Priapism as a complication of scorpionism in children is rare and is categorized as grade II of severity. The pathogenesis is the activation of parasympathetic pathways that stimulate the release of acetylcholine. An 8-year-old boy, a known case of steroid-dependent nephrotic syndrome, presented with a history of persistent penile erection for the previous 12 hours. He had a history of a black scorpion (Heterometrus swammerdami) sting on his right leg 4 days earlier. He was given adequate analgesia, and prazosin was started at 30 µg/kg/dose because of the parasympathetic overactivity. Doppler ultrasonography of the penile shaft showed a bilateral thickened, bulky, and edematous corpus cavernosa and no arterial flow due to venous congestion, suggesting ischemic (low-flow) priapism. Detumescence was not accomplished with saline irrigation and aspiration or with intracorporeal irrigation with phenylephrine. Thus, a distal T-shunt was done. We illustrate an interesting case of scorpion envenomation with delayed ischemic priapism.
{"title":"Case Report: Scorpion Envenomation with Delayed Ischemic Priapism in a Preadolescent-An Unusual Presentation.","authors":"Rahul Gupta, Pradeep Kumar Gunasekaran, Bharat Choudhary, Gautam Ram Choudhary","doi":"10.4269/ajtmh.24-0223","DOIUrl":"https://doi.org/10.4269/ajtmh.24-0223","url":null,"abstract":"<p><p>Priapism as a complication of scorpionism in children is rare and is categorized as grade II of severity. The pathogenesis is the activation of parasympathetic pathways that stimulate the release of acetylcholine. An 8-year-old boy, a known case of steroid-dependent nephrotic syndrome, presented with a history of persistent penile erection for the previous 12 hours. He had a history of a black scorpion (Heterometrus swammerdami) sting on his right leg 4 days earlier. He was given adequate analgesia, and prazosin was started at 30 µg/kg/dose because of the parasympathetic overactivity. Doppler ultrasonography of the penile shaft showed a bilateral thickened, bulky, and edematous corpus cavernosa and no arterial flow due to venous congestion, suggesting ischemic (low-flow) priapism. Detumescence was not accomplished with saline irrigation and aspiration or with intracorporeal irrigation with phenylephrine. Thus, a distal T-shunt was done. We illustrate an interesting case of scorpion envenomation with delayed ischemic priapism.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141750850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ashton D Hall, Kavya Patel, Michael B Burch, Lea M Rotert
{"title":"Disseminated Blastomycosis.","authors":"Ashton D Hall, Kavya Patel, Michael B Burch, Lea M Rotert","doi":"10.4269/ajtmh.24-0133","DOIUrl":"https://doi.org/10.4269/ajtmh.24-0133","url":null,"abstract":"","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141750852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Thishan Channa Yahathugoda, Nirmitha Lalindi De Silva, Janaka Ruben, Sharmini Gunawardena, Mirani Vasanthamala Weerasooriya, John Horton, Philip Budge, Eric Ottesen, Sarah Mary Sullivan, Mariana Stephens, John Shen, Ute Klarmann-Schulz, Achim Hoerauf, Joseph Patrick Shott, Charles Mackenzie
Morbidity management of filarial lymphedema remains a challenge even during the post-lymphatic filariasis elimination era in Sri Lanka despite provision of the predominantly hygiene-based WHO Essential Package of Care. Because prior studies have suggested that 6 weeks of doxycycline may reduce progression of limb lymphedema, we conducted a randomized, placebo-controlled, superiority study to evaluate this possibility in Sri Lanka. Patients aged 14 to 65 years with lymphedema in one or both legs received either 200 mg of doxycycline daily for 6 weeks or matching placebo. The primary efficacy endpoint was improvement or lack of progression in lymphedema stage at 24 months postenrollment. Secondary endpoints included change in lymphedema stage at 12 and 24 months, frequency of acute adenolymphangitis episodes, and perceived disability measured by the WHO Disability Assessment Schedule 2.0 (WHODAS 2.0). Training and supplies for limb hygiene were provided throughout the study. Two hundred participants (100 in each arm) with lymphedema of Dreyer stages 1 to 3 were enrolled. By the end of the 2-year study, 29% of the doxycycline patients and 34% of those on placebo showed improvement (i.e., a decrease in lymphedema stage), whereas 11% and 15% of the two groups showed worsening of the lymphedema. Adenolymphangitis rates were comparable in the two groups (43 doxycycline and 38 placebo recipients), although attacks lasted slightly longer in placebo patients (6.5 days versus 5.2 days). In both groups, perceived disability improved initially, with partial rebound in the second year. Only 34 adverse events affecting 24 patients (11%) occurred during the 6-week treatment period. Although doxycycline did not significantly impact lymphedema progression in this study, the results clearly indicate that clinical and personal benefits can be obtained from intensive hygiene management alone.
{"title":"LEDoxy-SL: A Placebo-Controlled, Double-Blind, Randomized, 24-Month Trial of Six Weeks of Daily Doxycycline Plus Hygiene-Based Essential Care for Reducing Progression of Filarial Lymphedema in Sri Lanka.","authors":"Thishan Channa Yahathugoda, Nirmitha Lalindi De Silva, Janaka Ruben, Sharmini Gunawardena, Mirani Vasanthamala Weerasooriya, John Horton, Philip Budge, Eric Ottesen, Sarah Mary Sullivan, Mariana Stephens, John Shen, Ute Klarmann-Schulz, Achim Hoerauf, Joseph Patrick Shott, Charles Mackenzie","doi":"10.4269/ajtmh.24-0050","DOIUrl":"10.4269/ajtmh.24-0050","url":null,"abstract":"<p><p>Morbidity management of filarial lymphedema remains a challenge even during the post-lymphatic filariasis elimination era in Sri Lanka despite provision of the predominantly hygiene-based WHO Essential Package of Care. Because prior studies have suggested that 6 weeks of doxycycline may reduce progression of limb lymphedema, we conducted a randomized, placebo-controlled, superiority study to evaluate this possibility in Sri Lanka. Patients aged 14 to 65 years with lymphedema in one or both legs received either 200 mg of doxycycline daily for 6 weeks or matching placebo. The primary efficacy endpoint was improvement or lack of progression in lymphedema stage at 24 months postenrollment. Secondary endpoints included change in lymphedema stage at 12 and 24 months, frequency of acute adenolymphangitis episodes, and perceived disability measured by the WHO Disability Assessment Schedule 2.0 (WHODAS 2.0). Training and supplies for limb hygiene were provided throughout the study. Two hundred participants (100 in each arm) with lymphedema of Dreyer stages 1 to 3 were enrolled. By the end of the 2-year study, 29% of the doxycycline patients and 34% of those on placebo showed improvement (i.e., a decrease in lymphedema stage), whereas 11% and 15% of the two groups showed worsening of the lymphedema. Adenolymphangitis rates were comparable in the two groups (43 doxycycline and 38 placebo recipients), although attacks lasted slightly longer in placebo patients (6.5 days versus 5.2 days). In both groups, perceived disability improved initially, with partial rebound in the second year. Only 34 adverse events affecting 24 patients (11%) occurred during the 6-week treatment period. Although doxycycline did not significantly impact lymphedema progression in this study, the results clearly indicate that clinical and personal benefits can be obtained from intensive hygiene management alone.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141750855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Teite Rebecca Hildebrandt, Helmut Ramharter, Anita Lumeka Kabwende, Lilian Endamne, Saskia D Davi, Ayôla Akim Adegnika, Ghyslain Mombo-Ngoma, Selidji T Agnandji, Johannes Mischlinger, Rella Manego Zoleko, Michael Ramharter
Loiasis, a filarial pathogen exclusively endemic in central and western Africa, causes a wide spectrum of symptoms. Understanding the breadth of its clinical manifestations is of importance for adequate patient care and to understand its disease burden. Recurring transient pain in the oral cavity was reported as a self-perceived symptom of loiasis in in-depth interviews of patients in a high transmission region in Gabon. Pain was described as stabbing in character and transient for a few days in its temporal course. A quantitative epidemiological survey indicated that transient tooth pain was experienced by 22% of patients infected with Loa loa. Among those individuals, it was exclusively reported by patients suffering from migratory loiasis (24%). Similar findings have been previously described for other filarial pathogens, indicating that transient swellings of the periodontium and the soft tissue of the oral cavity may explain this symptom reported by patients with migratory loiasis.
丝虫病是一种仅在非洲中部和西部流行的丝虫病原体,可引起多种症状。了解其临床表现的广泛性对于充分护理病人和了解其疾病负担非常重要。在对加蓬一个高传播地区的患者进行的深入访谈中发现,口腔中反复出现的短暂疼痛是一种自我感觉良好的丝虫病症状。据描述,这种疼痛具有刺痛的特点,在时间过程中会持续数天。一项定量流行病学调查显示,22% 的 Loa loa 感染者经历过短暂的牙痛。在这些人中,仅有 24% 的迁徙性 Loiasis 患者报告过这种情况。以前对其他丝虫病原体也有过类似的发现,表明牙周和口腔软组织的一过性肿胀可能是游走性丝虫病患者报告的这一症状的原因。
{"title":"Recurring Transient Tooth Pain as Newly Described Symptom of Migratory Loiasis: A Mixed-Methods Study in Rural Gabon.","authors":"Teite Rebecca Hildebrandt, Helmut Ramharter, Anita Lumeka Kabwende, Lilian Endamne, Saskia D Davi, Ayôla Akim Adegnika, Ghyslain Mombo-Ngoma, Selidji T Agnandji, Johannes Mischlinger, Rella Manego Zoleko, Michael Ramharter","doi":"10.4269/ajtmh.24-0059","DOIUrl":"https://doi.org/10.4269/ajtmh.24-0059","url":null,"abstract":"<p><p>Loiasis, a filarial pathogen exclusively endemic in central and western Africa, causes a wide spectrum of symptoms. Understanding the breadth of its clinical manifestations is of importance for adequate patient care and to understand its disease burden. Recurring transient pain in the oral cavity was reported as a self-perceived symptom of loiasis in in-depth interviews of patients in a high transmission region in Gabon. Pain was described as stabbing in character and transient for a few days in its temporal course. A quantitative epidemiological survey indicated that transient tooth pain was experienced by 22% of patients infected with Loa loa. Among those individuals, it was exclusively reported by patients suffering from migratory loiasis (24%). Similar findings have been previously described for other filarial pathogens, indicating that transient swellings of the periodontium and the soft tissue of the oral cavity may explain this symptom reported by patients with migratory loiasis.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141750884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kacey C Ernst, Pilar Fernandez, Maria Diuk-Wasser, Aaron J Enriquez, Kevin Berry, Mary H Hayden
Lyme disease transmission dynamics in the northeastern United States vary by context. Periurban regions, including Block Island, RI, have experienced decades of endemic transmission. In urban areas, including Staten Island, a borough in New York City, NY, Lyme disease is an emerging issue. Knowledge, attitudes, and practices around Lyme disease evolve as an area progresses from emergent to endemic. We conducted focus group discussions and household surveys within Staten Island, NY and Block Island, RI to compare knowledge, attitudes, and practices surrounding Lyme disease and other tick-borne diseases. Qualitative data were coded into themes, and survey data were used to provide more general context of the focus group discussions. Using item response theory, we developed an index of knowledge from relevant factors within the household survey. We identified a significant difference in knowledge scores between the two study areas. Additionally, we identified key differences across multiple domains. Participants from Block Island were more likely to report prior tick exposure and Lyme disease in themselves or household members and were more likely to express concerns about the environmental impact of mitigation strategies. Individuals on Staten Island were more likely to assign responsibility of prevention and control to local, state, and federal government than to take personal prevention measures. Prevention of Lyme disease and other tick-borne diseases must be tailored to the community context and monitored over time as perceptions and priorities may evolve as transmission dynamics transition from emergent to endemic.
{"title":"Contrasting Perceptions, Knowledge, and Actions around Lyme Disease in an Urban Area of Emerging Lyme Disease and an Area of Endemic Lyme Disease in the Northeastern United States.","authors":"Kacey C Ernst, Pilar Fernandez, Maria Diuk-Wasser, Aaron J Enriquez, Kevin Berry, Mary H Hayden","doi":"10.4269/ajtmh.24-0035","DOIUrl":"https://doi.org/10.4269/ajtmh.24-0035","url":null,"abstract":"<p><p>Lyme disease transmission dynamics in the northeastern United States vary by context. Periurban regions, including Block Island, RI, have experienced decades of endemic transmission. In urban areas, including Staten Island, a borough in New York City, NY, Lyme disease is an emerging issue. Knowledge, attitudes, and practices around Lyme disease evolve as an area progresses from emergent to endemic. We conducted focus group discussions and household surveys within Staten Island, NY and Block Island, RI to compare knowledge, attitudes, and practices surrounding Lyme disease and other tick-borne diseases. Qualitative data were coded into themes, and survey data were used to provide more general context of the focus group discussions. Using item response theory, we developed an index of knowledge from relevant factors within the household survey. We identified a significant difference in knowledge scores between the two study areas. Additionally, we identified key differences across multiple domains. Participants from Block Island were more likely to report prior tick exposure and Lyme disease in themselves or household members and were more likely to express concerns about the environmental impact of mitigation strategies. Individuals on Staten Island were more likely to assign responsibility of prevention and control to local, state, and federal government than to take personal prevention measures. Prevention of Lyme disease and other tick-borne diseases must be tailored to the community context and monitored over time as perceptions and priorities may evolve as transmission dynamics transition from emergent to endemic.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141750851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nerve function impairment (NFI) in leprosy results in serious deformities of the face, hands, and feet and contributes significantly to the stigma associated with the disease. Most literature on NFI focuses on either type 1 reaction-associated NFI, or the silent neuropathy, whereas NFI associated with type 2 reaction (T2R) is less well researched. The latter, however, can be more refractory to conventional treatment, not solely owing to its recurrent nature. We present a therapeutically challenging case of a 31-year-old male with borderline lepromatous leprosy with recurrent T2R associated with recurrent and progressive sensorimotor NFI, largely unresponsive to oral steroids and multibacillary, multidrug therapy.
{"title":"Case Report: Recurrent Type 2 Leprosy Reaction Associated with Multiple Nerve Function Impairments Refractory to Steroids: A Therapeutic Challenge.","authors":"Ananta Khurana, Savitha Sharath, Abhishek Panchal, Kabir Sardana, Saurabh Gupta","doi":"10.4269/ajtmh.23-0486","DOIUrl":"https://doi.org/10.4269/ajtmh.23-0486","url":null,"abstract":"<p><p>Nerve function impairment (NFI) in leprosy results in serious deformities of the face, hands, and feet and contributes significantly to the stigma associated with the disease. Most literature on NFI focuses on either type 1 reaction-associated NFI, or the silent neuropathy, whereas NFI associated with type 2 reaction (T2R) is less well researched. The latter, however, can be more refractory to conventional treatment, not solely owing to its recurrent nature. We present a therapeutically challenging case of a 31-year-old male with borderline lepromatous leprosy with recurrent T2R associated with recurrent and progressive sensorimotor NFI, largely unresponsive to oral steroids and multibacillary, multidrug therapy.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141750849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-23Print Date: 2024-09-04DOI: 10.4269/ajtmh.24-0251
Michael E DeWitt, John W Sanders
{"title":"Tropical Diseases in the United States: Beyond Poverty - Advancing an Ecological Framework in Tropical Medicine.","authors":"Michael E DeWitt, John W Sanders","doi":"10.4269/ajtmh.24-0251","DOIUrl":"10.4269/ajtmh.24-0251","url":null,"abstract":"","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11376151/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141750885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Amoebic liver abscess (ALA) is the most common extra-intestinal complication of Entamoeba histolytica, accounting for 50,000 deaths annually, and is endemic in South Asia. Diagnosis based on microscopic examination is insensitive, and serological assays are not discerning of current infections in endemic settings with high exposure. For a rapid and confirmatory laboratory diagnosis of ALA, the performance of a polymerase chain reaction (PCR), quantitative real time PCR (qPCR), digital droplet PCR (ddPCR), and a loop-mediated isothermal amplification (LAMP) assay that detects E. histolytica DNA in liver abscess pus, and a lectin antigen detection ELISA were evaluated against clinical diagnosis (based on predefined criteria) as the gold standard. Owing to the lack of a laboratory gold standard, a Bayesian latent class analysis approach was also used to determine sensitivity and specificity of these assays. In the latent class analysis, qPCR and ddPCR showed the highest sensitivity (98% and 98.1%) and specificity (both 96.6%), and although clinical diagnosis had a comparable sensitivity to qPCR and ddPCR (95.2%), poorer specificity (64.3%) was seen. Kappa agreement analysis showed that qPCR and ddPCR had a perfect agreement of 1 followed by an agreement of 0.76 (95% CI: 0.64-0.88) with PCR. Considering the performance characteristics and relative ease of setting up qPCR as well as the wide availability of qPCR equipment needed, this would be the most optimal assay for rapid, confirmatory, molecular diagnosis of ALA in the tertiary care laboratory setting in India, whereas further optimization of LAMP or antibody-based detection is required for use at smaller or secondary hospitals.
{"title":"Evaluation of Molecular Assays for Diagnosis of Amoebic Liver Abscess in India with Bayesian Latent Class Analysis.","authors":"Sitara Swarna Rao Ajjampur, Sanket Mankad, Malathi Manuel, Renita Ruth, Ashok D Prabakaran, Venkateshprabhu Janagaraj, Thambu David, Philip Joseph, Priscilla Rupali","doi":"10.4269/ajtmh.23-0492","DOIUrl":"https://doi.org/10.4269/ajtmh.23-0492","url":null,"abstract":"<p><p>Amoebic liver abscess (ALA) is the most common extra-intestinal complication of Entamoeba histolytica, accounting for 50,000 deaths annually, and is endemic in South Asia. Diagnosis based on microscopic examination is insensitive, and serological assays are not discerning of current infections in endemic settings with high exposure. For a rapid and confirmatory laboratory diagnosis of ALA, the performance of a polymerase chain reaction (PCR), quantitative real time PCR (qPCR), digital droplet PCR (ddPCR), and a loop-mediated isothermal amplification (LAMP) assay that detects E. histolytica DNA in liver abscess pus, and a lectin antigen detection ELISA were evaluated against clinical diagnosis (based on predefined criteria) as the gold standard. Owing to the lack of a laboratory gold standard, a Bayesian latent class analysis approach was also used to determine sensitivity and specificity of these assays. In the latent class analysis, qPCR and ddPCR showed the highest sensitivity (98% and 98.1%) and specificity (both 96.6%), and although clinical diagnosis had a comparable sensitivity to qPCR and ddPCR (95.2%), poorer specificity (64.3%) was seen. Kappa agreement analysis showed that qPCR and ddPCR had a perfect agreement of 1 followed by an agreement of 0.76 (95% CI: 0.64-0.88) with PCR. Considering the performance characteristics and relative ease of setting up qPCR as well as the wide availability of qPCR equipment needed, this would be the most optimal assay for rapid, confirmatory, molecular diagnosis of ALA in the tertiary care laboratory setting in India, whereas further optimization of LAMP or antibody-based detection is required for use at smaller or secondary hospitals.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141750853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Linda Bohou Kombila, Solène Lerolle, Illich Manfred Mombo, Neil-Michel Longo-Pendy, Danielle Koumba Mavoungou, Gaël Darren Maganga, Francois-Loïc Cosset, Jessica Vanhomwegen, Christina Deschermeier, Eric Maurice Leroy, Vincent Legros, Nadine N'dilimabaka, Pierre Becquart
Crimean-Congo hemorrhagic fever (CCHF) is a tick-borne viral disease with a mortality rate reaching up to 40% in humans. Currently, CCHF affects three continents: Asia, Europe, and Africa. An increase in confirmed cases in Africa has been observed since 2000. In Central Africa, several countries have reported the circulation of CCHV virus (CCHFV). However, in Gabon, there is a lack of recent data on the circulation of the virus in the Gabonese population. To provide an overview of the epidemiological situation in Gabon, we tested 3,081 human serum samples collected between 2005 and 2008 in villages throughout the country for anti-CCHFV antibodies. Using a double-antigen ELISA kit, our study found 15/3,081 samples positive for CCHFV. These positive samples were also tested using the Blackbox CCHFV IgG kit and the Luminex technique. These analyses confirmed seven and four positives for the Blackbox CCHFV IgG kit and the Luminex technique, respectively. This study suggests low circulation of CCHFV in the rural human population of Gabon. Competent authorities must survey CCHFV to identify and prevent clinical cases in the human population.
{"title":"First Detection of Antibodies Specific to Crimean-Congo Hemorrhagic Fever Virus in Rural Populations of Gabon.","authors":"Linda Bohou Kombila, Solène Lerolle, Illich Manfred Mombo, Neil-Michel Longo-Pendy, Danielle Koumba Mavoungou, Gaël Darren Maganga, Francois-Loïc Cosset, Jessica Vanhomwegen, Christina Deschermeier, Eric Maurice Leroy, Vincent Legros, Nadine N'dilimabaka, Pierre Becquart","doi":"10.4269/ajtmh.24-0054","DOIUrl":"https://doi.org/10.4269/ajtmh.24-0054","url":null,"abstract":"<p><p>Crimean-Congo hemorrhagic fever (CCHF) is a tick-borne viral disease with a mortality rate reaching up to 40% in humans. Currently, CCHF affects three continents: Asia, Europe, and Africa. An increase in confirmed cases in Africa has been observed since 2000. In Central Africa, several countries have reported the circulation of CCHV virus (CCHFV). However, in Gabon, there is a lack of recent data on the circulation of the virus in the Gabonese population. To provide an overview of the epidemiological situation in Gabon, we tested 3,081 human serum samples collected between 2005 and 2008 in villages throughout the country for anti-CCHFV antibodies. Using a double-antigen ELISA kit, our study found 15/3,081 samples positive for CCHFV. These positive samples were also tested using the Blackbox CCHFV IgG kit and the Luminex technique. These analyses confirmed seven and four positives for the Blackbox CCHFV IgG kit and the Luminex technique, respectively. This study suggests low circulation of CCHFV in the rural human population of Gabon. Competent authorities must survey CCHFV to identify and prevent clinical cases in the human population.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141750854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-16Print Date: 2024-09-04DOI: 10.4269/ajtmh.24-0100
Daniel Z Hodson, Tapiwa Kumwenda, Claudia Wallrauch, Ethel Rambiki, Christopher Tymchuk, Francesco Taccari, Tom Heller
Miliary tuberculosis is a form of disseminated tuberculosis that can be difficult to detect when the classic pattern is absent on chest radiograph and advanced cross-sectional imaging is not readily available. While the focused assessment with sonography for HIV-associated tuberculosis (FASH) protocol for extrapulmonary tuberculosis emphasizes easy-to-teach findings, experienced sonographers may detect additional, subtler signs that can aid in diagnosis. We report a case of a 20-year-old man with miliary tuberculosis diagnosed on computed tomography of the chest. We describe subtle sonographic signs of disseminated tuberculosis including subpleural irregularities and comet-tail artifacts, a bright liver pattern, peritoneal nodules, and a nonspecific sponge spleen pattern. We then discuss important differential diagnoses for each finding. Knowledge of subtle sonographic signs outside of the FASH protocol can aid clinicians in detecting disseminated tuberculosis, including the miliary form, when advanced imaging may not be available.
绒毛膜结核是播散性结核的一种形式,当胸片上没有典型模式,又没有先进的横断面成像技术时就很难发现。虽然针对肺外结核病的 HIV 相关结核病声像图重点评估(FASH)方案强调易学的检查结果,但经验丰富的声像图医师可能会发现更多有助于诊断的微妙征象。我们报告了一例通过胸部计算机断层扫描确诊为粟粒性肺结核的 20 岁男性病例。我们描述了播散性结核的细微声像图征象,包括胸膜下不规则和彗尾伪影、明亮的肝脏形态、腹膜结节和非特异性海绵脾形态。然后,我们将讨论每个发现的重要鉴别诊断。了解 FASH 方案之外的细微声像图征象有助于临床医生在无法获得先进成像技术的情况下发现播散性肺结核,包括粟粒型肺结核。
{"title":"Subtle Sonographic Signs of Disseminated Tuberculosis: A Case Report and Narrative Literature Review.","authors":"Daniel Z Hodson, Tapiwa Kumwenda, Claudia Wallrauch, Ethel Rambiki, Christopher Tymchuk, Francesco Taccari, Tom Heller","doi":"10.4269/ajtmh.24-0100","DOIUrl":"10.4269/ajtmh.24-0100","url":null,"abstract":"<p><p>Miliary tuberculosis is a form of disseminated tuberculosis that can be difficult to detect when the classic pattern is absent on chest radiograph and advanced cross-sectional imaging is not readily available. While the focused assessment with sonography for HIV-associated tuberculosis (FASH) protocol for extrapulmonary tuberculosis emphasizes easy-to-teach findings, experienced sonographers may detect additional, subtler signs that can aid in diagnosis. We report a case of a 20-year-old man with miliary tuberculosis diagnosed on computed tomography of the chest. We describe subtle sonographic signs of disseminated tuberculosis including subpleural irregularities and comet-tail artifacts, a bright liver pattern, peritoneal nodules, and a nonspecific sponge spleen pattern. We then discuss important differential diagnoses for each finding. Knowledge of subtle sonographic signs outside of the FASH protocol can aid clinicians in detecting disseminated tuberculosis, including the miliary form, when advanced imaging may not be available.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11376169/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141625729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}