Tuberculosis a re-emerging disease

Two billion people, nearly one-third of the population worldwide, are infected by M. tuberculosis. Since 2008, the number of foreign TB cases in Italy has overtaken native cases. Even though TB prevalently affects elderly Italian natives, the diagnosis of the disease in these subjects is difficult and frequently delayed because of the low index of suspicion due to loss of clinical experience. Moreover, the large use of TNF inhibitors has created a new risk group for the disease, highlighting the need for tougher screening practices to reduce new cases of severe TB. Immigration from high-incidence countries like Romania has increased the number of cases of multi-drug resistant TB. These cases are usually difficult to treat because of fewer treatment options and also difficulty in managing patients with adverse socioeconomic conditions such as homelessness. It is mandatory that young doctors acquire experience in the diagnosis and treatment of TB, a disease that is not so infrequent as it was a decade or two ago.     

Case report: Brucellosis: a re-emerging disease in Thailand

Brucellosis is a zoonotic disease prevalent in many countries, but it has been reported only once in Thailand, 36 years ago. We describe here two consecutive cases of brucellosis in Bangkok, Thailand. Both cases presented with prolonged fever and weight loss. Blood cultures taken from 2 patients yielded Brucella melitensis. The slide agglutination test of blood samples were also positive, with a titer of 1:64 for antibodies to Brucella. The first patient responded to a combination of doxycycline, gentamicin, and ciprofloxacin; the other responded to doxycycline and rifampicin. Brucellosis is a potential public health threat, therefore, preventive measures should be actively implemented. This clinical syndrome should be included in the differential diagnosis of patients presenting with prolonged fever, particularly those with contact to animals which could serve as reservoirs.     

Chikungunya: a re-emerging virus

In the past decade, chikungunya--a virus transmitted by Aedes spp mosquitoes--has re-emerged in Africa, southern and southeastern Asia, and the Indian Ocean Islands as the cause of large outbreaks of human disease. The disease is characterised by fever, headache, myalgia, rash, and both acute and persistent arthralgia. The disease can cause severe morbidity and, since 2005, fatality. The virus is endemic to tropical regions, but the spread of Aedes albopictus into Europe and the Americas coupled with high viraemia in infected travellers returning from endemic areas increases the risk that this virus could establish itself in new endemic regions. This Seminar focuses on the re-emergence of this disease, the clinical manifestations, pathogenesis of virus-induced arthralgia, diagnostic techniques, and various treatment modalities.     

Leptospirosis: a re-emerging infection

Leptospirosis, long thought to be a disease of sewage workers and found post-flooding is re-emerging as a potentially life threatening infectious disease in urban India during monsoon and immediately after due to poor sanitation and drainage. However, it is often ignored and under diagnosed due to a low index of suspicion. We present a fatal case of leptospirosis with acute liver failure, respiratory failure and jaundice and encephalopathy.     

Scurvy in a Patient with Depression

Scurvy is a nearly-forgotten disease in developed countries where adequate nutrition is easily available. It still may occur, however, when, for a variety of reasons, people fail to eat a diet containing adequate vitamin C. We report the case of a 52-year-old patient with depression who developed scurvy.     

Tuberculous pyomyositis: a re-emerging entity of many faces

Clinical Rheumatology - Tuberculosis (TB) has become a global concern due to its increasing incidence, particularly in immunocompromised patients, closely following the migratory patterns of...     

新发和再发虫媒传染病

近几十年来节肢动物传播的病原体在全球范围内扩散,成为新的公共卫生威胁。气候变化、城市化、土地开垦、人口增长、生活习俗的改变以及便捷的交通等自然和社会因素正在推动它们广泛传播。本文对近年来新发和再发虫媒传染病的病原学、流行病学、临床表现、诊断、治疗和预防作一综述。     

Emerging and re-emerging infectious diseases

Microbial pathogens discovered as aetiological agents of human disease over the last 25 years are reviewed. Strengthening of laboratory and public health surveillance is of paramount importance for early detection and management of emerging infectious diseases.