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Rickettsia Infection

Rickettsiosis


Presentation

  • CONCLUSION: The results show a high prevalence of antibodies to Rickettsia belonging to the spotted fever group in each of the three study areas, in addition to presenting evidence of the typhus group Rickettsia in El Valle de Anton.[ncbi.nlm.nih.gov]
  • Methods: We present the case of a 47yo man who presented with a two-day history of severe back pain, “band-like” sensation around the umbilicus, numbness extending to the feet bilaterally, urinary hesitancy, and progressive gait disturbance.[neurology.org]
  • We present here the tick-borne rickettsioses described through 2005 and focus on the epidemiological circumstances that have played a role in the emergence of the newly recognized diseases.[ncbi.nlm.nih.gov]
  • However, in the present report, ticks started to be particularly aggressive to people before the death of the dog. Also, the son of the owner presented with a tick-borne eruptive fever, before the dog died.[plosntds.org]
Arthralgia
  • Seven days later he returned with worsening symptoms of fever (39.9 C), headache, cough, arthralgia, and lethargy. A provisional diagnosis of scrub typhus was made, and he was given doxycycline.[doi.org]
  • Therapy with doxycycline (100 mg twice a day for 7 days) typically leads to rapid improvement; however, a subset of patients may experience a prolonged convalescence characterized by arthralgia and malaise.[ncbi.nlm.nih.gov]
  • Nine patients (75%) described arthralgia. Tender lymphadenopathy in proximity to the eschar was documented for 3 patients. Only 1 patient reported nausea and vomiting; none reported diarrhea.[doi.org]
  • It occurred in a 40-year-old man living in suburban area in southeast Virginia who presented with fever, headache, diffuse myalgias and arthralgias, and multiple eschars on his lower extremities.[doi.org]
Petechiae
  • These lesions are 0.5–1.5 cm wide, with a central area of ulcerated or scabbed skin surrounded by a halo of erythema ( A and B ) or petechiae (C). Panel D shows multiple eschars on patient 4.[doi.org]
  • These lesions may progress to become maculopapular, owing to the leakage of edema fluid from the affected blood vessels, with the development of a hemorrhage (petechia) in the center of the lesions. Figure 2.[textbookofbacteriology.net]
  • This 43-year-old man presented with fever, petechiae, pulmonary infiltrates, acute renal failure, encephalopathy, and hyperbilirubinemia after a stay in Tunisia, where he was in contact with animals in his family farm.[doi.org]
  • Conjunctival petechiae, subconjunctival hemorrhages, keratitis, nongranulomatous anterior uveitis, and iris nodule have also been described in association with rickettsial infection [ 8, 11, 12 ].[omicsonline.org]
  • Hemorrhagic manifestations, including petechiae and suffusions, were frequent (69.5%). The case fatality rate was 30% (R. N. Angerami, M. R. Resende, S. B. Stuchi Raquel, G. Katz, E. Nascimento, and L. J. Silva, Abstr. 4th Int. Conf.[doi.org]
Exanthema
  • Relevant clinical features included myalgias (80%), headache (66%), icterus (52%), exanthema (47%), consciousness impairment (43%), vomiting (42%), abdominal pain (38%), respiratory distress (37.5%), acute renal insufficiency (35.3%), and hypotension[doi.org]
Papular Rash
  • Evaluation of a papular rash lesion from 1 patient showed an intraepidermal pustule and a diffuse mixed inflammatory cell infiltrate of the superficial to middermis comprising neutrophils and mononuclear cells, associated with karyorrhectic and necrotic[doi.org]
  • The ticks regularly bit her, and her son, a 30 year-old man (not tested here) who presented at that time with a febrile syndrome and a maculo-papular rash. He did not sick medical care.[plosntds.org]
Night Sweats
  • A previously healthy 30-year-old man (a friend of patient 1) developed high fever, night sweats and headache in May 2007 followed by a maculopapular rash involving the palms 10 days later.[plosntds.org]
Pustular Rash
  • Other features that distinguish R. parkeri rickettsiosis from RMSF include the occurrence of an eschar (identified in 90% of the patients in this series), a vesicular or pustular rash (observed in 40% of the patients in this series), and the relative[doi.org]
Aggressive Behavior
  • This finding is characteristic of few other tick-borne rickettsioses, an example being African tick bite fever caused by R. africae, due to the aggressive behavior of the tick vectors and a high tick infection rate [5], [32].[plosntds.org]
Headache
  • Seven days later he returned with worsening symptoms of fever (39.9 C), headache, cough, arthralgia, and lethargy. A provisional diagnosis of scrub typhus was made, and he was given doxycycline.[doi.org]
  • R. parkeri rickettsiosis and RMSF have similar signs and symptoms, including fever, headache, and rash, but also typically include the appearance of an inoculation eschar (seen at right) at the site of tick attachment.[cdc.gov]
  • Other typical symptoms may include: fever headache muscle aches swollen lymph glands cough rash. Less common severe infections can be associated with confusion and breathing difficulties.[sahealth.sa.gov.au]
  • Case Report 24 year old male was admitted in downtown hospital with history of high grade fever associated with chill, headache, yellowish discoloration of urine, rash in abdomen and chest of 3weeks duration.[pubs.sciepub.com]
  • PCR, DNA copies mL 1 (mean C t value) Typhus group PCR, DNA copies mL 1 (mean C t value) Serology Final diagnosis 1 35 F Fever Headache Rash Eschar Leucopenia Thrombocytopenia ELT None Italy Skin biopsy 7886 (31.4) Negative NA MSF 2 41 F Fever Headache[doi.org]

Treatment

  • Culture pos: culture positive skin biopsies, Culture neg: culture negative skin biopsies; No treatment: skin biopsies obtained from patients without treatment, Treatment: skin biopsies obtained from patients receiving a treatment; Marseille: skin biopsies[doi.org]
  • We evaluated culture sensitivity compared to PCR based on sampling delay and previous antibiotic treatment.[ncbi.nlm.nih.gov]
  • Doxycycline has been used in the treatment of rickettsial infection.[en.wikipedia.org]
  • Treatment Treatment is usually with the tetracycline antibiotic doxycycline which reduces the duration and severity of infection. Prevention Exclusion of people with rickettsial infections from childcare, preschool, school and work is not necessary.[sahealth.sa.gov.au]
  • Following 10-day course of doxycycline treatment, the patients displayed a significant clinical improvement.[journals.lww.com]

Prognosis

  • Identification of specific etiology is important for appropriate treatment in order to optimize prognosis.[neurology.org]
  • Prognosis Although prognosis of systemic infection is good in most cases, rickettsioses may be severe and potentially lethal, and should be treated accordingly [ 1 ].[omicsonline.org]
  • Moreover, the recognition of typhus group rickettsiosis is clinically and epidemiologically relevant, as these infections may be associated with a worse prognosis than spotted fevers ( Dumler et al., 1991 ; Bechah et al., 2008).[doi.org]

Etiology

  • We also assess the pathogenic potential of rickettsial strains that to date have been associated only with arthropods, and we discuss diseases of unknown etiology that may be rickettsioses.[ncbi.nlm.nih.gov]
  • Identification of specific etiology is important for appropriate treatment in order to optimize prognosis.[neurology.org]
  • BACKGROUND: Rickettsia was suggested as a possible etiology of Buerger's disease (BD) in the 1980s but this suggestion was never ruled out or proven.[ncbi.nlm.nih.gov]

Epidemiology

  • During 1998-2007, clinical samples from 12 patients with illnesses epidemiologically and clinically compatible with R. parkeri rickettsiosis were submitted for diagnostic evaluation.[ncbi.nlm.nih.gov]
  • During most of the 20th century, the epidemiology of tick-borne rickettsioses could be summarized as the occurrence of a single pathogenic rickettsia on each continent.[ncbi.nlm.nih.gov]
  • Here, we summarize the clinical and epidemiological characteristics of patients with confirmed or probable R. parkeri rickettsiosis, comment on the clinical differences between this disease and RMSF, and discuss the epidemiological importance of these[doi.org]
  • The presence of 3 rickettsial diseases on this small island demonstrates the complexity of rickettsial epidemiology in Australia. Dr Unsworth is a postdoctoral research associate at Texas A&M University, College Station, Texas, USA.[doi.org]
Sex distribution
Age distribution

Pathophysiology

  • The effects of the rickettsial damage to the pulmonary microcirculation are an important component of the pathophysiology of severe Rocky Mountain spotted fever.[ncbi.nlm.nih.gov]
  • PATHOPHYSIOLOGY: Transmitted to humans by the larval form of trombiculid mites (ie, chiggers) that live and breed in the soil and scrub vegetation. Both the reservoir & vector passes O tsutsugamushi transovarially. Chigger- 1/500 th inch.[slideshare.net]
  • The most important pathophysiologic effect is increased vascular permeability with consequent edema, loss of blood volume, hypoalbuminemia, decreased osmotic pressure, and hypotension.[textbookofbacteriology.net]
  • Peach phony RLO Papaya Bunchy Top Disease [17] Infection occurs in nonhuman mammals; for example, species of Rickettsia have been found to afflict the South American guanaco, Lama guanacoe. [18] Pathophysiology [ edit ] This section needs expansion.[en.wikipedia.org]

Prevention

  • Prevention Exclusion of people with rickettsial infections from childcare, preschool, school and work is not necessary. There is no vaccine available to prevent infection.[sahealth.sa.gov.au]
  • Clinical specimens from patients in the United States who reside within the range of A. maculatum for whom an eschar or vesicular rash was described were evaluated by or 1 laboratory assays at the Centers for Disease Control and Prevention (Atlanta, GA[ncbi.nlm.nih.gov]
  • References Centers for Disease Control and Prevention.[cdc.gov]
  • PREVENTION: Endemic areas- protective clothing & insect repellents. Short-term vector reduction using environmental insecticides and vegetation control. Chemoprophylaxis-doxycycline in high-risk groups (eg, military personnel).[slideshare.net]

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