By Bryan Rosner on Jul 14, 2010 in General News | comments(0)
Full article: http://ukpmc.ac.uk/articles/PMC1490240;jsessionid=7D7D2D45FB70B5A24793992EDD921DFB.jvm4
Excerpt:
Abstract
A case of 65-year-old male is reported who presented with myalgias, headache, and fever. He subsequently developed myocarditis and was diagnosed to have anaplasmosis on peripheral blood smear. He was treated with doxycycline for 30 days. A coronary angiogram done after recovery showed normal epicardial arteries. The case illustrates the importance of a careful examination of the peripheral smear, with a high index of clinical suspicion, which led to prompt treatment and complete recovery of the patient
Ehrlichiosis, first discovered before 1910, has been recognized to cause human infection since 1986.1 It belongs to Rickettsiaceae family. Ehrlichiae are small, obligate intracellular bacteria that grow in cytoplasmic vacuoles to form clusters called morulae. Three distinct species cause human ehrlichiosis. E. chaffeensis predominantly affects the monocytes and is hence termed human monocytic ehrlichiosis (HME) while E. phagocytophilium, and E. ewingii cause human granulocytic ehrlichiosis.2E. phagocytophiliumE. equi are now recognized as the same organism and has been renamed Anaplasma phagocytophilum; the disease is now known as Human Granulocytic Anaplasmosis (HGA). Both HME and HGA share similar clinical and laboratory features and are treated with the same antimicrobials.
By Linda on Jul 5, 2010 in Infections | comments(0)
Full article: http://www.ispub.com/ostia/index.php
Excerpt:
Thrombocytopenia is a common manifestation of all tick-borne diseases. Low platelet numbers contribute significantly towards the morbidity and mortality of infection. However, the pathogenesis of thrombocytopenia in many of the tick-borne diseases is poorly understood. Quantitative changes in platelet counts associated with infection may result from decreased marrow production, hypersplenism, consumption due to widespread endothelial damage or disseminated intravascular coagulation, as well as immune-mediated platelet destruction. Infection-induced thrombocytopenia may infrequently be associated with serious thrombosis. Direct infection of platelets by selected tick-borne pathogens also facilitates their dissemination within the host. This article reviews the mechanisms of thrombocytopenia associated with tick-borne infections, and discusses the therapeutic options available for managing this potentially fatal complication.
Conclusions
Thrombocytopenia due to tick-borne infection is likely to be of multifactorial etiology. In many of these infections, however, the actual mechanism of thrombocytopenia still remains unknown. Iatrogenic causes in some cases, such as drugs, should not be overlooked. Low platelet numbers in infected individuals may not only manifest with increased bleeding, but may herald more widespread life-threatening microthrombus formation. In addition to quantitative platelet disorders, qualitative defects may also be present. For example, inhibition of platelet migration has been induced by serum from E.canis-infected dogs, even before platelet numbers declined and before the appearance of specific humoral
antibodies (Kakoma et al 1978). The release of platelet factor 3, a phospholipid released from activated platelets that is necessary for the intrinsic conversion of prothrombin to thrombin, is also markedly decreased as a result of ehrlichial infection (Pierce et al 1977). Furthermore, platelet aggregation in ehrlichiosis can be prevented by autoantibodies directed against their surface glycoproteins (Lovering et al 1980; Harrus et al 1996).
Therapy for thrombocytopenia requires treatment or removal of the underlying infection, in addition to maintenance of platelet counts and hemostatic function. However, identification and correction of a specific tick-borne infection is only possible if the infection is considered in the differential diagnosis of thrombocytopenia. Rapid treatment of the underlying infection should result in normalization of platelet counts. Ehrlichia, bartonella and RMSF should also be excluded in cases presenting with a clinical picture resembling TTP, particularly in those patients that prove difficult to manage, and in regions where the incidence of tick-borne illness is high. The efficacy of platelet transfusions in many of the tick-borne diseases is unclear and anecdotal (Van Eeden et al 1985).
By Linda on Feb 20, 2010 in Infections | comments(0)
Background.
The goal of this case is to review the zoonotic infection, human granulocytic ehrlichiosis, presenting with pyrexia.
Case.
A 22-year-old multigravid female presented to the emergency department with a painful skin rash, high fever, and severe myalgias. The patient underwent a diagnostic evaluation for zoonotic infections due to her geographical and seasonal risk factors. Treatment of human granulocytic ehrlichiosis was successful though the patient spontaneously aborted presumably due to the severity of the acute illness.
Conclusion.
Treatment of human granulocytic ehrlichiosis in pregnancy presents unique challenges.Management of pyrexia during pregnancy is limited to external cooling in the setting of thrombocytopenia and elevated
aminotransferases. Extensive counseling regarding teratogenic potential of medications allows the patient to weigh the pros and cons of treatment
By Linda on Dec 15, 2009 in Infections | comments(0)
Genetic control of the innate immune response to Borrelia hermsii influences the course of relapsing fever in inbred strains of mice.
Benoit VM, Petrich A, Alugupalli KR, Marty-Roix R, Moter A, Leong JM, Boyartchuk VL.
Department of Molecular Genetics and Microbiology, and Program in Gene Function and Expression, University of Massachusetts Medical School, Worcester, MA 01605; Institut für Mikrobiologie und Hygiene, Charité – Universitätsmedizin Berlin, Campus Charité Mitte, 10117 Berlin, Germany; Department of Microbiology and Immunology, Thomas Jefferson University, Philadelphia, PA 19107. Continued
