Increased Detection of Rickettsialpox in a New York City Hospital Following the Anthrax Outbreak of 2001

Koss, Tamara; Carter, Eric L.; Grossman, Marc E.; Silvers, David N.; Rabinowitz, Asher D.; Singleton, Joseph; Zaki, Sherif R.; Paddock, Christopher D.

doi:10.1001/archderm.139.12.1545

Cited by 50 publications

(12 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although more than 800 cases of rickettsialpox have been reported since the disease was first described in 1946 in the New York City borough of Queens (Huebner et al 1946, Greenberg et al 1947a, more than half of the cases were reported during the first 3 years after the initial description of the disease (Rose 1949), well before liver function tests were incorporated into clinical practice in the mid-to-late 1950s. We are aware of only 20 prior cases in which liver enzyme levels were mentioned, and in all but one the levels were within normal limits (Brettman et al 1981, Koss et al 2003). In the one previously reported case in which the levels were mildly elevated, the aspartate aminotransferase level was 63 U/L, the alanine aminotransferase level was 128 U/L, and the alkaline phosphatase level was 177 U/L (Koss et al 2003).…”

Section: Discussionmentioning

confidence: 99%

“…We are aware of only 20 prior cases in which liver enzyme levels were mentioned, and in all but one the levels were within normal limits (Brettman et al 1981, Koss et al 2003). In the one previously reported case in which the levels were mildly elevated, the aspartate aminotransferase level was 63 U/L, the alanine aminotransferase level was 128 U/L, and the alkaline phosphatase level was 177 U/L (Koss et al 2003). Posttreatment liver enzyme levels, however, were not provided.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Hepatitis in Association with Rickettsialpox

Madison

Kim‐Schluger

Braverman

et al. 2008

Vector-Borne and Zoonotic Diseases

View full text Add to dashboard Cite

Rickettsialpox is an acute, self-limited, febrile illness caused by Rickettsia akari and transmitted by Liponyssoides sanguineus, a mite that infests the common house mouse, Mus musculus. Liver involvement in rickettsialpox has received little attention, although hepatitis has been reported in several other rickettsial infections. In this report, we describe two patients with rickettsialpox who had acute hepatitis that resolved completely. In the appropriate clinical setting, rickettsialpox should be considered in the differential diagnosis of hepatitis.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Hepatitis in Association with Rickettsialpox

Madison

Kim‐Schluger

Braverman

et al. 2008

Vector-Borne and Zoonotic Diseases

View full text Add to dashboard Cite

show abstract

“…Following its original discovery rickettsialpox received substantial attention from medical and public health professionals worldwide which then progressively diminished, possibly due to the relatively mild course of the illness and decreasing familiarity of clinicians with the disease, the availability of effective antibiotics and the broad use of pesticides for rodent control [1,74,75]. It was not until 2001 that widespread interest in rickettsialpox reemerged because of differential diagnostic considerations for its cutaneous lesions since the vesicular rash and later scab could lead to its misidentification as chickenpox, herpes, and/or anthrax [12,41,42,58,60,84].…”

Section: Introductionmentioning

confidence: 99%

Rickettsialpox — a rare but not extinct disease: review of the literature and new directions

Eremeeva

Мунис-Родригес

2020

Russian Journal of Infection and Immunity

View full text Add to dashboard Cite

Rickettsialpox is an urban zoonosis caused by Rickettsia akari. To date R. akari is the only well-characterized mite-borne member of the spotted fever group. It is transmitted by the mouse mite, Liponyssoides sanguineus, commonly found on peridomestic rodents. While the disease was first discovered in New York City in 1946, a few years later a similar outbreak occurred in the Ukraine SSR. Numerous serosurveys and diagnosis of sporadic cases of rickettsialpox suggest its global distribution; however, the actual contemporary geography of rickettsialpox and its incidence are unknown. Rickettsialpox is characterized by the classic clinical triad found in rickettsioses of a black eschar, high fever, and rash but the latter is atypical as it is papulovesicular. Dermatological manifestations and the progression of rickettsialpox may mimic other infectious and noninfectious syndromes, including sexually transmitted diseases. The purpose of this review is to increase awareness of this unique disease through reanalysis of classic and contemporary clinical descriptions of rickettsialpox, evaluation of its worldwide distribution, and updates on the public health importance of the disease as well as the ecology and vector associations of R. akari. Our review data suggests that only limited genetic diversity exists among the available isolates of R. akari associated with previous outbreaks; additional effort is still required to define specific genetic markers permitting direct surveillance, accurate and reliable diagnosis, tracking and studying of the vector and host associations of contemporary isolates. The potential of R. akari to cross into other vector species emphasizes the necessity for detection of outbreaks of the disease in new regions of the world and in novel ecological settings. We describe existing gaps and limitations in our current understanding of the pathogenesis of rickettsialpox, the epidemiology of this disease and the genetic diversity of R. akari. We propose research priorities for what is needed to improve our understanding of this neglected rickettsial disease and its etiologic agent.

show abstract

“…Early in the febrile course, a maculopapular eruption with intraepidermal vesicles usually appears, sparing the palms and soles of the feet [17]. If misdiagnosis occurs, symptoms can lead to mistaken for signs of potentially more serious diseases, such as cutaneous anthrax or smallpox [18,19]. Thus, it is recommended to confirm the clinical observations with serological testing.…”

Section: Introductionmentioning

confidence: 99%

Proteomic analysis of Rickettsia akari proposes a 44 kDa-OMP as a novel biomarker for Rickettsialpox diagnosis

Csicsay¹,

Flores-Ramirez²,

Zúñiga-Navarrete³

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Rickettsialpox is a febrile illness caused by the mite-borne pathogen Rickettsia akari. Several cases of this disease are reported worldwide. Nevertheless, the relationship between the immunogenicity of R. akari and the disease development remains poorly understood. Therefore, misdiagnosis is frequent. Our study is aimed to identify immunogenic proteins that may improve disease recognition and enhance subsequent treatment. To achieve this goal, two proteomics methodologies were applied, followed by immunoblot confirmation. Results: Three hundred and sixteen unique proteins were identified in the whole-cell extract of R. akari. The most represented protein groups were found to be those involved in translation, post-translational modifications, energy production, and cell wall development. A significant number of proteins belonged to amino acid transport and intracellular trafficking. Also, some proteins affecting the virulence were detected. In silico analysis of membrane enriched proteins revealed 25 putative outer membrane proteins containing beta-barrel structure and 11 proteins having a secretion signal peptide sequence. Using rabbit and patient sera, various immunoreactive proteins were identified from which the 44 kDa uncharacterized protein (A8GP63) has demonstrated a unique detection capability. It positively distinguished the sera of patients with Rickettsialpox from other rickettsia positive patient sera. Conclusion: Our proteomic analysis certainly contributed to the knowledge of the pathogenesis of R. akari. The result obtained may also serve as a guideline for a more accurate diagnosis of rickettsial diseases. Identified R. akari antigenic protein can be design as a unique marker of rickettsialpox and used as a target for the development of more effective treatment.

show abstract

Increased Detection of Rickettsialpox in a New York City Hospital Following the Anthrax Outbreak of 2001

Cited by 50 publications

References 27 publications

Hepatitis in Association with Rickettsialpox

Hepatitis in Association with Rickettsialpox

Rickettsialpox — a rare but not extinct disease: review of the literature and new directions

Proteomic analysis of Rickettsia akari proposes a 44 kDa-OMP as a novel biomarker for Rickettsialpox diagnosis

Contact Info

Product

Resources

About