Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Case histories of boutonneuse fever are described in order to exemplify major characteristics of most rickettsioses: recent travel history, feverish illness with severe headache, skin eruptions and histological findings. Up-to-date informations concerning the epidemiologic situation of typhus, scrub typhus and Rocky Mountain spotted fever are given. The characteristics of Q fever and the possibility of rickettsial laboratory infections are pointed out.
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PMID:[Boutonneuse fever in tourists as a model for clinical diagnosis of rickettsioses (author's transl)]. 10 66

An outbreak of 69 cases of scrub typhus occurred among Chinese military personnel stationed in the Pescadores Islands, Taiwan Province, Republic of China between May and November 1975. A retrospective epidemiological study of this outbreak indicated that military personnel over 40 were more likely to have scrub typhus than those under 40. High risk groups included the Garrison Force (home guard), anti-aircraft gunners and infantry and armoured units stationed at Hsing-jen. The onset of symptoms in 69% occurred within one year of residence in the Pescadores. The clinical course of scrub typhus and the serological response to infection were also studied. Eschar formation, fever, headache chills and lymph node enlargement were the predominant clinical manifestations noted. The indirect immunofluorescent antibody test (IFAT) demonstrated diagnostic (four-fold) rises in antibody titres to Rickettsia tsutsugamushi reference strains in 36 of 41 paired sera tested. 11 of 19 patients from whom only single sera were obtained had IFA titres presumptive of scrub typhus (greater than or equal to 1:160). Of 19 patients experiencing possible primary infections, 13 (68%) responded with antibodies directed against more than one reference strain of R. tsutsugamushi. These results suggest that several antigenically diverse strains of R. tsutsugamushi may be active in the Pescadores.
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PMID:Epidemiological and serological study of scrub typhus among Chinese military in the Pescadores islands of Taiwan. 41 17

A single dose of 200 mg of doxycycline was shown to be as effective as a seven day course of tetracycline, in patients suspected of having scrub typhus. 65 (44%) of the 149 patients studied fulfilled the criteria for definite diagnosis of scrub typhus; 10 had an additional diagnosis. Rickettsia tsutsugamushi was isolated from 49 (75%) patients. There was no difference between the two treatment groups in time to defervescence, abolition of cough and headache, or in the time taken to recover well-being. There were no relapses in either group. Of the remaining 84 patients, a causal diagnosis was achieved in 52. Irrespective of a diagnosis there was no difference in apparent response to either doxycycline or tetracycline.
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PMID:Single dose doxycycline therapy for scrub typhus. 70 48

Between May and September 1973, 68 cases of scrub typhus in Chinese military personnel on the Pescadores Islands were studied. The common symptoms and signs were fever, chills, headache, eschar, myalgia, and lymph node enlargement. Most eschars were located in the axilla, waist, groin and genitals, and neck. These lesions were painless and not noticed by the patients themselves. Regional lymph node enlargement at the site of eschar drainage was common. Relative bradycardia with fever was observed in 40%, a skin rash in 35% of the patients. Leucopenia was noted more frequently in the febrile than in the convalescent stage, but more than half of the patients had a normal count. Lymphocytosis was prominent, especially during the convalescent period. An acceleration of ESR was noted. Instead of depression of the erythroid series in the marrow which was reported previously, 47% of examined patients were found to have erythroid hyperplasia. Two patients showed marked hypocellularity of the marrow in the acute febrile stage; later on became normocellular. Albuminuria was present in 15 and BUN increased in 12 patients. Elevation of serum bilirubin and SGOT was also noted. Biologic false positive VDRL tests were observed in nine patients. In 30 tests elevation of Proteus OX-K titres between 1:160 and 1:640 was noted. A geometric mean OX-K titre rise in the patients is presented; the mean titre reached a peak in the third week of illness, and then fell off. Most of the patients were treated with tetracycline 500 mg every six hours for about nine days. The fever usually subsided within 36 hours. Complications or mortality were not encountered.
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PMID:Clinical observations of scrub typhus on Penghu (the Pescadores Islands). 117 79

We report on a 20-year-old man who had scrub typhus with the unusual neurologic complication of brachial plexus neuropathy. The clinical features of fever, headache, pneumonitis, eschar, high Weil-Felix OX-K agglutination and Rickettsia tsutsugamushi immunofluorescence titers confirmed the diagnosis of scrub typhus. Brachial plexus neuropathy was proven by an electrophysiologic examination. He had a nearly complete recovery after adequate medical treatment.
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PMID:Brachial plexus neuropathy associated with scrub typhus: report of a case. 135 27

Scrub typhus rarely figures among the imported tropical diseases in western Europe. Rickettsia tsutsugamushi is transmitted by larval mites. A typical eschar develops at the site of the mite bite during the incubation period, after which systemic symptoms (remittent or continuous high fever, severe headache, tender lymphatic glands and symptoms of bronchitis) develop with sudden onset. Antibodies appear during the second week and can be shown by a positive and increasing titer against Prot. OXK (Weil-Felix) or by specific rickettsial agglutination. The Weil-Felix reaction is neither very sensitive nor very specific. Therefore, treatment should be started as soon as suspicion arises whether a positive serology is available or not. Tetracycline drugs are effective treatment and fever subsides in less than 24 hours in most patients. - We report the rare observation of a tourist who imported tsutsugamushi fever from India.
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PMID:[Imported tsutsugamushi fever]. 239 62

Hantaviruses, the causative agents of HFRS, have become more widely recognized. Epidemiologic evidence indicates that these pathogens are distributed worldwide. People who come into close contact with infected rodents in urban, rural and laboratory environments are at particular risk. Transmission to man occurs mainly via the respiratory tract. The epidemiology of the hantaviruses is intimately linked to the ecology of their principal vertebrate hosts. Four distinct viruses are now recognized within the hantavirus genus and that number is likely to increase to six very soon; however, further investigations are necessary. Much more work is still needed before we fully understand the wide spectrum of clinical signs and symptoms of HFRS as well as the pathogenicity of the different viruses in the hantavirus genus of the Bunyaviridae family. HFRS is difficult to diagnose on clinical grounds alone and serological evidence is often needed. A fourfold rise in IgG antibody titer in a 1-week interval, and the presence of the IgM type of antibodies against hantaviruses are good evidence for an acute hantavirus infection. Physicians should be alert for HFRS each time they deal with patients with acute febrile flu-like illness, renal failure of unknown origin and sometimes hepatic dysfunction. Especially the mild form of HFRS is difficult to diagnose. Acute onset, headache, fever, increased serum creatinine, proteinuria and polyuria are signs and symptoms compatible with a mild form of HFRS. Differential diagnosis should be considered for the following diseases in the endemic areas of HFRS: acute renal failure, hemorrhagic scarlet fever, acute abdomen, leptospirosis, scrub typhus, murine typhus, spotted fevers, non-A, non-B hepatitis, Colorado tick fever, septicemia, dengue, heartstroke and DIC. Treatment of HFRS is mainly supportive. Recently, however, treatment of HFRS patients with ribavirin in China and Korea, within 7 days after onset of fever, resulted in a reduced mortality as well as shortened course of illness.
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PMID:Hemorrhagic fever with renal syndrome. 257 14

Laboratory-reared, Rickettsia tsutsugamushi-infected Leptotrombidium arenicola and L. fletcheri chiggers were fed on 1 and 2 human volunteers respectively. All subjects developed typical clinical signs and symptoms of scrub typhus beginning days 8-10 post chigger attachment (PCA); these included fever, severe headache, myalgia, regional lymphadenopathy, and eschar. The two L. fletcheri subjects developed a transient generalized rash on days 3-4 after the onset of fever, and these two individuals also appeared to suffer a more severe clinical disease. Rickettsemias were detected in all three volunteers beginning on day 7 PCA, 1-3 days before the onset of clinical disease. Rises in indirect fluorescent antibody titers occurred starting on days 13-19 PCA (day 4-11 post fever) and in Weil-Felix OXK titers starting on days 26-22 PCA (days 7-14 post fever). These results strongly suggest that the use of laboratory-reared chiggers is a reliable means of transmitting scrub typhus infections to volunteers.
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PMID:Transmission of scrub typhus to human volunteers by laboratory-reared chiggers. 680 5

We report a case of tsutsugamushi disease found in south western Shikoku. A 64-year-old male who lived in Towa Village in Kochi, developed a fever and headache on April 6, 1994, and was admitted to Uwajima City Hospital on April 15, with a ten-day history of illness. He had an eschar on the right anterior side of the breast and an enlargement of the right axillary lymph node, without a rash. Laboratory data showed mild liver injury and atypical lymphocytes with 6% in peripheral blood. After his blood was drawn for rickettsial isolation, the minocycline was administered. His symptoms improved rapidly and was discharged in good condition. We successfully isolated the causative agent, Rickettsia tsutugamushi, and designated it as the Shiba strain. High antibody titer against the Kato, Karp and Gilliam strains was detected in serum on admission and increased during the course of the disease. In Shikoku, tsutsugamushi disease is rare and only 13 cases were reported during last ten years. Especially in south western district of Shikoku, there have been no case reported since 1960. This case is important epidemiologically and suggests that we should pay attention to this disease.
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PMID:[A case of tsutsugamushi disease which occurred in south western Shikoku]. 756 Dec 56

Twenty-two cases of rickettsiosis imported to Germany (13 men, nine women, average age 42 years) in a 5-year period were analyzed retrospectively regarding the travel histories, symptoms and clinical findings, laboratory features and course of the disease. The two primary rickettsial diseases were boutonneuse fever (18 patients) and scrub typhus (three patients). One patient had murine typhus. The main symptom was fever in 91% followed by headache (64%), myalgia (40%), arthralgia (50%) and diarrhea (36%). The most frequent clinical finding was lymphadenopathy in 65%. Eschar was detectable in 55% of patients with Rickettsia conori infection and in one patient with Rickettsia tsutsugamushi infection. All patients with R. tsutsugamushi infection as well as 33% of the patients with R. conori infection had a macular exanthema. One patient with scrub typhus had pleural and pericardial effusions. Seventy-three percent had an increased ESR. Three patients had leucocytosis, three increased transaminases and two normochromic anemia. The incubation period for R. conori infection was 5 to 28 days (average 14 days), for R. tsutsugamushi infection 7 to 21 days (average 16 days). Twenty-one patients were treated with tetracycline or doxycycline, one with erythromycin. All patients were cured. One patient had a relapse. Due to the fact that the symptoms are often not characteristic and that the routine laboratory findings are of only marginal help, the diagnosis of rickettsial diseases is often not easy. A detailed travel history sometimes gives an important hint for diagnosis.
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PMID:Imported rickettsioses in German travelers. 762 71


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