ABSTRACT
Febrile tick-borne diseases can be caused by different pathogens. The study objective was to prospectively determine the etiology of infection among adults exposed to tick bite and to detect acute human granulocytic anaplasmosis (HGA), a recently emerging infection, in north-eastern Poland. We evaluated 68 patients (34 males and 34 females, mean age 44.2+/-15 years) who had fever within 4 weeks after a tick bite. Paired sera were tested for antibodies against tick-borne encephalitis virus, Borrelia burgdorferi and Anaplasma phagocytophilum. Microscopic examination of EDTA whole blood and nested PCR targeting A. phagocytophilum 16S rDNA gene fragment were carried out at enrolment. Tick-borne infections were diagnosed in 57 individuals (84%). Sixty-four patients were hospitalised. Tick-borne encephalitis (TBE) was revealed in 49 cases; in 39 patients as a single infection, in three patients concurrent with erythema migrans or other Lyme borreliosis symptoms, in five patients concurrent with probable or possible Lyme borreliosis, and in two patients concurrent with A. phagocytophilum infection. Diagnosis of HGA was confirmed in one patient by PCR and in another one by seroconversion. In two further individuals, A. phagocytophilum infection was confirmed by immunofluorescence (antibody titers > or = 1:128), which, however, does not fulfil the ESCAR (European Society of Clinical Microbiology and Infectious Diseases Study Group on Coxiella, Anaplasma, Rickettsia, and Bartonella) criteria for HGA case definition. Lyme borreliosis was diagnosed in 16 patients; in six of them as a single infection. Both confirmed HGA cases and seropositive individuals had A. phagocytophilum infection concurrent either with Lyme borreliosis (two cases) or with TBE (two cases). The clinical course was severe in three and moderate to mild in the remaining TBE cases, as well as in all Lyme borreliosis and HGA cases. TBE was found the most prevalent disease among adults with febrile illnesses occurring after a tick bite in north-eastern Poland. Concurrent tick-borne infections were frequent with multiple pathogens involved. Two confirmed acute HGA cases (fulfilling the European case definition criteria defined by ESCAR) were detected for the first time in a prospective manner in Poland.
Subject(s)
Fever/etiology , Tick-Borne Diseases/etiology , Adolescent , Adult , Aged , Anaplasmosis/microbiology , Animals , Bites and Stings , Encephalitis, Tick-Borne/microbiology , Female , Humans , Lyme Disease/microbiology , Male , Middle Aged , Poland , Prospective Studies , Ticks/microbiologyABSTRACT
Outbreaks and sporadic cases of Escherichia coli O157 human infection are noticed since 1982 worldwide. Although the percentage of infected animal (bovine) reservoir in Poland is low (0.73%) human illness could develop. Shiga toxigenic strains can cause severe gastrointestinal disease with hemolytic-uremic syndrome and thrombocytic thrombophlebitic purpura with serious sequelae. For this reason we have examined 28 patients hospitalized with bloody diarrhoea for E. coli O157:H7 infection using Multiplex PCR Test. Only one person (0.036%), a 78-year old woman, presented characteristic symptoms (three days lasting bloody diarhoea, abdominal crumps, fever, neurological symptoms), endoscopical findings (marked oedema, facile haemorrhage, longitudinal ulcer-like lesions) and positive results on PCR. Despite low incidence of E. coli O157 infection doctors should be aware that such infection in Poland is likely to happen.
Subject(s)
Colitis , Escherichia coli Infections/diagnosis , Escherichia coli Infections/microbiology , Escherichia coli O157/genetics , Escherichia coli O157/isolation & purification , Hemorrhage/complications , Adolescent , Adult , Aged , Colitis/complications , Colitis/diagnosis , Colitis/microbiology , Female , Humans , Male , Middle Aged , Polymerase Chain Reaction/methods , Trinucleotide Repeats/geneticsABSTRACT
HLA class I and II antigens are common among patients with ulcerative colitis. They can be involved in the autoaggressive mechanisms of the disease. The aim of the study was to evaluate the prevalence of HLA B and HLA DR antigens and estimate the correlation to extra-bowel manifestations of the disease. 50 patients with ulcerative colitis and 20 healthy controls were examined. HLA-B27, -B7, -B40, -DR1, -DR2, -DR3, -DR4 and -DR7 were determined using monoclonal antibodies in microlymphocytotoxic method. HLA I and/or HLA II antigens were detected in 36% of patients: HLA I in 28% and HLA II 16%. 46% of the patients were demonstrating joint changes, with 65% of them presenting HLA molecules. 16% of the examined patients presented symptoms of intrahepatic cholestasis; with 67% having HLA I/II molecules. The difference from the control group was statistically significant, only 25% of healthy persons presented HLA I/II antigens. The incidence of joint involvement and cholestasis was higher in ulcerative colitis patients with HLA class I and/or HLA II.
