ABSTRACT
Rickettsia is emerging in the subcontinent and clinically presents as non-specific febrile illness. At present there is no cheap & easily available diagnostic tool in our hand. Beside this, Weil-Felix test is becoming abandoned. So, high index of clinical suspicions is essential to diagnose rickettsia at early stage and to prevent mortality & morbidity. 40 cases were recorded among the admitted febrile patients in MMCH since 2003 to 2005. Cases were selected by clinical suspicions; exclusions of other common febrile illness & thereafter supported by lab. Investigations, specially by positive Weil-felix test. Cases were distributed through out the year but 19 (47.5%) cases were detected in March to May. 12 (30%) cases were found in August to October. The remaining 9 cases were detected in the rest 6 months. All (40) cases were presented with fever (100%), headache was present in 33 (82.5%) cases, rashes were present in 15 (37.5%) cases, isolated splenomegaly was found in 15 (37.5%) cases & hepatosplenomegaly in 12 (30%) cases, arthralgia in 13 (32.5%) cases, lymphadenopathy in 5 (12.5%) cases; 2 (5%) cases attended with unconsciousness & epistaxis in 1 (2.25%) case. Scrub typhus were 19 (47.5%), Indian tick typhus 16 (40%), 5 (12.5%) cases were with dual pathology and were associated with enteric fever. 15 (37.5%) cases were treated with tetracycline only. 20 (50%) cases with only doxyclycline & 5 (12.5%) cases with tetracycline and ceftriaxone as these cases were associated with enteric fever. All patients (100%) cured with treatment.
Subject(s)
Adolescent , Adult , Anti-Bacterial Agents/therapeutic use , Bangladesh , Ceftriaxone/therapeutic use , Child , Developing Countries , Doxycycline/therapeutic use , Female , Humans , Male , Middle Aged , Prospective Studies , Rickettsia/drug effects , Rickettsia Infections/diagnosis , Tetracycline/therapeutic useABSTRACT
A angiomatose epitelóide bacilar foi descrita, primeiramente, em 1983 por Stoler e cols, em paciente aidético. O agente etiológico assemelha-se a um organismo Rickéttsia-símile relacionado a Rochalimaea quintana, facilmente observado em cortes histológicos pela técnica de Warthin-Starry. O tratamento é feito com a eritromicina. As lesöes cutâneas säo variadas, constituindo pápulas, placas ou nódulos. Lesöes sistêmicas säo descritas em pacientes com a síndrome de imunodeficiencia adquirida. O diagnóstico diferencial deve ser feito com o sarcoma de Kaposi e o granuloma piogênico. O quadro histopatológico é marcado por intensa proliferaçäo de vasos com singular revestimento epitelóide e grande número de bacilos