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An Electroporation Method to Transform Rickettsia spp. with a Fluorescent Protein-Expressing Shuttle Vector in Tick Cell Lines
Published on: October 11, 2022
Study on 40 cases of rickettsia
M T Miah1, S Rahman, C N Sarker
1Mymensingh Medical College and Hospital, Mymensingh.
Abstract:
Rickettsia is emerging in the subcontinent and clinically presents as non-specific febrile illness. At present there is no cheap & easily available diagnostic tool in our hand. Beside this, Weil-Felix test is becoming abandoned. So, high index of clinical suspicions is essential to diagnose rickettsia at early stage and to prevent mortality & morbidity. 40 cases were recorded among the admitted febrile patients in MMCH since 2003 to 2005. Cases were selected by clinical suspicions; exclusions of other common febrile illness & thereafter supported by lab. Investigations, specially by positive Weil-felix test. Cases were distributed through out the year but 19 (47.5%) cases were detected in March to May. 12 (30%) cases were found in August to October. The remaining 9 cases were detected in the rest 6 months. All (40) cases were presented with fever (100%), headache was present in 33 (82.5%) cases, rashes were present in 15 (37.5%) cases, isolated splenomegaly was found in 15 (37.5%) cases & hepatosplenomegaly in 12 (30%) cases, arthralgia in 13 (32.5%) cases, lymphadenopathy in 5 (12.5%) cases; 2 (5%) cases attended with unconsciousness & epistaxis in 1 (2.25%) case. Scrub typhus were 19 (47.5%), Indian tick typhus 16 (40%), 5 (12.5%) cases were with dual pathology and were associated with enteric fever. 15 (37.5%) cases were treated with tetracycline only. 20 (50%) cases with only doxyclycline & 5 (12.5%) cases with tetracycline and ceftriaxone as these cases were associated with enteric fever. All patients (100%) cured with treatment.
Insights
Rickettsia infections present as non-specific fevers in the subcontinent, lacking accessible diagnostics. Early clinical suspicion is crucial for timely treatment and preventing severe outcomes in febrile patients.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Epidemiology
Background:
- Rickettsial infections are an emerging threat in the subcontinent, often presenting as non-specific febrile illnesses.
- Current diagnostic tools are limited in availability and affordability, hindering early detection.
- The Weil-Felix test is becoming obsolete, necessitating alternative diagnostic approaches.
Purpose of the Study:
- To investigate the clinical presentation and epidemiological patterns of rickettsial infections in febrile patients.
- To highlight the importance of clinical suspicion in the absence of readily available diagnostic methods.
- To document treatment outcomes for rickettsial diseases in the study population.
Main Methods:
- A retrospective study of 40 febrile patients admitted between 2003 and 2005.
- Case selection based on clinical suspicion, exclusion of other common febrile illnesses, and laboratory confirmation (Weil-Felix test).
- Data collection on clinical signs, symptoms, seasonal distribution, specific rickettsial types, and treatment regimens.
Main Results:
- Fever was universal (100%), with headache (82.5%) and rashes (37.5%) being common. Other symptoms included splenomegaly, hepatosplenomegaly, arthralgia, and lymphadenopathy.
- Seasonal peaks observed in March-May (47.5%) and August-October (30%).
- Scrub typhus (47.5%) and Indian tick typhus (40%) were the predominant types; 12.5% had dual pathology with enteric fever.
Conclusions:
- Rickettsial diseases present with diverse, often non-specific symptoms, underscoring the need for high clinical suspicion.
- Prompt diagnosis and appropriate antibiotic treatment (tetracycline, doxycycline) lead to complete recovery.
- Further development of accessible diagnostic tools is essential for managing emerging rickettsial infections.
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