Presentation
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]
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]
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]
Eyes
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Visual Impairment
Ocular involvement associated with rickettsial infection usually has a selflimited course, but it can result in persistent visual impairment. [omicsonline.org]
Skin
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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]
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. [dx.doi.org]
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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 [dx.doi.org]
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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]
Musculoskeletal
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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]
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. [dx.doi.org]
Neurologic
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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]
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
Identification of specific etiology is important for appropriate treatment in order to optimize prognosis. [neurology.org]
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]
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]
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]
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]