Abstract
Sepsis is a complex inflammatory disorder believed to originate from an infection by any types of microbes and/or their products. It is the leading cause of death in intensive care units (ICUs) throughout the globe. The mortality rates depend both on the severity of infection and the host's response to infection. Literature survey on pathobiology of sepsis in general and failure of more than hundred clinical trials conducted so far in search of a possible cure for sepsis resulted in the preparation of this manuscript. Sepsis lacks a suitable animal model that mimics human sepsis. However, based on the results obtained in animal models of sepsis, clinical trials conducted so far have been disappointing. Although involvement of multiple mediators and pathways in sepsis has been recognized, only few components are being targeted and this could be the major reason behind the failure of clinical trials. Inability to recognize a single critical mediator of sepsis may be the underlying cause for the poor therapeutic intervention of sepsis. Therefore, sepsis is still considered as a disease-in search of cure.
Highlights
Brazilian Spotted Fever (BSF) and bartonellosis are zoonotic diseases respectively considered reemerging and emerging
The study reports the first case of active co-infection by Brazilian spotted fever and bartonellosis based on serological evidence
The authors aim to demonstrate the importance of performing systematic syndromic investigations on nonspecific febrile syndromes, guided by the epidemiological history and considering the possibility of co-infection by zoonosis sharing the same ecological niche
Summary
Brazilian Spotted Fever (BSF) and bartonellosis are zoonotic diseases respectively considered reemerging and emerging. BSF, described in Brazil since the 1920s, is caused by Rickettsia rickettsii, and ticks are its vectors and reservoirs, especially those from Amblyomma sculptum species (from the Amblyomma cajennense complex), other infected species may participate in its transmission [1]. It has wide geographical distribution with limited outbreaks in the Brazilian southeastern and southern regions, and in some locations in the midwest, northeast and north regions [2]. The current study aims to report the first human case with serological evidence of active co-infection by R. rickettsii and B. henselae, recorded in Rio de Janeiro, Brazil. It is an alert to health professionals about the possibility of co-infection, the impact of this event on the research algorithm, the following up of complications and the empirical choice for specific therapies
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