[Far-eastern spotted fever: description of new infectious disease].

Historical data concerning description and identification of etiology of tick-borne spotted fever in Russia are presented in the paper. Review of studies shows that by uncovering the etiology of tick-borne spotted fever in the Russian Far East, an emerging disease may be discovered. Another, different from classical Rickettsia sibirica, bacteria causes spotted fever there. The application of described methods resulted in first isolation of etiological agent of far-eastern spotted fever, Rickettsia heilongjiangensis, strains from patients.

[Bartonella infection in hematological practice].

AIM: To characterize the clinical and histological features of Bartonella infection in patients asking for hematological advice and to assess the significance of serological and molecular methods for the diagnosis of this infection. MATERIALS AND METHODS: The case histories of 747 patients asking for advice at the Hematology Research Cancer, Russian Academy of Medical Sciences, for lymphadenopaphy were retrospectively studied. The study included 10 patients in whom Bartonella infection could be suspected. For verification of the diagnosis, the authors conducted a serological study of the patients' sera and a molecular study of archival paraffined lymph node biopsy specimens. RESULTS: The study showed it possible to make a retrospective diagnosis of cat-scratch disease (CSD) by polymerase chain reaction (PCR) used in the study of archival lymph node biopsy specimens and stained preparations. CONCLUSION: CSD should be suspected when a patient has sustained lymphadenopathy and a respective epidemiological history (feline contact). Bartonella infection should be diagnosed on the basis of a dynamic serological study and, if possible, PCR of cells from biopsy specimens of lymph nodes or the lesion developed at the site of Bartonella penetration into the human body (primary affect).

[A case of cat scratch disease in a patient with diabetes mellitus and chronic renal failure].

The article describes a case of cat scratch disease in a female patient with severe chronic pathology. This relatively rare disease was manifested by regional (in the site of microbial intrusion) lymphadenopathy, and general infectious syndrome. The presence of oncohematological process was excluded without biopsy; serologic examination with bartonella antibodies confirmed the diagnosis. Combined treatment with two antibiotics, rifampicin and doxycycline, was successful. The article stresses that general practitioners should be aware of this disease; timely diagnosis and specific treatment are of utter importance.

[Bartonella and bartonellosis--emerging and re-emerging infections: epidemiology, clinical course, diagnosis].

Information on the epidemiology, clinic and diagnostics of bartonellosis is updated. The importance of bartonellosis lies in the fact that its main risk group embraces patients with immunodeficiencies of different origin, the number of such patients constantly growing. The diagnostics of bartonellosis is insufficiently developed and the research on Bartonella organisms, except for the trunch (Volynia) fever causative agent, is insufficient in our country.

[Microorganism "Montezuma" of the order Rickettsiales: the potential causative agent of tick-borne disease in the Far East of Russia]. / Mikroorganizm "Montezuma" iz poriadka Rickettsiales: potentsial'nyi vozbuditel' kleshchevogo transmissivnogo zabolevaniia na Dal'nem Vostoke Rossii.

A new microorganism, tentatively named "Montezuma" was detected in ticks and in specimens (blood, bioptic specimens of the primary affect) taken from patients with an acute fever disease, etiologically linked with the bites of Ixodes ticks in the Far East of the Russian Federation. After sequencing the products of the amplification of DNA isolated from ticks with wide-spectrum primers new primers were developed, highly specific to the unusual sequence thus obtained. The study revealed that ticks of the species Ixodes persulcatus (97%) and Haemophysalis concinnae (5%) contained DNA of this microorganism. The same DNA was detected in materials taken from the patients. The phylogenetic analysis of the gene showed that this organism formed an independent and well defined branch within the order Rickettsiales. The nearest homology (89%) was observed with recently detected endosymbiotes Acanthamoeba. The similarity with their relatives from the families Rickettsiaceae and Anaplasmataceae of the order Rickettsiales was within 81-86%, which made it possible to infer the existence of, probably, only a new genus, but also a family. The isolated DNA belonged, supposedly, to the new microoganism which caused a tick-borne disease in humans, transmitted through bites of Ixodes ticks, and was, supposedly, widely spread in the southern area of the Khabarovsk Territory.

[Bartonella and bartonellosis--emerging and re-emerging infections. Taxonomy, bacteriology, pathogenesis and genetics]. / Bartonelly i bartonellezy--novye i vozvrashchaiushchiesia. Taksonomiia, bakteriologiia, patogenez i genetika.

The review updates knowledge on the taxonomy, bacteriology and genetics of Bartonella as well as pathogenesis of bartonellosis. The role of Bartonella in human pathology, formerly considered to be rather modest, causes now growing anxiety. In this connection Bartonella are now believed to be the causative agents of so-called emerging and re-emerging diseases, i.e. diseases, formerly unknown to man, and diseases, believed to be eradicated and playing at present no important role in human pathology. These microorganisms are a bright example of successes of molecular biology in the detection of microorganisms, as well as in their phylogenetics and systematics.

[The first case of granulocytic ehrlichiosis in the Far East of the Russian Federation]. / Pervyi sluchai granulotsitarnogo érlikhioza na dal'nem Vostoke Rossiiskoi Federatsii.

A serological survey of a patient admitted to the Clinic of Infectious Diseases, Far-East State Medical University, for suspected North Asian tick-borne rickettsiosis (NATBR) revealed antibodies in the increasing titers to Ehrlichia phagocytophila and no antibodies to other causative agents of natural and focal infections in the Far East. The disease presented with significant intoxication and maculopapular eruption. This disease differed from the standard NATBR in that there was neither primary affect at the site of pathogen entry, regional lymphadenitis, nor involvement of the liver in the pathological process (elevated levels of AIAT, AsAT, pigment metabolic disturbance), and that there was a steady-state tendency to leukopenia.

[The onset of chronic Lyme-borreliosis after the cure of tick-borne rickettsia infection in simultaneous infection]. / Razvitie khronichekogo Laim-borrelioza posle izlecheniia kleshchevogo rikketsioza pri odnovremennom infitsirovanii.

A case of a male patient with chronic Lyme borreliosis running with marked neurological symptoms (Garin-Bujardoux-Bannwarth syndrome) is reported. Two years before the disease manifestation the patient was infected by the tick with both borrelia and Rickettsia sibirica. The latter infection provoked an acute fever in tick-borne rickettsiosis immediately after the tick's bite. This masked development of Lyme borreliosis which manifested only 5 months later as a neurological disease. It is thought necessary to propose a rational scheme of antibiotic treatment of patients with tick-transmissible diseases.