Brazilian spotted fever: real-time PCR for diagnosis of fatal cases.

Abstract:

:Suspicion of Brazilian spotted fever (BSF) should occur in endemic regions upon surveillance of the acute febrile icteric hemorrhagic syndrome (AFIHS). However, limitations associated with currently available laboratory tests pose a challenge to early diagnosis, especially in fatal cases. Two real-time PCR (qPCR) protocols were evaluated to diagnose BSF in 110 fatal AFIHS cases, collected in BSF-endemic regions in 2009-2010. Of these, 24 were positive and 86 negative by indirect immunofluorescence (IFA) assay (cut-off IgG and/or IgM ≥ 128). DNA from these samples was used in the qPCR protocols: one to detect Rickettsia spp. (citrate synthase gene) and another to determine spotted fever group (SFG) Rickettsia species (OmpA gene). Of the 24 IFA-positive samples, 5 (21%) were positive for OmpA and 9 (38%) for citrate synthase. In the IFA-negative group (n=86), OmpA and citrate synthase were positive in 23 (27%) and 27 (31%), respectively. These results showed that the 2 qPCR protocols were about twice as sensitive as the IFA test alone (93% concordance). In conclusion, qPCR is a sensitive method for the diagnosis of fatal BSF cases and should be considered for routine surveillance of AFIHS in places like Brazil, where spotted fever-related lethality is high and other endemic diseases like dengue and leptospirosis can mislead diagnosis.

journal_name

Ticks Tick Borne Dis

authors

dos Santos FC,do Nascimento EM,Katz G,Angerami RN,Colombo S,de Souza ER,Labruna MB,da Silva MV

doi

10.1016/j.ttbdis.2012.10.027

subject

Has Abstract

pub_date

2012-12-01 00:00:00

pages

312-4

issue

5-6

eissn

1877-959X

issn

1877-9603

pii

S1877-959X(12)00112-4

journal_volume

3

pub_type

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