Early diagnosis of Japan spotted fever by PCR using skin samples

Kurokawa, Ichiro; Kondo, Makoto; Akachi, Shigehiro

doi:10.1007/s10156-012-0529-x

Cited by 14 publications

(12 citation statements)

References 17 publications

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“…Accordingly, we recommend that a skin (eschar) sample, if obtained at the acute stage of illness, should be used preferentially for this assay. Kim et al and Kurokawa et al also reported that areas of skin bitten by arthropod vectors (eschar) are available as sample specimens for the PCR detection of O. tsutsugamushi and R. japonica, respectively (22,23).…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Diagnostic Assay for Rickettsioses Using Duplex Real-Time PCR in Multiple Laboratories in Japan

Kawamori

Shimazu²,

Sato³

et al. 2018

Jpn J Infect Dis

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Tsutsugamushi disease and Japanese spotted fever are representative rickettsioses in Japan, and are caused by infection with Orientia tsutsugamushi and Rickettsia japonica, respectively. For molecular-based diagnosis, conventional PCR assays, which independently amplify respective rickettsial DNA, are usually used; however, this approach is time-consuming. Here, we describe a new duplex real-time PCR assay for the simultaneous detection of O. tsutsugamushi and spotted fever group rickettsiae, and its evaluation using several PCR conditions in 6 public health laboratories. The detection limit of the assay was estimated to be 10 copies and the sensitivity was almost identical to that of 3 conventional PCR methods. A total of 317 febrile patients were selected as clinically suspected or confirmed cases of rickettsioses. The detection efficiency of this assay for O. tsutsugamushi from blood or skin (eschar) specimens appeared to be almost the same as that of the conventional PCR method, even when performed in different laboratories, whereas the efficiency for spotted fever group rickettsiae tended to be higher than that of the 2 traditional double PCR assays. Our duplex real-time PCR is thus a powerful tool for the rapid diagnosis of rickettsioses, especially at the acute stage of infection.

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Section: Discussionmentioning

confidence: 99%

Evaluation of Diagnostic Assay for Rickettsioses Using Duplex Real-Time PCR in Multiple Laboratories in Japan

Kawamori

Shimazu²,

Sato³

et al. 2018

Jpn J Infect Dis

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“…Therefore, PCR-based diagnosis has been used for the early diagnosis of JSF. 3,10,11 PCR examinations have high sensitivity. However, it also depends on the amount of target DNA in the samples.…”

Section: Discussionmentioning

confidence: 99%

“…The samples from the bite eschar and/or skin lesions have been used for PCR study to increase the sensitivity of PCR for the diagnosis for JSF. 3,10,11 However, because sampling of skin lesions is invasive and not always available, a peripheral blood sample is generally used for diagnosis of JSF by PCR. Thus, approaches to increase the sensitivity of PCR-based diagnosis have been expected.…”

Section: Discussionmentioning

confidence: 99%

Improvement in early diagnosis of Japanese spotted fever by using a novel RickPCRsystem

Kondo

Akachi

Kawano

et al. 2015

The Journal of Dermatology

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Rickettsia diseases, including Japanese spotted fever (JSF), are serious infections. Delayed diagnosis occasionally results in life-threatening liver disorders and disseminated intravascular coagulation (DIC). Because of the shortness of the latent period, serological diagnosis is not preferable for early diagnosis of JSF. Until now, a polymerase chain reaction (PCR)-based diagnosis method has been used for early diagnosis, and the sensitivity reaches as high as 90% using skin biopsy samples as we previously reported. On the other hand, the sensitivity of the same PCR method using blood samples is limited at less than 50%. In the present study, using peripheral blood samples, we developed a novel diagnostic method for JSF using a Rick PCR system with original PCR primers, showing improved sensitivity compared with the conventional nested PCR. It may constitute a preferable diagnostic tool for early and sensitive diagnosis of Rickettsia infection.

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“…Molecular diagnosis of Rickettsia spp. by polymerase chain reaction (PCR) has a sensitivity of 90% when skin biopsy samples are used but falls to 50% when blood is used [78]. Similarly, PCR can be poorly sensitive for the detection of invasive Salmonella spp.…”

Section: Diagnostic Challengesmentioning

confidence: 99%

Challenges in the Etiology and Diagnosis of Acute Febrile Illness in Children in Low- and Middle-Income Countries

2016

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Acute febrile illness is a common cause of hospital admission, and its associated infectious causes contribute to substantial morbidity and death among children worldwide, especially in low- and middle-income countries. Declining transmission of malaria in many regions, combined with the increasing use of rapid diagnostic tests for malaria, has led to the increasing recognition of leptospirosis, rickettsioses, respiratory viruses, and arboviruses as etiologic agents of fevers. However, clinical discrimination between these etiologies can be difficult. Overtreatment with antimalarial drugs is common, even in the setting of a negative test result, as is overtreatment with empiric antibacterial drugs. Viral etiologies remain underrecognized and poorly investigated. More-sensitive diagnostics have led to additional dilemmas in discriminating whether a positive test result reflects a causative pathogen. Here, we review and summarize the current epidemiology and focus particularly on children and the challenges for future research.

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Early diagnosis of Japan spotted fever by PCR using skin samples

Cited by 14 publications

References 17 publications

Evaluation of Diagnostic Assay for Rickettsioses Using Duplex Real-Time PCR in Multiple Laboratories in Japan

Evaluation of Diagnostic Assay for Rickettsioses Using Duplex Real-Time PCR in Multiple Laboratories in Japan

Improvement in early diagnosis of Japanese spotted fever by using a novel RickPCRsystem

Challenges in the Etiology and Diagnosis of Acute Febrile Illness in Children in Low- and Middle-Income Countries

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