1. Rickettsia typhi as Cause of Fatal Encephalitic Typhus in Hospitalized Patients, Hamburg, Germany, 1940–1944
- Author
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Petra Eggert, Birgit Muntau, Dennis Tappe, and Jessica Rauch
- Subjects
Infectious Encephalitis ,Male ,0301 basic medicine ,Pathology ,typhus ,World War II ,Epidemiology ,vector-borne infections ,lcsh:Medicine ,epidemic ,Disease Outbreaks ,0302 clinical medicine ,Germany ,rat ,Rickettsia typhi ,Rickettsia prowazekii ,bacteria ,Rickettsia typhi as Cause of Fatal Encephalitic Typhus in Hospitalized Patients, Germany, 1940–1944 ,body louse ,biology ,food and beverages ,Typhus, Endemic Flea-Borne ,Immunohistochemistry ,nested PCR ,Infectious Diseases ,Synopsis ,Female ,Encephalitis ,Microbiology (medical) ,medicine.medical_specialty ,animal structures ,030231 tropical medicine ,T cells ,endemic typhus ,rickettsiosis ,Real-Time Polymerase Chain Reaction ,Murine typhus ,lcsh:Infectious and parasitic diseases ,03 medical and health sciences ,fatality ,medicine ,Humans ,lcsh:RC109-216 ,outbreak ,business.industry ,brain lesions ,fungi ,lcsh:R ,hospitalized patients ,typhus nodules ,Outbreak ,flea ,CD8 ,biology.organism_classification ,medicine.disease ,bacterial infections and mycoses ,CD4 ,030104 developmental biology ,Rickettsiosis ,encephalitic typhus ,murine typhus ,business ,Nested polymerase chain reaction ,Typhus - Abstract
Clinical and histopathologic features of R. prowazekii and R. typhi typhus can be similar, so molecular analyses should be performed to distinguish the 2 pathogens., We evaluated formalin-fixed paraffin-embedded tissue specimens from 7 patients who died with encephalitic typhus in Hamburg, Germany, during World War II. The archived specimens included only central nervous system tissues >70 years old that had been stored at room temperature. We demonstrated successful detection of Rickettsia typhi DNA by a nested qPCR specific to prsA in 2 patients. These results indicate that R. typhi infections contributed to typhus outbreaks during World War II. Immunohistochemical analyses of brain tissue specimens of R. typhi DNA–positive and –negative specimens showed perivascular B-cell accumulation. Around blood vessels, nodular cell accumulations consisted of CD4-positive and CD8-positive T cells and CD68-positive microglia and macrophages; neutrophils were found rarely. These findings are similar to those of previously reported R. prowazekii tissue specimen testing. Because R. typhi and R. prowazekii infections can be clinically and histopathologically similar, molecular analyses should be performed to distinguish the 2 pathogens.
- Published
- 2018