Acute-phase Diagnosis of Murine and Scrub Typhus in Belgian Travelers by Polymerase Chain Reaction: a Case Report

Overview

Journal BMC Infect Dis

Publisher Biomed Central

Specialty Infectious Diseases

Date 2017 Apr 15

PMID 28407761

Citations 8

Authors

Caroline Theunissen

Lieselotte Cnops

Marjan Van Esbroeck

Ralph Huits

Emmanuel Bottieau

Affiliations

Soon will be listed here.

Abstract

Background: Rickettsiosis is a potential life threatening infectious disease in travelers. Clinical recognition is not always straightforward, as typical manifestations such as rash and/or eschar may be absent. Definite diagnosis is based on seroconversion and therefore often delayed until the convalescent phase of disease.

Case Presentation: In this case report, we describe four patients with severe travel-related rickettsiosis (two patients with murine- and two patients with scrub typhus), in whom acute- phase diagnosis was possible by real-time polymerase chain reaction on serum or blood.

Conclusions: Despite its limitations, we think that polymerase chain reaction can contribute significantly to the early diagnosis and treatment of rickettsial disease in travelers.

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References

van der Vaart T, van Thiel P, Juffermans N, van Vugt M, Geerlings S, Grobusch M . Severe murine typhus with pulmonary system involvement. Emerg Infect Dis. 2014; 20(8):1375-7. PMC: 4111165. DOI: 10.3201/eid2008.131421. View

Taylor A, Paris D, Newton P . A Systematic Review of Mortality from Untreated Scrub Typhus (Orientia tsutsugamushi). PLoS Negl Trop Dis. 2015; 9(8):e0003971. PMC: 4537241. DOI: 10.1371/journal.pntd.0003971. View

Parola P, Paddock C, Socolovschi C, Labruna M, Mediannikov O, Kernif T . Update on tick-borne rickettsioses around the world: a geographic approach. Clin Microbiol Rev. 2013; 26(4):657-702. PMC: 3811236. DOI: 10.1128/CMR.00032-13. View

Jensenius M, Han P, Schlagenhauf P, Schwartz E, Parola P, Castelli F . Acute and potentially life-threatening tropical diseases in western travelers--a GeoSentinel multicenter study, 1996-2011. Am J Trop Med Hyg. 2013; 88(2):397-404. PMC: 3583336. DOI: 10.4269/ajtmh.12-0551. View

Bechah Y, Socolovschi C, Raoult D . Identification of rickettsial infections by using cutaneous swab specimens and PCR. Emerg Infect Dis. 2011; 17(1):83-6. PMC: 3375762. DOI: 10.3201/eid1701.100854. View

Leder K, Torresi J, Libman M, Cramer J, Castelli F, Schlagenhauf P . GeoSentinel surveillance of illness in returned travelers, 2007-2011. Ann Intern Med. 2013; 158(6):456-68. PMC: 4629801. DOI: 10.7326/0003-4819-158-6-201303190-00005. View

Cracco C, Delafosse C, Baril L, Lefort Y, Morelot C, Derenne J . Multiple organ failure complicating probable scrub typhus. Clin Infect Dis. 2000; 31(1):191-2. DOI: 10.1086/313906. View

Thiebaut M, Bricaire F, Raoult D . Scrub typhus after a trip to Vietnam. N Engl J Med. 1997; 336(22):1613-4. DOI: 10.1056/NEJM199705293362220. View

Saisongkorh W, Chenchittikul M, Silpapojakul K . Evaluation of nested PCR for the diagnosis of scrub typhus among patients with acute pyrexia of unknown origin. Trans R Soc Trop Med Hyg. 2004; 98(6):360-6. DOI: 10.1016/j.trstmh.2003.10.012. View

10.

Bottieau E, Clerinx J, Schrooten W, Van den Enden E, Wouters R, Van Esbroeck M . Etiology and outcome of fever after a stay in the tropics. Arch Intern Med. 2006; 166(15):1642-8. DOI: 10.1001/archinte.166.15.1642. View

11.

Watthanaworawit W, Turner P, Turner C, Tanganuchitcharnchai A, Richards A, Bourzac K . A prospective evaluation of real-time PCR assays for the detection of Orientia tsutsugamushi and Rickettsia spp. for early diagnosis of rickettsial infections during the acute phase of undifferentiated febrile illness. Am J Trop Med Hyg. 2013; 89(2):308-310. PMC: 3741253. DOI: 10.4269/ajtmh.12-0600. View

12.

Shaked Y, Shpilberg O, Samra Y . Involvement of the kidneys in Mediterranean spotted fever and murine typhus. Q J Med. 1994; 87(2):103-7. View

13.

Nachega J, Bottieau E, Zech F, Van Gompel A . Travel-acquired scrub typhus: emphasis on the differential diagnosis, treatment, and prevention strategies. J Travel Med. 2007; 14(5):352-5. DOI: 10.1111/j.1708-8305.2007.00151.x. View

14.

Wei Y, Chiu C, Lai Y, Lai C, Lin H . Successful treatment of septic shock and respiratory failure due to leptospirosis and scrub typhus coinfection with penicillin, levofloxacin, and activated protein C. J Microbiol Immunol Infect. 2011; 45(3):251-4. DOI: 10.1016/j.jmii.2011.09.015. View

15.

Fournier P, Jensenius M, Laferl H, Vene S, Raoult D . Kinetics of antibody responses in Rickettsia africae and Rickettsia conorii infections. Clin Diagn Lab Immunol. 2002; 9(2):324-8. PMC: 119950. DOI: 10.1128/cdli.9.2.324-328.2002. View

16.

Kelly D, Foley D, Richards A . A Spatiotemporal Database to Track Human Scrub Typhus Using the VectorMap Application. PLoS Negl Trop Dis. 2015; 9(12):e0004161. PMC: 4683066. DOI: 10.1371/journal.pntd.0004161. View

17.

Jensenius M, Davis X, von Sonnenburg F, Schwartz E, Keystone J, Leder K . Multicenter GeoSentinel analysis of rickettsial diseases in international travelers, 1996-2008. Emerg Infect Dis. 2009; 15(11):1791-8. PMC: 2857242. DOI: 10.3201/eid1511.090677. View

18.

Dumler J, Barbet A, Bekker C, Dasch G, Palmer G, Ray S . Reorganization of genera in the families Rickettsiaceae and Anaplasmataceae in the order Rickettsiales: unification of some species of Ehrlichia with Anaplasma, Cowdria with Ehrlichia and Ehrlichia with Neorickettsia, descriptions of six new species.... Int J Syst Evol Microbiol. 2002; 51(Pt 6):2145-2165. DOI: 10.1099/00207713-51-6-2145. View

19.

Griffith M, Peter J, Karthik G, Ramakrishna K, Prakash J, Kalki R . Profile of organ dysfunction and predictors of mortality in severe scrub typhus infection requiring intensive care admission. Indian J Crit Care Med. 2014; 18(8):497-502. PMC: 4134622. DOI: 10.4103/0972-5229.138145. View

20.

Watt G, Strickman D . Life-threatening scrub typhus in a traveler returning from Thailand. Clin Infect Dis. 1994; 18(4):624-6. DOI: 10.1093/clinids/18.4.624. View