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Murine typhus, Algeria.

Mouffok N, Parola P, Raoult D - Emerging Infect. Dis. (2008)

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Although cat fleas and opposums have been suggested as vectors in some places in the United States, the main vector of murine typhus is the rat flea (Xenopspylla cheopis), which maintains R. typhi in rodent reservoirs... They were tested by immunofluoresence assay (IFA), by using spotted fever group (SFG) rickettsial antigens (R. conorii conorii, R. conorii israelensis, R. sibirica mongolitimonae, R. aeschlimmanii, R. massiliae, R. helvetica, R. slovaca, and R. felis) and R. typhi and R. prowazekii as previously reported... He had not received any antimicrobial drugs before admission... No rash, eschar, or specific signs were found... However, IFAs on convalescent-phase serum were negative for SFG antigens (except R. felis: immunoglobulin [Ig] G 64, IgM 128), but they showed raised antibodies against R. typhi and R. prowazekii (IgG 2,048, IgM 1,024)... Convalescent-phase serum obtained 2 weeks later was positive for several SFG antigens (IgM only; the highest level was 256 for R. conorii), and higher levels of antibodies were obtained against R. typhi and R. prowazekii (IgG 256, IgM 256)... WB and cross-absorption studies confirmed R. typhi infection (Figure)... However, R. typhi may cross-react with other rickettsial antigens, including SFG rickettsiae, but especially with the other typhus group rickettsia, R. prowazekii, the agent of epidemic typhus... It is still prevalent in Algeria... This cross-reactivity led to some difficulties in interpreting serologic results... These assays are, however, time-consuming and only available in specialized reference laboratories... Clinicians need to be aware of the presence murine typhus in Algeria, especially among patients with unspecific signs and fever of unknown origin... Tetracyclines remain the treatment of choice.

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Western blot assay and cross-adsorption studies of an immunofluoresence assay–positive serum sample from a patient with rickettsiosis in Algeria. Antibodies were detected at the highest titer (immunoglobulin [Ig] G 256, IgM 256) for both Rickettsia typhi and R. prowazekii antigens. Columns Rp and Rt, Western blots using R. prowazekii and R. typhi antigens, respectively. MW, molecular weight, indicated on the left. When adsorption is performed with R. typhi antigens (column Ads with Rt Ag), it results in the disappearance of the signal from homologous and heterologous antibodies, but when it is performed with R. prowazekii antigens (column Ads with Rp Ag), only homologous antibody signals disappear, indicating that the antibodies are specific for R. typhi.
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Figure 1: Western blot assay and cross-adsorption studies of an immunofluoresence assay–positive serum sample from a patient with rickettsiosis in Algeria. Antibodies were detected at the highest titer (immunoglobulin [Ig] G 256, IgM 256) for both Rickettsia typhi and R. prowazekii antigens. Columns Rp and Rt, Western blots using R. prowazekii and R. typhi antigens, respectively. MW, molecular weight, indicated on the left. When adsorption is performed with R. typhi antigens (column Ads with Rt Ag), it results in the disappearance of the signal from homologous and heterologous antibodies, but when it is performed with R. prowazekii antigens (column Ads with Rp Ag), only homologous antibody signals disappear, indicating that the antibodies are specific for R. typhi.

Mentions: The second patient, a 25-year-old farmer, was hospitalized for a 5-day history of fever, headache, diarrhea, and lack of response to treatment with amoxicillin and acetaminophen. He reported contact with cats and cattle. A discrete macular rash and pharyngitis were observed. Standard laboratory findings were within normal limits, except neutrophil count was elevated at 11.2/μL (normal levels 3–7/μL). Acute-phase serum was negative for rickettsial antigens. Convalescent-phase serum obtained 2 weeks later was positive for several SFG antigens (IgM only; the highest level was 256 for R. conorii), and higher levels of antibodies were obtained against R. typhi and R. prowazekii (IgG 256, IgM 256). WB and cross-absorption studies confirmed R. typhi infection (Figure). Both patients recovered after a 3-day oral doxycycline regimen and have remained well. (A single 200-mg dose of oral doxycycline usually leads to defervescence within 48–72 hours [1]).


Murine typhus, Algeria.

Mouffok N, Parola P, Raoult D - Emerging Infect. Dis. (2008)

Western blot assay and cross-adsorption studies of an immunofluoresence assay–positive serum sample from a patient with rickettsiosis in Algeria. Antibodies were detected at the highest titer (immunoglobulin [Ig] G 256, IgM 256) for both Rickettsia typhi and R. prowazekii antigens. Columns Rp and Rt, Western blots using R. prowazekii and R. typhi antigens, respectively. MW, molecular weight, indicated on the left. When adsorption is performed with R. typhi antigens (column Ads with Rt Ag), it results in the disappearance of the signal from homologous and heterologous antibodies, but when it is performed with R. prowazekii antigens (column Ads with Rp Ag), only homologous antibody signals disappear, indicating that the antibodies are specific for R. typhi.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2570932&req=5

Figure 1: Western blot assay and cross-adsorption studies of an immunofluoresence assay–positive serum sample from a patient with rickettsiosis in Algeria. Antibodies were detected at the highest titer (immunoglobulin [Ig] G 256, IgM 256) for both Rickettsia typhi and R. prowazekii antigens. Columns Rp and Rt, Western blots using R. prowazekii and R. typhi antigens, respectively. MW, molecular weight, indicated on the left. When adsorption is performed with R. typhi antigens (column Ads with Rt Ag), it results in the disappearance of the signal from homologous and heterologous antibodies, but when it is performed with R. prowazekii antigens (column Ads with Rp Ag), only homologous antibody signals disappear, indicating that the antibodies are specific for R. typhi.
Mentions: The second patient, a 25-year-old farmer, was hospitalized for a 5-day history of fever, headache, diarrhea, and lack of response to treatment with amoxicillin and acetaminophen. He reported contact with cats and cattle. A discrete macular rash and pharyngitis were observed. Standard laboratory findings were within normal limits, except neutrophil count was elevated at 11.2/μL (normal levels 3–7/μL). Acute-phase serum was negative for rickettsial antigens. Convalescent-phase serum obtained 2 weeks later was positive for several SFG antigens (IgM only; the highest level was 256 for R. conorii), and higher levels of antibodies were obtained against R. typhi and R. prowazekii (IgG 256, IgM 256). WB and cross-absorption studies confirmed R. typhi infection (Figure). Both patients recovered after a 3-day oral doxycycline regimen and have remained well. (A single 200-mg dose of oral doxycycline usually leads to defervescence within 48–72 hours [1]).

View Article: PubMed Central - PubMed

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Although cat fleas and opposums have been suggested as vectors in some places in the United States, the main vector of murine typhus is the rat flea (Xenopspylla cheopis), which maintains R. typhi in rodent reservoirs... They were tested by immunofluoresence assay (IFA), by using spotted fever group (SFG) rickettsial antigens (R. conorii conorii, R. conorii israelensis, R. sibirica mongolitimonae, R. aeschlimmanii, R. massiliae, R. helvetica, R. slovaca, and R. felis) and R. typhi and R. prowazekii as previously reported... He had not received any antimicrobial drugs before admission... No rash, eschar, or specific signs were found... However, IFAs on convalescent-phase serum were negative for SFG antigens (except R. felis: immunoglobulin [Ig] G 64, IgM 128), but they showed raised antibodies against R. typhi and R. prowazekii (IgG 2,048, IgM 1,024)... Convalescent-phase serum obtained 2 weeks later was positive for several SFG antigens (IgM only; the highest level was 256 for R. conorii), and higher levels of antibodies were obtained against R. typhi and R. prowazekii (IgG 256, IgM 256)... WB and cross-absorption studies confirmed R. typhi infection (Figure)... However, R. typhi may cross-react with other rickettsial antigens, including SFG rickettsiae, but especially with the other typhus group rickettsia, R. prowazekii, the agent of epidemic typhus... It is still prevalent in Algeria... This cross-reactivity led to some difficulties in interpreting serologic results... These assays are, however, time-consuming and only available in specialized reference laboratories... Clinicians need to be aware of the presence murine typhus in Algeria, especially among patients with unspecific signs and fever of unknown origin... Tetracyclines remain the treatment of choice.

Show MeSH
Related in: MedlinePlus