Seek and Find! PCR analyses of skin infections in West-European travelers returning from abroad with an eschar

Morand, Aurélie; Angelakis, Emmanouil; Chaabane, Mehdi Ben; Parola, Philippe; Raoult, Didier

doi:10.1016/j.tmaid.2018.02.009

Cited by 14 publications

(9 citation statements)

References 32 publications

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“…Previously in Greece, R. typhi infections were considered endemic in some Greek regions [9,10] whereas for Europe, exposure to R. typhi has been recorded in Spain, Canary Islands [16], Cyprus [17], Italy [18], and Croatia [19]. Although autochthonous cases of murine typhus have not been described in the countries of North Europe, sporadic cases are commonly identified in travelers who visited endemic areas [7,15,20]. In Cyprus although to date many cases of murine typhus have been described, the first confirmed case was reported in a Swedish woman who developed fever, severe headache, myalgia and rash, three weeks after a visit to Cyprus [21].…”

Section: Discussionmentioning

confidence: 99%

Sunbathing, a possible risk factor of murine typhus infection in Greece

et al. 2021

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Background There are few studies about the presence of murine typhus in Greece. Our objective was to conduct a large scale retrospective investigation to determine the clinical and epidemiological features of patients diagnosed with murine typhus in Greece. Methodology/Principal findings From 2012 to 2019 serum samples from hospitalized patients and outpatients throughout Greece suspected for murine typhus infection were tested by immunofluorescence assay for Rickettsia typhi. Immunofluorescence positive samples obtained since 2016 were also tested by qPCR targeting R. typhi. Clinical and epidemiological data were retrospectively collected for the patients with confirmed murine typhus. Overall, we tested 5,365 different patients and, in total, 174 patients from all geographic regions of Greece were diagnosed with murine typhus. The most frequently reported sign or symptom was fever (89%), followed by headache (84%) and rash (81%). The classical triad of fever, headache, and rash was present in 72% of patients during their illness. Severe infections with complications including acute renal failure or septic shock were not recorded. The majority of cases (81%) occurred during May–October and peaked in June and September. Most of patients (81%) infected in Athens, recalled that their only activity the last weeks before symptoms onset was swimming on the beach and 59% of them also reported an insect bite while sunbathing. Conclusions/Significance Our results may reflect the reemergence of murine typhus in Greece and we highlight the importance of awareness of this difficult-to-recognize undifferentiated febrile illness.

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Section: Discussionmentioning

confidence: 99%

Sunbathing, a possible risk factor of murine typhus infection in Greece

et al. 2021

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“…All previous cases had been diagnosed on a skin biopsy sample. Swabbing of ulcers or eschars is a noninvasive, highly sensitive, diagnostic method that advantageously avoids performing a skin biopsy [ 14 ]. It is noteworthy that antibody detection by immunoblotting detected antibodies directed against the 14 and 16 kDa L. infantum antigens, which are present in the Leishmania species of the Vianna complex [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

“Chiclero’s Ulcer” Due to Leishmania mexicana in Travelers Returning from Central America: A Case Report and Review of the Literature

et al. 2021

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Cutaneous leishmaniasis (CL) due to a New World species of Leishmania is increasingly seen among returning international travelers, and most cases arise from travel to Mexico, Central and South America. We described a case of CL in a women presenting a nonhealing ulceration under her right ear with slight increase of size of the left parotid gland under the skin lesion, evolving for 4 months. In her history of travel, she reported a ten-day stay in Mexico during the Christmas vacation in the Yucatan region with only half a day walking in the tropical forest. Diagnosis of CL due to Leishmania mexicana was done via PCR detection and sequencing from swab sampling of the lesion. The patient recovered without antiparasitic treatment. Clinicians should consider diagnosing Chiclero’s ulcer in patients returning from endemic areas such as Central America and Texas who present with chronic ulceration. A noninvasive sampling is sufficient for the PCR-based diagnosis of this disease.

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“…Swabbing the ulcerated base of an eschar with a saline dipped sterile cotton swab is an effective method to detect the nucleic acids of Rickettsia. 79 Since PCR requires the expense of a thermocycler, reagents, and technical expertise, more inexpensive and easy to use nucleic amplification tests are desirable. The loop-mediated isothermal amplification assay is such a method and offers the ability to detect fewer than 100 copes of DNA per reaction.…”

Section: Diagnosismentioning

confidence: 99%

The Rickettsioses

Blanton

2019

Infectious Disease Clinics of North America

143

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Rickettsia are small, obligately intracellular Gram negative bacilli. They are distributed among a variety of hematophagous arthropod vectors and cause illness throughout the world. Rickettsioses present as an acute undifferentiated febrile illness and are often accompanied by headache, myalgias, and malaise. Cutaneous manifestations include rash and eschar, which both occur at varying incidence depending on the infecting species. Serology is the mainstay of diagnosis, and the indirect immunofluorescence assay is the test of choice. Reactive antibodies are seldom present during early illness, so testing should be performed on both acute-and convalescent-phase sera. Doxycycline is the treatment of choice.

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Seek and Find! PCR analyses of skin infections in West-European travelers returning from abroad with an eschar

Abstract: By targeting the most commonly encountered causative agents of travel-related skin infections, our strategy provides a sensitive and rapid diagnostic method.

Cited by 14 publications

References 32 publications

Sunbathing, a possible risk factor of murine typhus infection in Greece

Sunbathing, a possible risk factor of murine typhus infection in Greece

“Chiclero’s Ulcer” Due to Leishmania mexicana in Travelers Returning from Central America: A Case Report and Review of the Literature

The Rickettsioses

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