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Early Predictors of Enteric Fever in Children Presenting With Fever Without Focus: A Prospective Study.

Objective Blood culture is the gold standard for diagnosing enteric fever (EF), but its unavailability in many health facilities often leads to the overuse of antimicrobials. This study aimed to determine whether EF can be predicted early using clinical features and basic laboratory parameters, thus bypassing the need for blood culture. Methodology This prospective cohort study, conducted from September 2015 to February 2017 in Delhi, included children (6 months to 15 years old) presenting with "fever without focus" within the first week of onset. Based on the investigation results, children w…

Fever management in children and insights into fever of unknown origin: a survey among Italian pediatricians.

BACKGROUND: Fever is a common symptom in children, but despite existing guidelines, pediatricians may not fully apply recommendations. Fever of Unknown Origin (FUO) is generally referred to as an unexplained prolonged fever. However, a standardized FUO definition and management is missing. OBJECTIVE: To collect updated data on the approach to fever and FUO among Italian pediatricians. METHODS: A cross-sectional anonymous survey was conducted among a large sample of primary care and hospital pediatricians. The panel group formulated and proposed a practical FUO definition, using a modified De…

Genetic diversity of the dengue virus population in dengue fever and dengue hemorrhagic fever patients.

BACKGROUND: The error-prone replication of dengue virus (DENV) in host results in the highly diverse viral population. Together with the host factor, intra-host diversity may influence the disease severity. Therefore, it is worth investigating whether there is a correlation between intra-host genetic diversity and disease severity. OBJECTIVE: To investigate the genetic diversity in DENV for four serotypes of the dengue population from patients with dengue fever (DF) and dengue hemorrhagic fever (DHF) using next-generation sequencing (NGS) technology. METHODS: Forty RNA samples categorized in…

Risk factors associated with an outbreak of dengue fever/dengue haemorrhagic fever in Hanoi, Vietnam.

Dengue fever/dengue haemorrhagic fever (DF/DHF) appears to be emerging in Hanoi in recent years. A case-control study was performed to investigate risk factors for the development of DF/DHF in Hanoi. A total of 73 patients with DF/DHF and 73 control patients were included in the study. The risk factor analysis indicated that living in rented housing, living near uncovered sewers, and living in a house discharging sewage directly into to ponds were all significantly associated with DF/DHF. People living in rented houses were 2·2 times more at risk of DF/DHF than those living in their own homes …

Economic impact of dengue fever/dengue hemorrhagic fever in Thailand at the family and population levels.

Dengue fever and dengue hemorrhagic fever constitute a substantial health burden on the population in Thailand. In this study, the impact of symptomatic dengue virus infection on the families of patients hospitalized at the Kamphaeng Phet Provincial Hospital with laboratory-confirmed dengue in 2001 was assessed, and the disability-adjusted life years (DALYs) lost for fatal and non-fatal cases of dengue were calculated using population level data for Thailand. When we accounted for the direct cost of hospitalization, indirect costs due to loss of productivity, and the average number of persons …

Identification of typhoid fever and paratyphoid fever cases at presentation in outpatient clinics in Jakarta, Indonesia.

In Jakarta, Indonesia, over 80% of patients with typhoid fever or paratyphoid fever are treated in outpatient settings. In a community-based prospective passive surveillance study, we identified 59 typhoid, 23 paratyphoid fever and 259 non-enteric fever outpatients, all blood culture-confirmed. We compared their symptoms with the aim of developing a clinical prediction rule that may help direct empirical antibiotic treatment to cases with suspected (para)typhoid fever, rather than all febrile patients, or refer patients for additional diagnostic tests. Paratyphoid fever (Salmonella paratyphi A…

Antibody responses in acute and chronic Q fever and in subjects vaccinated against Q fever.

An analysis is made of the antibody response to Coxiella burnettii Phase-1 and Phase-2 antigens, as measured by immunofluorescence in the IgM, IgG or IgA immunoglobulin classes, or by complement-fixation, in patients with acute and chronic Q fever and in vaccinated or skin-tested subjects. In acute (primary) Q fever, IgM specific antibodies to Phase-1 antigen are present in early convalescence together with IgM, IgG, IgA and CF antibodies to Phase-2 antigen. IgM specific antibody may persist for at least 678 days after onset of the acute illness. Patients with chronic Q fever have no IgM speci…

Drug-induced fever: cases seen in the evaluation of unexplained fever in a general hospital population.

This study involved cases of unexplained fever for which an infectious disease consultation was requested and for which an untoward drug reaction was thought responsible. Twelve cases that met strict criteria for drug-induced fever are presented. Antimicrobial agents were responsible for eight cases; other causes included antihypertensive and anticonvulsant drugs and allopurinol. The duration of drug administration before fever appeared was highly variable. Most patients had no history of previous drug reaction. Seven patients had fever with on other symptoms or signs that would suggest a diag…

An epidemic of Rift Valley fever in Egypt. 1. Diagnosis of Rift Valley fever in man.

Rift Valley fever (RVF) virus was isolated from 53 of 56 sera collected from patients with a clinical picture of dengue-like illness during the peak of the epidemic of RVF in Egypt in the autumn of 1977. RVF virus was also isolated from the throat washings of two patients and the faeces of four, all of whom were positive for virus isolation from the serum. All the isolates were identified by the complement fixation (CF) test. Serological diagnosis of RVF, using paired sera from 16 patients, was made by both the haemagglutination-inhibition (HI) and CF tests. HI antibodies were demonstrated in …

A study of the relationship between the fever caused by bacterial pyrogens and the fever accompanying acute infections.

The relationship between the fever of acute infection and that following injection of bacterial pyrogen was studied by administering pyrogens to animals convalescent from acute infections. Rabbits surviving dermal pneumococcal infections or peritonitis due to Escherichia coli were given intravenous injections of typhoid or E. coli vaccine. They showed no evidence of tolerance to the fever-promoting effect of these pyrogenic materials. Tolerance did develop in infected animals given daily pyrogen injections during the course of the infection. Certain previous observations upon the ability of ra…

ETIOLOGY OF YELLOW FEVER : I. SYMPTOMATOLOGY AND PATHOLOGICAL FINDINGS OF THE YELLOW FEVER PREVALENT IN GUAYAQUIL.

The clinical and pathological features of the yellow fever prevalent in Guayaquil conform with those described by other investigators of this disease as it has occurred elsewhere, both epidemically and endemically.

Typhoid toxin: reframing enteric fever.

SUMMARYSalmonella enterica serovars Typhi and Paratyphi A cause enteric (typhoid/paratyphoid) fever, a systemic disease that remains a major source of morbidity and mortality worldwide. The most distinctive clinical manifestations, such as sustained fever with relative bradycardia, leukopenia, neuropsychiatric symptoms/encephalopathy, and ileal perforation, have long lacked a unifying mechanistic explanation. Over the past two decades, studies of typhoid toxin have reframed how we understand this disease. Typhoid toxin is a human-adapted, chimeric A2B5 exotoxin assembled exclusively inside inf…

Абдоминальные проявления лихорадки Q.

ЦЕЛИ: Гепатопатия стетоза, селенопатия и гипоэхоический желчный брюшной УЗИ являются признаками внезапного воспаления брюшной полости. Такая клиническая картина из-за температуры Q часто встречается. Однако инфекционные этиологии для первичного мезентерического аденита редки. МЕТОДЫ: Было проведено полное биохимическое и клиническое обследование пациентов, за которым последовал спектр серологических и молекулярных биологических тестов с целью обнаружения причинно-следственного агента, имеющего очень серьезную, высокоинфекционную болезнь. Результаты: Здесь мы сообщаем о двух исключительных случ

Совпадение в аннотации оригинала
OBJECTIVES: Hepatopathy of the steatosis type, splenopathy, and a hypoechoic enlarged gallbladder on abdominal ultrasonography are indications of sudden inflammation affecting the abdominal region. Such a clinical picture due to Q fever is common. However, infectious etiologies for primary mesenteric adenitis are rare. METHODS: A complete biochemistry and c…

Enteric (typhoid and paratyphoid) fever.

Enteric fever, caused by the human-restricted bacteria Salmonella enterica serovar Typhi (typhoid) and Salmonella enterica serovar Paratyphi A, B, and C (paratyphoid), affects persons residing in, or travelling from, areas lacking safe water, sanitation, and hygiene infrastructure. Transmission is by the faecal-oral route. A gradual fever onset over 3-7 days with malaise, headache, and myalgia is typical. Symptoms can be altered by previous antimicrobial use. Life-threatening complications can arise in the second week of untreated illness. Differentiation from other febrile illnesses is challe…

Familial Mediterranean Fever in Childhood.

Familial Mediterranean fever (FMF) is the most prevalent monogenic autoinflammatory disorder, characterized by recurrent fever and serositis. It primarily affects individuals of Mediterranean descent, including Arabs, Armenians, Turks, and Jews. The Mediterranean fever (MEFV) gene, responsible for FMF, was discovered in 1997. Biallelic pathogenic variants lead to excessive activation of the pyrin inflammasome, resulting in inflammation. Clinical manifestations include recurrent fever, abdominal pain, and joint involvement, with attacks typically lasting 12-72 hours. Diagnosis relies on clinica…

[Rat bite fever in children].

BACKGROUND: Worldwide, disease in children due to exposure to rats is increasing, also in the Netherlands. Not only the generally known pathogen Leptospira should be considered, also S. moniliformis, Yersinia pestis, Lymphocytic choriomeningitis virus, Hantavirus, Francisella tularensis and Pasteurella multocida are also known rat-associated zoonosis. CASE DESCRIPTION: An 12-year-old boy visited the pediatrician with fever, headache and nausea, followed by generalized erythema and arthritis. The boy had a pet rat. The patient's blood culture was positive for S. moniliformis. The patient was t…

Crimean-Congo haemorrhagic fever virus.

Crimean-Congo haemorrhagic fever (CCHF) is a severe tick-borne illness with a wide geographical distribution and case fatality rates of 30% or higher. Caused by infection with the CCHF virus (CCHFV), cases are reported throughout Africa, the Middle East, Asia and southern and eastern Europe. The expanding range of the Hyalomma tick vector is placing new populations at risk for CCHF, and no licensed vaccines or specific antivirals exist to treat CCHF. Furthermore, despite cases of CCHF being reported annually, the host and viral determinants of CCHFV pathogenesis are poorly understood. CCHFV ca…