Association rickettsiose et infarctus cérébral: une nouvelle observation

Boulahri, Tarik; Taous, Abdellah; Berri, Maha Ait; Traibi, Imane; Elbenaye, Jalal; Rouimi, A.

doi:10.11604/pamj.2017.26.80.11434

Cited by 6 publications

(5 citation statements)

References 9 publications

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“…The most common neurological manifestations reported in rickettsial infections include meningitis, encephalitis, and acute disseminated encephalomyelitis [5]. However, unilateral facial nerve palsy [6], cerebral infarction [7], or visual loss [8] have also been diagnosed. Therefore, it is critical to enhance the awareness of physicians worldwide on CNS rickettsial infections (CNS R).…”

Section: Introductionmentioning

confidence: 99%

Rickettsial infections of the central nervous system

et al. 2019

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As a result of migrations and globalization, people may face a possible increase in the incidence of central nervous system rickettsial infections (CNS R). These diseases, caused by Rickettsia species and transmitted to humans by arthropod bites, are putatively lethal. However, the diagnosis of CNS R is challenging and often delayed due to their nonspecific clinical presentation and the strict intracellular nature of rickettsiae. Furthermore, transfer of rickettsiae to the brain parenchyma is not yet understood. The aim of this review is to analyze and summarize the features and correlated findings of CNS R in order to focus attention on these intriguing but frequently neglected illnesses. We also incorporated data on CNS infections caused by Rickettsia- related microorganisms.

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Section: Introductionmentioning

confidence: 99%

Rickettsial infections of the central nervous system

et al. 2019

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“…Instances of unilateral facial, cerebral infarction, and visual impairment in Rickettsia spp. infections have been documented previously as well [ 101 , 102 , 103 ].…”

Section: Discussionmentioning

confidence: 99%

Hemophagocytic Lymphohistiocytosis (HLH) in Patients with Tick-Borne Illness: A Scoping Review of 98 Cases

Jevtic,

da Silva,

Haylock

et al. 2024

Infectious Disease Reports

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Hemophagocytic lymphohistiocytosis (HLH) secondary to tick-borne infections is a rare but potentially life-threatening syndrome. We performed a scoping review according to PRISMA guidelines to systematically analyze the existing literature on the topic. A total of 98 patients were included, with a mean age of 43.7 years, of which 64% were men. Most cases, 31%, were reported from the USA. Immunosuppression was present in 21.4%, with the most common cause being previous solid organ transplantation. Constitutional symptoms were the most common, observed in 83.7% of the patients, while fever was reported in 70.4% of cases. Sepsis was present in 27.6%. The most common laboratory abnormalities in this cohort were thrombocytopenia in 81.6% of patients, while anemia, leukopenia, and leukocytosis were observed in 75.5%, 55.1%, and 10.2%, respectively. Liver enzyme elevation was noted in 63.3% of cases. The H-score was analyzed in 64 patients, with the mean value being 209, and bone marrow analysis was performed in 61.2% of patients. Ehrlichia spp. was the main isolated agent associated with HLH in 45.9%, followed by Rickettsia spp. in 14.3% and Anaplasma phagocytophilum in 12.2%. Notably, no patient with Powassan virus infection or Lyme borreliosis developed HLH. The most common complications were acute kidney injury (AKI) in 35.7% of patients, shock with multiple organ dysfunction in 22.5%, encephalopathy/seizure in 20.4%, respiratory failure in 16.3%, and cardiac complications in 7.1% of patients. Treatment included antibiotic therapy alone in 43.9%, while 5.1% of patients were treated with immunosuppressants alone. Treatment with both antibiotics and immunosuppressants was used in 51% of patients. Appropriate empiric antibiotics were used in 62.2%. In 43.9% of cases of HLH due to tick-borne disease, patients received only antimicrobial therapy, and 88.4% of those recovered completely without the need for immunosuppressive therapy. The mortality rate in our review was 16.3%, and patients who received inappropriate or delayed empiric therapy had a worse outcome. Hence, we suggest empiric antibiotic treatment in patients who are suspected of having HLH due to tick-borne disease or in whom diagnostic uncertainty persists due to diagnostic delay in order to minimize mortality.

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“…Severe CNS involvement has been reported in adults with Rickettsia conorii infection 5 , but rarely in children 6 . Neurologic sequelae include meningitis, encephalitis, acute disseminated encephalomyelitis, unilateral facial nerve palsy 7 , cerebral infarction 8 , visual loss 9 and ataxia. In our case series, the first patient had altered sensorium with status epilepticus, the second had episodes of drowsiness noticed only during fever with clinical features of raised intracranial pressure and the third had fever with headache and normal sensorium.…”

Section: Discussionmentioning

confidence: 99%