends to occur in the second or third stages.1 The Borrelia bugdorferi spirochaete can produce symptomatic neurological disease or remain dormant in the central nervous system for long periods of time.4 Central nervous system involvement can present as meningitis, encephalitis, cranial neuritis, and radiculoneuropathy early on. Thereafter, encephalomyelitis and encephalopathy may occur. Lyme has also been associated with the development of psychiatric conditions, including bipolar, major depression, and schizophrenia, among others.5 Neuroborreliosis can be treated with oral or parenteral antibiotics, such as doxycycline, amoxycillin, or a cephalosporin.2
Cerebrospinal fluid CXCL13 in non-borrelial central nervous system infections: contribution of CXCL13 to the differential diagnosis
Published in Infectious Diseases, 2023
Dita Smíšková, Olga Džupová, Lenka Moravcová, Dušan Pícha
Using the same cut-off, the specificity of CXCL13 as a diagnostic biomarker of LNB was lower in our study than in the meta-analysis by Rupprecht et al. 78 vs. 96%, as well as in other studies [11]. This is partially due to the inclusion of patients with NS; without them, the specificity would have increased to 82%. In fact, the chemokine CXCL13 is more accurately a marker of spirochetal CNS infection, not just borrelia and hypothetically could also be useful in CNS involvement by another pathogenic spirochaete, Leptospira. However, to date, no information on CXCL13 levels in CSF or serum in leptospiral infection has been published.