Concomitant Mediterranean spotted fever and systemic lupus erythematosus: a rare case report

Distribution of different Rickettsia species in countries of the WHO Eastern Mediterranean (WHO-EMRO) region: An overview

SUBJECT

Rickettsia is a zoonotic bacterial pathogen transmitted by vectors and has extensive reservoirs in animal and human populations. Rickettsiosis is a public health problem all over the world. However, comprehensive information on the geographical distribution of different Rickettsia species, infection status of reservoirs, vectors, and human cases is lacking in most parts of the world. Therefore, this study aimed to investigate the geographical distribution of different Rickettsia species and their vectors in countries of the WHO-EMRO region.

METHODS

In this review study, a search was conducted for reports and published studies on Rickettsia species from WHO-EMRO region countries in various databases from 1995 to 2022. Finally, the reported status of human cases, reservoirs, and vectors associated with each species in different countries was documented.

RESULTS

Reports of infections related to the detection of Rickettsia species were only available for 15 out of 22 WHO-EMRO member countries. A total of twenty-four Rickettsia species, including R. sibrica, R. lusitaniae, R. africae, R. prowazekii, R. felis, R. typhi, R. rickettsii, R. aeschlimannii, R. conorii, R. massiliae, R. helvetica, R. monacensis, R. rhipicephali, R. bellii, R. asembonensis, R. hoogstraalii, R. andeanae, R. raoultii, R. asiatica, R. slovaca, R. australis, R. barbariae, Candidatus R. amblyommii, and Candidatus R. goldwasserii, were reported from WHO-EMRO member countries. Furthermore, human cases infected with six different Rickettsia species, including R. sibrica, R. prowazekii, R. felis, R. typhi, R. rickettsii, R. aeschlimannii, R. conorii, R. massiliae, and R. helvetica, were reported from these countries.

CONCLUSION

The vast diversity of Rickettsia vectors has contributed to the ongoing discovery of new Rickettsia species. Therefore, further research on the reservoir hosts of Rickettsia infections in the understudied WHO-EMRO region is crucial. This research sheds light on Rickettsia disease's epidemiology and transmission dynamics in this region.

Rehabilitation in Systemic Lupus Erythematosus With Class 4 Lupus Nephritis Secondary to Pneumonia: A Case Report

We herein report an undisclosed case of systemic lupus erythematosus (SLE) with class 4 lupus nephritis (LN). It is an autoimmune disease that occurs when the body's immune system attacks its tissues. It results in significant tissue damage and inflammation in the afflicted organs. It may affect the kidneys, brain, lungs, skin, joints, and blood vessels. A 30-year-old female presented to Acharya Vinoba Bhave Rural Hospital (AVBRH) with the complaint of breathlessness, cough with expectoration, and fever for two months. The patient is having musculoskeletal renal difficulties and psychological effects. The objective is to reduce the symptoms and to improve the quality of life. A multidisciplinary treatment approach is used, which includes physiotherapy intervention and patient education. In conclusion, this case report mainly focuses on a multidisciplinary treatment approach to improve patient outcomes and quality of life.