tetracycline and Boutonneuse-Fever

The rickettsial diseases are an important group of infectious agents that have dermatological manifestations. These diseases are important to consider in endemic areas, but in certain suspicious cases, possible acts of bioterrorism should warrant prompt notification of the appropriate authorities.. In this two part review article, we review these diverse diseases by examining established and up-to-date information about the pathophysiology, epidemiology, clinical manifestations, and treatment of the ricksettsiae.. Using PubMed to search for relevant articles, we browsed over 500 articles to compose a clinically based review article.. Part one focuses on pathophysiology of the rickettsial diseases and the clinical aspects of the spotted fever group.. At the completion of part one of this learning activity, participants should be able to discuss all of the clinical manifestations and treatments of the sported fever group. Participants should also be familiar with the pathophysiology of the rickettsial diseases.

Topics: Animals; Anti-Bacterial Agents; Boutonneuse Fever; Diagnosis, Differential; Doxycycline; Humans; Insect Vectors; Prognosis; Tetracycline; Ticks

Topics: Adult; Aged; Boutonneuse Fever; Clinical Trials as Topic; Doxycycline; Humans; Middle Aged; Random Allocation; Tetracycline

Eighty one children aged between 1 and 13 years participated in a randomised comparative trial of tetracycline hydrochloride and erythromycin stearate for treatment of Mediterranean spotted fever. Both therapeutic regimens proved effective, but in patients treated with tetracycline both clinical symptoms and fever disappeared significantly more quickly. Likewise, when those patients who began treatment within the first 72 hours of illness are considered the febrile period had a significantly shorter duration in the group treated with tetracycline. One patient was switched to tetracycline because there was no improvement of clinical manifestations, with persistence of fever, myalgias, and prostration, after receiving eight days of treatment with erythromycin. These results suggest that tetracyclines are superior to erythromycin in the treatment of Mediterranean spotted fever.

Topics: Adolescent; Boutonneuse Fever; Child; Child, Preschool; Clinical Trials as Topic; Erythromycin; Female; Humans; Infant; Male; Random Allocation; Tetracycline; Time Factors

To confirm and better understand the deleterious effect of fluoroquinolones reported during Rickettsia conorii infection in humans.. We used a new plaque assay to test the effect of ciprofloxacin on cells infected by R. conorii. Controls were mock-treated infected cells and infected cells treated with doxycycline. We used real-time quantitative RT-PCR to quantify vapC and vapB transcripts in cells infected by R. conorii treated with ciprofloxacin or mock treated.. By plaque assay, at baseline (0 h) there is no difference in lytic area between cells treated with ciprofloxacin (whatever concentration used) and controls. Ciprofloxacin at 0.5 and 50 mg/L induced a significant increase in lytic areas compared with the control at 2 h, 4 h, 6 h (P<0.0001) and 24 h (P<0.0001 and P=0.035, respectively) when not induced with doxycycline. By real-time quantitative RT-PCR, ciprofloxacin was found to cause an up-regulation of toxin-antitoxin (TA) module transcription. Indeed, the mRNA levels of vapC and vapB were significantly increased at 2 h and 4 h in cells treated with 50 mg/L ciprofloxacin (not with 0.5 mg/L ciprofloxacin) compared with control levels (fold change >2.9).. These in vitro findings correlated with our previous clinical findings: fluoroquinolones have a deleterious effect during R. conorii infection, not found with doxycycline. We speculate that the toxic effect of fluoroquinolones on R. conorii-infected cells is mediated by the overexpression of TA, possibly followed by their release into the host cytoplasm as described in Rickettsia felis.

Topics: Anti-Bacterial Agents; Bacterial Proteins; Bacterial Toxins; Bacteriological Techniques; Boutonneuse Fever; Cell Culture Techniques; Ciprofloxacin; DNA-Binding Proteins; Gene Expression; Gene Expression Profiling; Humans; Membrane Glycoproteins; Real-Time Polymerase Chain Reaction; Rickettsia conorii; Rickettsia felis; Tetracycline; Up-Regulation

Tick bite fever (TBF) and Q fever are zoonotic infections, highly prevalent in southern Africa, which are caused by different genera of obligate intracellular bacteria. While TBF was first described nearly 100 years ago, it has only recently been discovered that there are several rickettsial species transmitted in southern Africa, the most common of which is Rickettsia africae. This helps to explain the highly variable clinical presentation of TBF, ranging from mild to severe or even fatal, that has always been recognised. Q fever, caused by Coxiella burnetii, is a protean disease that is probably extensively under-diagnosed. Clinically, it also shows a wide spectrum of severity, with about 60% of cases being clinically inapparent. Unlike TBF, Q fever may cause chronic infection, and a post-Q fever chronic fatigue syndrome has been described. The molecular pathophysiology of these diseases provides insight into different strategies that intracellular parasites may use to survive and cause disease. While newer macrolide and quinolone antibiotics show activity against these pathogens and may be useful in young children and pregnant women, the treatment of choice for acute infection in both diseases is still tetracycline-group antibiotics. Chronic Q fever remains challenging to treat.

Topics: Animals; Boutonneuse Fever; Child, Preschool; Female; Humans; Pregnancy; Pregnancy Complications, Infectious; Q Fever; Rickettsia Infections; South Africa; Tetracycline; Tick-Borne Diseases; Zoonoses

Topics: Adult; Arthritis, Infectious; Boutonneuse Fever; Female; Humans; Israel; Male; Middle Aged; Remission Induction; Rickettsia; Tetracycline

Topics: Boutonneuse Fever; Humans; Male; Middle Aged; Myocarditis; Tetracycline

Topics: Adult; Boutonneuse Fever; Diagnosis, Differential; Female; Humans; Male; Tetracycline

Authors present a prospective study of 130 cases of Mediterranean spotted fever treated between 1983 and 1985 in two Departments of Paediatrics of the Valles Occidental, area near Barcelona. Thirty-eight percent of the children came from suburban areas, an urban areas, an urban or rural origin being less frequent. Previous contacts with dogs existed in 86% of the cases. Most frequent clinical signs were fever (100%) maculo-papular rash (97%) and arthromyalgias (70%). The "tache noire" was found in 87% of the cases. Presence of arthritis in two patients is underlined. Indirect immunofluorescence to Rickettsia conorii was positive (much greater than 1/40) in 75% of the cases. All patients improved after treatment with tetracycline or erythromycin. There were no relapse.

Topics: Adolescent; Boutonneuse Fever; Child; Child, Preschool; Erythromycin; Humans; Infant; Infant, Newborn; Prospective Studies; Random Allocation; Spain; Tetracycline

Topics: Boutonneuse Fever; Erythromycin; Female; Humans; Pregnancy; Pregnancy Complications, Infectious; Tetracycline

Topics: Adolescent; Adult; Aged; Animals; Boutonneuse Fever; Child; Chloramphenicol; Dogs; Female; Humans; Liver Function Tests; Male; Middle Aged; Rickettsiaceae Infections; Tetracycline

Topics: Aged; Boutonneuse Fever; Female; Humans; Male; Middle Aged; Rickettsiaceae Infections; Tetracycline

Authors report six cases of boutonneuse Mediterranean fever seen in the last two years. All of them presented fever, malaise, generalised maculopapulous rash and a typical black spot or inoculation canker. Diagnosis was done by a positive Weil-Félix test. The treatment used was tetracycline with good results. Incidence of this disease is increasing in our country.

Topics: Boutonneuse Fever; Child; Child, Preschool; Female; Hemagglutination Tests; Humans; Insect Bites and Stings; Male; Rickettsiaceae Infections; Tetracycline; Ticks

Topics: Adolescent; Adult; Aged; Boutonneuse Fever; Doxycycline; Female; Humans; Male; Middle Aged; Rickettsiaceae Infections; Rolitetracycline; Tetracycline

Topics: Adolescent; Adrenal Cortex Hormones; Adult; Aged; Boutonneuse Fever; Child; Chloramphenicol; Female; Humans; Male; Middle Aged; Rickettsiaceae Infections; Sicily; Tetracycline