scholarly journals Murine Typhus: An Important Consideration for the Nonspecific Febrile Illness

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Gurjot Basra ◽  
Megan A. Berman ◽  
Lucas S. Blanton
Keyword(s):  
Infectious Diseases ◽  
20Th Century ◽  
Febrile Illness ◽  
Empiric Therapy ◽  
Acute Illness ◽  
Laboratory Studies ◽  
Murine Typhus ◽  
Transaminase Elevation ◽  
Macular Rash ◽  
Reservoir Hosts

Murine typhus is a widely distributed flea-borne infection caused byRickettsia typhi. Symptoms of murine typhus are nonspecific and mimic a variety of other infectious diseases. We herein report a case of murine typhus in an area where the broad use of DDT in the mid-20th century has now made it a rare disease. The patient described presented with headache, fever, and a faint macular rash. Initial laboratory studies revealed a slight transaminase elevation. Further questioning revealed exposure to opossums, prompting the consideration of murine typhus as a diagnosis. Although typhus group antibodies were not present during the patient’s acute illness, empiric therapy with doxycycline was initiated, and the patient defervesced. One month after convalescence, the patient returned to clinic with serum that contained typhus group antibodies with an IgG titer of 1 : 1024. Murine typhus is an important consideration during the workup of a patient with a nonspecific febrile illness. Exposure to reservoir hosts and the flea vector place humans at risk for this disease. Clinician recognition of this entity is required for diagnosis and effective therapy.

scholarly journals Some notes on a historical perspective of panic disorder

2006 ◽  
Vol 55 (2) ◽  
pp. 154-160 ◽  
Author(s):  
Antonio Egidio Nardi
Keyword(s):  
Panic Disorder ◽  
20Th Century ◽  
19Th Century ◽  
Greek Mythology ◽  
Laboratory Studies ◽  
Biochemical Tests ◽  
Wide Range ◽  
Therapeutic Development ◽  
History Of ◽  
The 19Th Century

This article aims to describe important points in the history of panic disorder concept, as well as to highlight the importance of its diagnosis for clinical and research developments. Panic disorder has been described in several literary reports and folklore. One of the oldest examples lies in Greek mythology - the god Pan, responsible for the term panic. The first half of the 19th century witnessed the culmination of medical approach. During the second half of the 19th century came the psychological approach of anxiety. The 20th century associated panic disorder to hereditary, organic and psychological factors, dividing anxiety into simple and phobic anxious states. Therapeutic development was also observed in psychopharmacological and psychotherapeutic fields. Official classifications began to include panic disorder as a category since the third edition of the American Classification Manual (1980). Some biological theories dealing with etiology were widely discussed during the last decades of the 20th century. They were based on laboratory studies of physiological, cognitive and biochemical tests, as the false suffocation alarm theory and the fear network. Such theories were important in creating new diagnostic paradigms to modern psychiatry. That suggests the need to consider a wide range of historical variables to understand how particular features for panic disorder diagnosis have been developed and how treatment has emerged.

scholarly journals Causes of death in Serbia since the mid-20th century

Stanovnistvo ◽  
2012 ◽  
Vol 50 (1) ◽  
pp. 89-106
Author(s):  
Ivan Marinkovic
Keyword(s):  
Cardiovascular Diseases ◽  
Infectious Diseases ◽  
20Th Century ◽  
Cause Of Death ◽  
21St Century ◽  
Causes Of Death ◽  
Total Population ◽  
Total Mortality ◽  
Population Mortality ◽  
Circulatory Diseases

The structure of the leading causes of death in Serbia has considerably changed in the last half century. Diseases which presented the main threat to the population a few decades ago are now at the level of a statistical error. On the one side are causes which drastically changed their share in total mortality in this time interval, while others have shown stability and persistence among the basic causes of death. Acute infectious diseases "have been replaced" with chronic noninfectious diseases, due to the improvement of general and health conditions. One of the consequences of such changes is increased life expectancy and a larger share of older population which resulted in cardiovascular diseases and tumors to dominate more and more in total mortality. Convergent trends in the structure of the leading causes of death in Serbia from the middle of the 20th century are the reasons why there are considerably fewer diseases and causes with a significant rate in total population mortality at the beginning of the 21st century. During the 1950s, there were five groups of diseases and causes which participated individually with more than 10% of population mortality (infectious diseases, heart and circulatory diseases, respiratory diseases, some perinatal conditions and undefined states) while at the beginning of the new century there were only two such groups (cardiovascular diseases and tumors). Identical trends exist in all European countries, as well as in the rest of the developed world. The leading causes of death in Serbia are cardiovascular diseases. An average of somewhat over 57.000 people died annually in the period from 2007 - 2009, which represents 55.5% of total population mortality. Women are more numerous among the deceased and this difference is increasing due to population feminization. The most frequent cause of death in Serbia, after heart and circulatory diseases, are tumors, which caused 21,415 deaths in 2009. Neoplasms are responsible for one fifth of all deaths. Their number has doubled in three decades, from 9,107 in 1975 to about 20,000 at the beginning of the 21st century, whereby tumors have become the fastest growing cause of death. Least changes in absolute number of deaths in the last half century were marked among violent deaths. Observed by gender, men are in average three times more numerous among violent deaths than women. In the middle of the 20th century in Serbia, one third of the deaths caused by violence were younger than 25 and as many as one half were younger than 35 years old. Only one tenth (11%) of total number of violent deaths were from the age group of 65 or older. At the end of the first decade of the 21st century (2009), the share of population younger than 25 in the total number of violent deaths was decreased four times (and amounted to 8%). At the same time, the rate of those older than 65 or more quadrupled (amounted to 39%).

scholarly journals Human genetic basis of interindividual variability in the course of infection

2015 ◽  
Vol 112 (51) ◽  
pp. E7118-E7127 ◽  
Author(s):  
Jean-Laurent Casanova
Keyword(s):  
Infectious Diseases ◽  
20Th Century ◽  
Genetic Basis ◽  
Human Genetics ◽  
Interindividual Variability ◽  
Background Information ◽  
Experimental Conditions ◽  
Life Threatening ◽  
History Of ◽  
The 19Th Century

The key problem in human infectious diseases was posed at the turn of the 20th century: their pathogenesis. For almost any given virus, bacterium, fungus, or parasite, life-threatening clinical disease develops in only a small minority of infected individuals. Solving this infection enigma is important clinically, for diagnosis, prognosis, prevention, and treatment. Some microbes will inevitably remain refractory to, or escape vaccination, or chemotherapy, or both. The solution also is important biologically, because the emergence and evolution of eukaryotes alongside more rapidly evolving prokaryotes, archaea, and viruses posed immunological challenges of an ecological and evolutionary nature. We need to study these challenges in natural, as opposed to experimental, conditions, and also at the molecular and cellular levels. According to the human genetic theory of infectious diseases, inborn variants underlie life-threatening infectious diseases. Here I review the history of the field of human genetics of infectious diseases from the turn of the 19th century to the second half of the 20th century. This paper thus sets the scene, providing the background information required to understand and appreciate the more recently described monogenic forms of resistance or predisposition to specific infections discussed in a second paper in this issue.

Parvovirus, Erythema Infectiosum, and Pregnancy

PEDIATRICS ◽  
1990 ◽  
Vol 85 (1) ◽  
pp. 131-133
Author(s):  
Keyword(s):  
Blood Cell ◽  
Red Blood Cell ◽  
Parvovirus B19 ◽  
Febrile Illness ◽  
Asymptomatic Infection ◽  
Acute Illness ◽  
Joint Involvement ◽  
Normal Person ◽  
Erythema Infectiosum ◽  
Aplastic Crisis

Recent outbreaks of erythema infectiosum (fifth disease) have caused consternation among pregnant women and their physicians, because of the risk of spontaneous abortion caused by this viral infection. This statement contains information concerning the infection and recommendations regarding control of exposure. The agent of erythema infectiosum is a single-stranded DNA virus called parvovirus B19, which infects humans only.1,2 Parvovirus B19 is principally transmitted by respiratory secretions,3 and a primary site of replication is the red blood cell precursors found in the bone marrow.4 After an incubation period of approximately 1 week's duration, the virus produces a febrile illness accompanied by reticulocytopenia, which lasts approximately 7 days.5 The normal person recovers without evident anemia and, in some cases, within another week, a distinctive rash, consisting of a slapped cheek appearance and an erythematous, lacy rash on the trunk and extremities, will develop. Atypical maculopapular rashes also occur.6 In adult patients, particularly women, arthralgia or arthritis may develop at this stage7,8; children infrequently experience joint involvement. Asymptomatic infection without rash may occur more frequently than illness with typical rash. Infection with parvovirus B19 can also cause aplastic crisis in patients with red blood cell abnormalities leading to shortened red blood cell halflives (such as sickle cell disease and autoimmune hemolytic anemia). The aplastic crises develop approximately 1 week after onset of the acute illness due to parvovirus B19.9 Patients with aplastic crisis appear to be contagious from the onset or before the onset of acute illness and through the subsequent week or so.

scholarly journals Mongolian Buddhist Scholars’ Works on Infectious Diseases (Late 17th Century to the Beginning of the 20th Century)

Religions ◽  
2019 ◽  
Vol 10 (4) ◽  
pp. 229 ◽  
Author(s):  
Batsaikhan Norov
Keyword(s):  
Infectious Diseases ◽  
20Th Century ◽  
Critical Period ◽  
Medical Knowledge ◽  
17Th Century ◽  
Political Control ◽  
Tibetan Buddhist ◽  
Medical Practices ◽  
Political Milieu ◽  
Preventive Methods

The Qing period saw both the flowering of Buddhism in Mongolia as well as the arrival of new infectious diseases such as smallpox and syphilis which had reached epidemic levels by the 17th to early 20th centuries. During that critical period, a considerable number of Mongolian Buddhist scholars produced a substantial amount of works dedicated to the ways of fighting epidemics. This paper explores the efforts of Mongolian Buddhist scholars in countering this new threat, within the unique social and political milieu of the time. Smallpox spread severely reduced the Mongolian population and could have influenced the change of political control in the region, as several prominent Mongolian leaders who fought against Qing domination were themselves victims of smallpox epidemics. Similarly, at the beginning of the 20th century, around half the Mongolian population was infected by syphilis and, as a result, the population further declined in numbers. Tibetan Buddhist medicine, which was introduced to Mongolia from Tibet, was enriched by Mongolian traditional medical practices and fused with traditional Mongolian and Chinese medical knowledge during Mongolian scholars’ search for preventive methods against infectious diseases. This article examines the works of three renowned Mongolian Buddhist scholars who dealt with issues of infectious diseases: Ye shes dpal ‘byor, Chakhar Géshé Lobsang Tsültim, and Lobsang chos ‘phel.

scholarly journals Lethal Infectious Diseases as Inborn Errors of Immunity: Toward a Synthesis of the Germ and Genetic Theories

2020 ◽  
Vol 16 (1) ◽  
Author(s):  
Jean-Laurent Casanova ◽  
Laurent Abel
Keyword(s):  
Infectious Diseases ◽  
20Th Century ◽  
Mendelian Inheritance ◽  
Annual Review ◽  
Publication Date ◽  
Recurrent Infections ◽  
Late 19Th Century ◽  
Inborn Errors ◽  
Inborn Errors Of Immunity ◽  
Classical Genetics

It was first demonstrated in the late 19th century that human deaths from fever were typically due to infections. As the germ theory gained ground, it replaced the old, unproven theory that deaths from fever reflected a weak personal or even familial constitution. A new enigma emerged at the turn of the 20th century, when it became apparent that only a small proportion of infected individuals die from primary infections with almost any given microbe. Classical genetics studies gradually revealed that severe infectious diseases could be driven by human genetic predisposition. This idea gained ground with the support of molecular genetics, in three successive, overlapping steps. First, many rare inborn errors of immunity were shown, from 1985 onward, to underlie multiple, recurrent infections with Mendelian inheritance. Second, a handful of rare and familial infections also segregating as Mendelian traits but striking humans resistant to other infections were deciphered molecularly from 1996 onward. Third, a growing number of rare or common sporadic infections were shown to result from monogenic, but not Mendelian, inborn errors from 2007 onward. A synthesis of the hitherto mutually exclusive germ and genetic theories is now in view. This article has been accepted for publication on April 14, 2020. Changes may still occur before final publication. Expected final online publication date for the Annual Review of Pathology: Mechanisms of Disease, Volume 16 is January 24, 2021. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

scholarly journals Headache in the presentation of noncephalic acute illness

2015 ◽  
Vol 06 (04) ◽  
pp. 494-498 ◽  
Author(s):  
Tomer Tzadok ◽  
Ronen Toledano ◽  
Lior Fuchs ◽  
Carmi Bartal ◽  
Victor Novack ◽  
...  
Keyword(s):  
Medical Center ◽  
Febrile Illness ◽  
Primary Headache ◽  
Headache Disorder ◽  
Respiratory Illness ◽  
Acute Illness ◽  
Common Symptom ◽  
Primary Headache Disorder ◽  
Primary Headache Disorders ◽  
Younger Age

ABSTRACT Background: Headache is a frequent symptom of many systemic diseases that do not involve cranial structures. In this observational study, we assessed factors associated with headache in the acute presentation of systemic conditions in a nonsurgical emergency department (ED). Methods: Consecutive patients, admitted to Soroka University Medical Center ED due to noncephalic illness, were prospectively surveyed using a structured questionnaire focused on the prevalence and characteristics of headache symptoms. Medical data were extracted from the patient's charts. Results: Between 1 and 6/2012, 194 patients aged 64.69 ± 19.52 years, were evaluated. Headache was reported by 83 (42.7%) patients and was more common among patients with febrile illness (77.5% vs. 22.5%, P < 0.001). Respiratory illness and level of O2saturation were not associated with headache. Headache in the presentation of a noncephalic illness was associated with younger age (58 vs. 69, P < 0.001) and with suffering from a primary headache disorder (48.2% vs. 10.8%, P < 0.001). Headache was also associated with higher body temperature and lower platelets count. Conclusions: Headache is a common symptom in acute noncephalic conditions and was found to be associated with younger age and febrile disease on presentation. Patients who present with primary headache disorders are more prone to have headache during acute illness. Acute obstructive respiratory disease, hypercarbia or hypoxemia were not associated with headache.

scholarly journals Where are all the new antibiotics? The new antibiotic paradox

2005 ◽  
Vol 16 (3) ◽  
pp. 159-160 ◽  
Author(s):  
JM Conly ◽  
BL Johnston
Keyword(s):  
North America ◽  
Infectious Diseases ◽  
20Th Century ◽  
Causes Of Death ◽  
Clinical Use ◽  
Infectious Agents ◽  
Antibiotic Development ◽  
Common Causes ◽  
New Antibiotics ◽  
The 1950S

At the beginning of the 20th century, illnesses caused by infectious agents ranked among the most common causes of death in North America and, indeed, worldwide. By the middle of the century, dramatic advances in the diagnosis, management and prevention of infectious diseases had occurred, and hopes were raised that many infectious diseases would be eliminated by the end of the 20th century. Much of this success in the management of infectious diseases was related to a continuous new armamentarium of antibiotics. The discovery of penicillin by Fleming in 1928 followed by the discovery and clinical use of sulphonamides in the 1930s heralded the age of modern antibiotherapy (1,2). Penicillin came into widespread use during the early 1940s. By the 1950s, the 'golden era' of antibiotic development and use was well underway, and multiple new classes of antibiotics were introduced over the next two decades (Table 1) (3).

scholarly journals Etiology of fever in Ugandan children: identification of microbial pathogens using metagenomic next-generation sequencing and IDseq, a platform for unbiased metagenomic analysis

2018 ◽  
Author(s):  
Akshaya Ramesh ◽  
Sara Nakielny ◽  
Jennifer Hsu ◽  
Mary Kyohere ◽  
Oswald Byaruhanga ◽  
...  
Keyword(s):  
Next Generation Sequencing ◽  
Pilot Study ◽  
Infectious Diseases ◽  
Parvovirus B19 ◽  
Human Herpesvirus ◽  
Febrile Illness ◽  
Microbial Pathogens ◽  
Next Generation ◽  
Syncytial Virus ◽  
Generation Sequencing

AbstractBackgroundFebrile illness is a major burden in African children, and non-malarial causes of fever are uncertain. We built and employed IDseq, a cloud-based, open access, bioinformatics platform and service to identify microbes from metagenomic next-generation sequencing of tissue samples. In this pilot study, we evaluated blood, nasopharyngeal, and stool specimens from 94 children (aged 2-54 months) with febrile illness admitted to Tororo District Hospital, Uganda.ResultsThe most common pathogens identified were Plasmodium falciparum (51.1% of samples) and parvovirus B19 (4.4%) from blood; human rhinoviruses A and C (40%), respiratory syncytial virus (10%), and human herpesvirus 5 (10%) from nasopharyngeal swabs; and rotavirus A (50% of those with diarrhea) from stool. Among other potential pathogens, we identified one novel orthobunyavirus, tentatively named Nyangole virus, from the blood of a child diagnosed with malaria and pneumonia, and Bwamba orthobunyavirus in the nasopharynx of a child with rash and sepsis. We also identified two novel human rhinovirus C species.ConclusionsThis exploratory pilot study demonstrates the utility of mNGS and the IDseq platform for defining the molecular landscape of febrile infectious diseases in resource limited areas. These methods, supported by a robust data analysis and sharing platform, offer a new tool for the surveillance, diagnosis, and ultimately treatment and prevention of infectious diseases.

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