The Role of Mediterranean Spotted Fever in the Spectrum of Pediatric Fever with Rashes

When febrile illnesses develop a rash in children, parents are very concerned about a serious disease. Many rashes associated with fever are caused by infectious diseases. Rashes are generally nonspecific and play a supportive role in differential diagnosis, but for some diseases, the appearance of the rash is essential in making a diagnosis. Here is presented the case of a 4-year-old boy with high fever, headache, abdominal pain, vomiting, diarrhea, and a generalized maculo-papular rash including palms and soles. On physical examination were found a black eschar, cervical lymphadenopathy, and hepatosplenomegaly. Laboratory findings resulted in moderate leukocytosis and moderate involvement of the liver and renal function. Based on this finding, a diagnosis of Mediterranean Spotted Fever was performed. The child recovered after medication with azithromycin. Because there is no reliable test that can confirm MSF in its early stages, the diagnosis is commonly made on the basis of clinical findings, so a high index of suspicion should be maintained while evaluating a child with fever and rash.

Serological Evidence of Human Coinfection by Brazilian Spotted Fever and Bartonellosis

Brazilian spotted fever and bartonellosis are zoonotic, emerging and under diagnosed diseases. Pets may be co-infected by multiple pathogens and become transmissions sources to humans. The study reports the first case of active co-infection by Brazilian spotted fever and bartonellosis based on serological evidence. The authors aim to demonstrate the importance of performing systematic syndromic investigations on nonspecific febrile syndromes, guided by the epidemiological history and considering the possibility of co-infection by zoonosis sharing the same ecological niche.

Brazilian Spotted Fever Mortality Profile: 2018 to 2022

Background: Spotted Fever (SF) is an acute febrile zoonosis of variable severity that typically occurs in an endemic manner with worldwide distribution. Considering that SF is a disease of significant public health importance, this study aims to identify the mortality profile due to SF in Brazil from 2018 to 2022. Methods: Quantitative and descriptive cross-sectional approach. Data were collected from Brazilian Spotted Fever (BSF) cases registered in the Notifiable Diseases Information System (SINAN-DATASUS) across all regions of Brazil. The data collected includes information on the following variables: year of symptom, evolution, sex, race, environment of infection, region of notification, and age group. Subsequently, the data was entered into Microsoft Excel to create tables and graphs. The chi-square test was then applied to statistically analyze the associations between qualitative variables. A modified Poisson regression model with robust variance was constructed to analyze the age group data and determine which categories had different probabilities of death. The results show the estimates obtained for prevalence ratios, as well as their respective confidence intervals and p-values. The statistical software SAS version 9.4 was used to perform the analysis and a significance level of 5% was considered. Results: From 2018 to 2022, a total of 1126 cases of BSF were reported. Out of these cases, 59.3% (668) were cured, 32.4% (364) resulted in death, 1.1% (13) died from other causes and 7.2% (81) had no recorded outcome. Regarding the region with the highest death rate, the Southeast region led with 99.45% (362) of cases, followed by the Northeast region with 0.45% (2). As for the age group, the majority (63.7%) fell between the ages of 20 and 59 years old. In terms of race/color, 52.7% of the population identified as white. Regarding the contamination environment, 39.3% were in leisure areas. The outcome of death by BSF showed statistically significant associations with sex (p-value = 0.03) and age group (p-value = 0.003). Conclusion: The profile of deaths from Brazilian Spotted Fever primarily affects individuals from the Southeast region of the country, particularly men, and whites aged 20 years or older being contaminated mainly in leisure environments. This study provides a detailed understanding of the pattern of BSP-related deaths, providing crucial information for public health authorities. These insights provide valuable support for formulating informed policies and effective BSP control and prevention strategies.

A compartment and metapopulation model of Rocky Mountain spotted fever in southwestern United States and northern Mexico

Rocky Mountain spotted fever(RMSF)is a fatal tick-borne zoonotic disease that has emerged as an epidemic in western North America since the turn of the 21st century.Along the US south-western border and across northern Mexico,the brown dog tick,Rhipicephalus sanguineus,is responsible for spreading the disease between dogs and humans.The widespread nature of the disease and the ongoing epidemics contrast with historically sporadic patterns of the disease.Because dogs are amplifying hosts for the Rickettsia rickettsii bacteria,transmission dynamics between dogs and ticks are critical for understanding the epidemic.In this paper,we developed a compartment metapopulation model and used it to explore the dynamics and drivers of RMSF in dogs and brown dog ticks in a theoretical region in western North America.We discovered that there is an extended lag—as much as two years—between introduction of the pathogen to a naïve population and epidemic-level transmission,suggesting that infected ticks could disseminate extensively before disease is detected.A single large city-size population of dogs was sufficient to maintain the disease over a decade and serve as a source for disease in surrounding smaller towns.This model is a novel tool that can be used to identify high risk areas and key intervention points for epidemic RMSF spread by brown dog ticks.

An unusual cause of optic neuritis:rickettsiosis disease

Optic neuritis(ON) may be associated to a range of autoimmune or infectious diseases.We report herein a case of ON induced by Rickettsia conorii.A 53-year-old woman presented with a recent decrease in visual acuity and headache.ON was diagnosed on the basis of ophthalmologic examination and flash visual evoked potentials.Etiological investigation made in our department eliminated first autoimmune disorders(vasculitis and connective tissue diseases).Rickettsial optic neuritis was confirmed by detection of specific antibodies in serum and the negativity of other serologic tests.An association between corticosteroids and cyclines was prescribed with improvement of visual acuity.

Diagnosing and reintegrating traceability of infectious diseases via metagenomic next-generation sequencing:Study of a severe case of Rickettsia japonica infection

Background:In this study,we present a case of Japanese spotted fever(JSF)caused by Rickettsia japonica and use this case to investigate the process of diagnosing and reintegrating traceability of infectious diseases via metagenomic next-generation sequencing(mNGS).Methods:From data relating to epidemiological history,clinical and laboratory examinations,and mNGS se-quencing,a diagnosis of severe JSF was concluded.Results:A detailed field epidemiological investigation discovered parasitic Haemaphysalis longicornis from a host animal(dog)in the domicile of the patient,within which R.japonica was detected,along with a diverse array of other potentially pathogenic microorganisms that could cause other infectious diseases.Conclusion:The mNGS provided an efficient method to diagnose JSF infection.This methodology could also be applied to field epidemiological investigations to establish the traceability of infectious diseases.

Use of eschar swab DNA to diagnose Rickettsia conorii subspecies conorii infection in Crimea:A case report

Mediterranean spotted fever(MSF)has been diagnosed clinically in the Crimean Peninsula since the 1930s.We describe the recent illness of an elderly patient from Crimea who had developed a classic triad of MSF symptoms consisting of fever,maculopapular rash,and eschar.Clinical diagnosis of rickettsiosis was confirmed using real-time PCR and sequencing of 4 Rickettsia protein genes.The strain causing clinical illness was characterized as Rickettsia conorii subspecies conorii Malish 7.This report corroborates the utility of eschar swab material as a source of DNA for PCR-based diagnostics that enables timely patient treatment and management.