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Rickettsia, Lyme Disease symptoms vary from person to person. (lymes disease lyme's disease lime disease limes disease)
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Rickettsia 364D: A Newly Recognized Cause of Eschar-Associated Illness
in California
Shapiro MR, Fritz CL, Tait K, Paddock CD, Nicholson WL, Abramowicz KF,
Karpathy SE, Dasch GA, Sumner JW, Adem PV, Scott JJ, Padgett KA, Zaki
SR, Eremeeva ME.
Clinical Infectious Diseases, 2010 Feb 15;50(4):541-8.
http://dx.doi.org/10.1086/649926
BACKGROUND: Four spotted fever group rickettsiae (SFGR) are known to
infect humans in the United States. A member of the SFGR designated 364D
and detected in Dermacentor occidentalis ticks has not previously been
identified as a human pathogen.
METHODS: An 80-year-old man from a rural northern California community
presented with an eschar on his forearm. A skin punch biopsy of the
lesion was evaluated by immunohistochemistry and molecular analysis.
Serum specimens obtained from the patient and 3 other area residents
with similar illnesses were tested by immunofluorescence and Western
immunoblot for antibodies to SFGR. Ticks were collected near the
patient's residence and tested for SFGR.
RESULTS: Abundant intracellular rickettsiae and fragmented rickettsial
antigens were observed in the mononuclear inflammatory infiltrates of
the biopsy. Nucleotide sequences of DNA fragments amplified from the
biopsy were identical to those of 364D. Convalescent sera from all four
patients exhibited high immunoglobulin G titers to Rickettsia
rickettsii, Rickettsia rhipicephali, and 364D antigens. Three adult D.
occidentalis were positive for 364D, R. rhipicephali, and an
unidentified Rickettsia species.
CONCLUSIONS: This is the first confirmation of human disease associated
with the SFGR 364D, which was likely transmitted by D. occidentalis.
Although the patients described here presented with a single cutaneous
eschar as the principal manifestation, the full spectrum of illness
associated with 364D has yet to be determined. Possible infection with
364D or other SFGR should be confirmed through molecular techniques in
patients who present with "spotless" Rocky Mountain spotted fever or
have serum antibodies to R. rickettsii with group-specific assays.
http://dx.doi.org/10.1086/649926
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