Risk factors for African tick-bite fever in rural central Africa

African tick-bite fever is an emerging infectious disease caused by the spotted fever group Rickettsia, Rickettsia africae, and is transmitted by ticks of the genus Amblyomma. To determine the seroprevalence of exposure to R. africae and risk factors associated with infection, we conducted a cross-sectional study of persons in seven rural villages in distinct ecological habitats of Cameroon. We examined 903 plasma samples by using an indirect immunofluorescence assay for antibodies to R. africae and analyzed demographic and occupational data collected from questionnaires. Of the 903 persons tested, 243 (26.9%) had IgG/IgM/IgA reactive with R. africae. Persons from four of the seven village sites were significantly more likely to be seropositive (P < 0.05), and lowland forest sites tended to have higher seroprevalences. These results suggest that African tick-bite fever is common in adults in rural areas of Cameroon and that ecological factors may play a role in the acquisition of R. africae infection.     

African tick-bite fever imported into Norway: presentation of 8 cases.

We report on 8 Norwegian travellers to Southern Africa with African tick-bite fever (ATBF), a recently described spotted fever group rickettsiosis. All patients had acute flu-like symptoms and developed I or multiple inoculation eschars. The patients were treated with either doxycycline or ciprofloxacin, and all recovered. The diagnosis of ATBF was confirmed by the detection of specific IgM antibodies to Rickettsia africae by microimmunofluoroscence in convalescent-phase serum samples.     

Cardiac involvement in a patient with clinical and serological evidence of African tick-bite fever

Background  

Myocarditis and pericarditis are rare complications of rickettsiosis, usually associated with Rickettsia rickettsii and R. conorii. African tick-bite fever (ATBF) is generally considered as a benign disease and no cases of myocardial involvement due to Rickettsia africae, the agent of ATBF, have yet been described.     

Systemic inflammatory responses after orthopedic surgery in patients with rheumatoid arthritis treated with tofacitinib

Clinical Rheumatology - To investigate the acute phase response to surgical stress in patients with rheumatoid arthritis (RA) treated with tofacitinib, a Janus kinase (JAK) inhibitor. A...     

African tick bite fever

African tick bite fever is an acute febrile illness that is frequently accompanied by headache, prominent neck muscle myalgia, inoculation eschars, and regional lymphadenitis. The disease is caused by Rickettsia africae, a recently identified spotted fever group rickettsia, which is transmitted by ungulate ticks of the Amblyomma genus in rural sub-Saharan Africa and the French West Indies. Whereas reports on African tick bite fever in indigenous populations are scarce, the number of reported cases in travellers from Europe and elsewhere has recently increased significantly. Treatment with doxycycline is associated with rapid recovery in most patients.An immunofluorescence assay is recommended for the diagnosis but seroconversion is commonly delayed and this limits the usefulness of the test. Travellers to endemic areas should be informed of the risk of contracting African tick bite fever and be encouraged to take personal protective measures against tick bites.     

Systemic amyloidosis in inflammatory bowel disease

Systemic amyloidosis comprises a group of diseases that develop as a consequence of an abnormal accumulation of different proteins in several organs, altering their function. Secondary amyloidosis develops after the accumulation of serum amyloid A protein (an acute phase reactant), mainly in the course of chronic inflammatory conditions such as rheumatologic diseases, familial Mediterranean fever, or tuberculosis. Inflammatory bowel disease (IBD) may also cause secondary amyloidosis. However, little is known about the true prevalence, risk factors, and clinical outcomes of amyloidosis among IBD patients. A few studies suggest that amyloidosis is more prevalent in Crohn's disease than in ulcerative colitis, mainly occurring in patients with an extensive, long-lasting, and penetrating disease pattern. In this article we review the available data on secondary amyloidosis and IBD, focusing on prevalence, risk factors, clinical presentation and therapeutic measures.     

Systemic inflammatory biomarkers in painful diabetic neuropathy

ObjectivesWe conducted a systematic review of the literature with meta-analysis to determine whether painful diabetic neuropathy is associated with a specific inflammatory profile.MethodsThe study is based on the PRISMA statement for systematic reviews. We performed a search of published studies up until January 2021 in MEDLINE and Web of Science based on heading and free text terms. The search strategy included the phrases: diabetic peripheral neuropathy, painful peripheral neuropathy individually and in combination with the terms: inflammation and inflammatory biomarkers. We screened titles and abstracts and performed data extraction. We also manually searched the article titles in the reference lists of key studies and reviews published in the last 20 years.Data extractionData extracted from the studies included study design, inclusion and exclusion criteria, sample type including serum and plasma, source of the sample including patients with peripheral diabetic neuropathy or patients with painful and painless neuropathy of any etiology. Blood concentrations of all measured cytokines were recorded. Whenever possible we calculated the effect size and confidence interval. Non-human studies were excluded from the meta-analysis.ResultsThirteen studies were included in this meta-analysis. The study design was cross-sectional, case control or cohort type studies. Specific inflammatory mediators are significantly higher in painful than in painless diabetic neuropathy as well as in painful neuropathies of any etiology. Markers of inflammation are also increased in those patients with diabetes mellitus, who suffer from peripheral neuropathy in comparison to patients with diabetes mellitus but no signs of peripheral neuropathy. A proinflammatory state may be the common denominator of pain and peripheral neuropathy in patients with diabetes mellitus but the inflammatory profiles seem to differ.     

Correction to: Systemic inflammatory responses after orthopedic surgery in patients with rheumatoid arthritis treated with tofacitinib

Clinical Rheumatology -     

Systemic complications of inflammatory bowel disease

Radiologic assessment of the sacroiliac joints should be part of every inflammatory bowel disease patient's workup; ankylosing spondylitis is 10 to 20 times more common in ulcerative colitis patients than in normal persons. Iritis, which occurs in 10 to 20% of ulcerative colitis patients, often precedes bowel symptoms. It may be necessary to use long-term, low-dose steroid therapy to control frequently recurring iritis.     

非洲猪瘟疫苗研究进展

非洲猪瘟是一种由非洲猪瘟病毒引起的急性、出血性、接触性、高致病性的传染性疾病,一旦发病,病死率可达100%。该病于2018年8月在我国境内暴发,三个多月的时间造成了数十亿元的经济损失,今后也将成为我国猪养殖业的巨大威胁。目前尚未有针对该病的预防疫苗与治疗措施。本文根据多年来非洲猪瘟疫苗研究的相关资料,从灭活疫苗、弱毒活疫苗、核酸疫苗、亚单位疫苗及病毒活载体疫苗五个方面进行综述,以期为今后非洲猪瘟疫苗的研制提供思路及参考。     

重型肝炎患者伴发全身性炎症反应综合征及其炎症介质

我们对重型肝炎临床表现及其血清中相关炎症介质进行了研究，以期了解全身性炎症反应综合征（SIRS）在其发生、发展中的作用。     

Serum cortisol and inflammatory response in neutropenic fever

There are no data on serum cortisol of hematological patients at the onset of neutropenic fever and its possible association with the severity of infection. The purpose of this study was to evaluate the association of serum cortisol with the level of C-reactive protein (CRP) and procalcitonin (PCT), widely used markers of infection and inflammation, and with the development of severe sepsis in this patient group. All clinical data were collected prospectively at the hematology ward of Kuopio University Hospital. Altogether, 69 hematological patients with 93 periods of neutropenic fever were included. Nineteen patients received therapy for acute myeloid leukemia, and 50 patients were autologous stem cell transplantation recipients. Each period of neutropenic fever was classified as severe sepsis or not. Serum cortisol, CRP, and PCT were determined at the onset of fever on day 0 and then at 8–9 a.m. on days 1–4. Level of serum cortisol correlated positively with maximal CRP level during days 0 to 4 in neutropenic fever periods without severe sepsis, but no correlation was observed in fever periods with severe sepsis. To conclude, the level of cortisol correlated with the severity of infection measured as maximal CRP or elevated PCT in fever periods without severe sepsis, but in fever periods with severe sepsis, the cortisol response was attenuated.     

非洲猪瘟的流行现状

非洲猪瘟是由非洲猪瘟病毒引起的猪烈性传染病,严重危害养猪业的健康发展,一旦暴发疫情,不但会对本国造成重大经济损失,甚至影响国际贸易。本文从非洲猪瘟的流行现状入手,阐述非洲猪瘟在世界各国的流行情况,以期为该病的监测防控工作提供借鉴。     

Systemic inflammatory response following acute myocardial infarction

Acute cardiomyocyte necrosis in the infarcted heart generates damage-associated molecular patterns, activating complement and toll-like receptor/interleukin-1 signaling, and triggering an intense inflammatory response. Inflammasomes also recognize danger signals and mediate sterile inflammatory response following acute myocardial infarction (AMI). Inflammatory response serves to repair the heart, but excessive inflammation leads to adverse left ventricular remodeling and heart failure. In addition to local inflammation, profound systemic inflammation response has been documented in patients with AMI, which includes elevation of circulating inflammatory cytokines, chemokines and cell adhesion molecules, and activation of peripheral leukocytes and platelets. The excessive inflammatory response could be caused by a deregulated immune system. AMI is also associated with bone marrow activation and spleen monocytopoiesis, which sustains a continuous supply of monocytes at the site of inflammation. Accumulating evidence has shown that systemic inflammation aggravates atherosclerosis and markers for systemic inflammation are predictors of adverse clinical outcomes (such as death, recurrent myocardial infarction, and heart failure) in patients with AMI.     

Lassa fever in West African sub-region: an overview

Lassa fever is an acute viral zoonotic illness caused by Lassa virus, an arenavirus known to be responsible for a severe haemorrhagic fever characterised by fever, muscle aches, sore throat, nausea, vomiting and, chest and abdominal pain. The virus exhibits persistent, asymptomatic infection with profuse urinary virus excretion in the ubiquitous rodent vector, Mastomys natalensis. Lassa fever is endemic in West Africa and has been reported from Sierra Leone, Guinea, Liberia, and Nigeria. Some studies indicate that 300,000 to 500,000 cases of Lassa fever and 5000 deaths occur yearly across West Africa. Studies reported in English, that investigated Lassa fever with reference to West Africa were identified using the Medline Entrez-PubMed search and were used for this review. The scarcity of resources available for health care delivery system and the political instability that characterise the West African countries would continue to impede efforts for the control of Lassa fever in the sub-region. There is need for adequate training of health care workers regarding diagnostics, intensive care of patients under isolation, contact tracing, adequate precautionary measures in handling infectious laboratory specimens, control of the vector as well as care and disposal of infectious waste.