Presentation
Wherever possible, different examples are shown of the same disease, in order to illustrate as wide a variety of presentations as possible. [books.google.com]
Only two (2{\%}) Rattus rattus out of 86 small mammals presented antibodies against TGR. [abdn.pure.elsevier.com]
and anorexia can be present Rash (maculopapular, nonconfluent, and blanching areas) Hallmark of infection Usually follows systemic symptoms Often transient and difficult to observe in murine typhus Absence should not rule out a possible rickettsial [arupconsult.com]
R. australis lacks only 46 genes that are present in R. prowazekii, the agent of epidemic typhus, the most severe human rickettsiosis ( 7 ). [jb.asm.org]
Abstract Rickettsial diseases are some of the most covert reemerging infections of the present times. [e-ijd.org]
Immune System
- Splenomegaly
Splenomegaly occurs in some cases. Fever may persist for 14 days without antibiotic treatment. The fatality rate in untreated cases is 1–40 per cent. [www2.health.vic.gov.au]
Splenomegaly may also be seen. Complications of systemic vasculitis can occur with multiple organ dysfunction syndrome, and peripheral and cerebral thrombosis. [ecdc.europa.eu]
Other features included splenomegaly (37%), tachycardia (24%) and seizures (15%). The most common complication of rickettsial diseases was meningoencephalitis (28%). [ijmm.org]
Entire Body System
- Gangrene
If untreated, the infection can lead to gangrene and necrosis (death of body tissue). [iamat.org]
Cardiovascular complications (frequent): endocarditis, myocarditis, arteritis obliterans, thrombophlebitis, gangrene of the extremities [ 28, 40, 24 ], gangrene of the scrotum [ 20 ]. [ncbi.nlm.nih.gov]
He had scrotal swelling and gangrene of scrotal skin ( Figure 5 ). [journals.plos.org]
The possibility of scrub typhus should be borne in mind whenever a patient with varying degree of renal insufficiency particularly if eschar exists along with history of environmental exposure DIC-like syndrome, hepatic failure, gangrene, and myocarditis [e-ijd.org]
- Weakness
Malaise or general weakness occurs 1 to 3 days before the onset of sudden high fever, headache, chills, cough, muscle pain, sensitivity to light, and lack of energy. [iamat.org]
Rhinoscleroma, Klebsiella pneumonia Klebsiella granulomatis Granuloma inguinale Klebsiella oxytoca Escherichia coli : Enterotoxigenic Enteroinvasive Enterohemorrhagic O157:H7 O104:H4 Hemolytic-uremic syndrome Enterobacter aerogenes / Enterobacter cloacae Slow/weak [en.wikipedia.org]
Spotted fever and typhus fever intragroup cross-reactivity is weak: cross-reactive titers are typically at least 16-fold lower than group-specific titers. [mayomedicallaboratories.com]
- Falling
Abortions Alcohol Assisted insemination Asthma and hay fever Bites, burns, cuts and pests Blood, organ and tissue Cancer Challenging behaviour Chemicals and contaminants Diabetes Dementia Dental care Drugs End of life care Essure contraceptive device Falls [sahealth.sa.gov.au]
- Collapse
Piraatlusest Somaalia piirkonnas ja rahvusvahelistest dokumentidest piraatluse vastu võitlemiseks Jim Peters ' collapse in the Vancouver Empire Games marathon. [sexociacur.weebly.com]
Respiratoric
- Pneumonia
Rhinoscleroma, Klebsiella pneumonia Klebsiella granulomatis Granuloma inguinale Klebsiella oxytoca Escherichia coli : Enterotoxigenic Enteroinvasive Enterohemorrhagic O157:H7 O104:H4 Hemolytic-uremic syndrome Enterobacter aerogenes / Enterobacter cloacae [en.wikipedia.org]
Complications are cirrhosis, hepatitis, encephalitis, interstitial pulmonary fibrosis, meningitis, and pneumonia. [e-ijd.org]
About a week after onset, the main features are continuous fever, signs of bronchitis or pneumonia, photophobia, conjunctivitis, generalised adenopathy, delirium, deafness and a maculopapular rash, most commonly over the trunk and proximal limb parts. [www2.health.vic.gov.au]
The differential diagnosis of dengue, malaria, pneumonia, leptospirosis and typhoid should be kept in mind. [ijmr.org.in]
Liver, Gall & Pancreas
- Hepatosplenomegaly
Cerebrospinal fluid cytology revealed 18 cells (lymphocytes - 16, neutrophils - 2); and biochemical parameters being proteins 65 mg/dl; glucose 90 mg/dl, ultrasound abdomen showed mild hepatosplenomegaly with fatty liver and right-sided mild pleural effusion [e-ijd.org]
Mild hepatosplenomegaly appeared, that regressed with fever [ 24 ]. Exanthematous eruption ( Fig. 2 ) occurs in the days 4–8 after onset. [ncbi.nlm.nih.gov]
Cardiovascular
- Thrombosis
Complications of systemic vasculitis can occur with multiple organ dysfunction syndrome, and peripheral and cerebral thrombosis. [ecdc.europa.eu]
There are tissue necrosis, small vessel thrombosis, and DIC. [e-ijd.org]
Eyes
- Photophobia
About a week after onset, the main features are continuous fever, signs of bronchitis or pneumonia, photophobia, conjunctivitis, generalised adenopathy, delirium, deafness and a maculopapular rash, most commonly over the trunk and proximal limb parts. [www2.health.vic.gov.au]
Rickettsialpox is generally benign and self-limiting, but neurological symptoms such as photophobia, vertigo, pain on movement of the eyes, and nuchal rigidity may be severe enough to warrant lumbar puncture. [13] Q fever is a bacterial infection affecting [e-ijd.org]
Skin
- Skin Rash
All these 134 patients had fever and skin rash, and of them 132(98%) had discrete maculopapular rash while eight (6%) had fern leaf type skin necrosis. Eight patients (6%) had healed tick bite marks. [journals.plos.org]
Systemic disease typically consists of high fever, headache and skin rash, with or without «tache noire» (dark spot). [omicsonline.org]
PCR testing and immunohistochemical staining of skin specimen obtained by performing a biopsy may help confirm the clinical diagnosis in patients with rash. [e-ijd.org]
- Cutaneous Manifestation
Conclusions Pattern of cutaneous manifestations have a pivotal role in making a clinical diagnosis of SFG. [journals.plos.org]
Diagnosis and treatment of tick infestation and tick-borne diseases with cutaneous manifestations. Dermatol Ther 2009;22:293-326. 21. Chapman AS, Bakken JS, Folk SM, Paddock CD, Bloch KC, Krusell A, et al. [e-ijd.org]
- Petechiae
One half of patients develop petechiae, often with severe illness. The progression of the rash is variable and may be difficult to discern. [aafp.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]
- Macula
[…] agents may be required for ocular disease: topical antibiotics for conjunctivitis or keratitis, topical steroids and mydriatic drops for anterior uveitis, systemic steroids for severe ophthalmic involvement, such as extensive retinitis threatening the macula [omicsonline.org]
Initially rash is in the form of pink, blanching, discrete maculae which subsequently becomes maculopapular, petechial or haemorrhagic [24]. None of these clinical symptoms and signs including eschar are diagnostic of rickettsial disease. [ijmr.org.in]
Psychiatrical
- Fear
Thirdly, the population had acquired fear and hatred against the deworming campaigns, because they neglected aesthetic considerations (“ Some clothes get a nasty look after boiling or after crossing through drying oven: woolen clothes shrink and get crumpled [ncbi.nlm.nih.gov]
Neurologic
- Excitement
At MIT, he continued work on strongly correlated systems in collaboration with Professor David Adler who had an adjoining officebut for the most part he got excited about sp2 carbon systems and graphite intercalation compounds, a new research direction [sexociacur.weebly.com]
Workup
Microbiology
- Coxiella Burnetii
burnetii Q fever Thiotrichales Francisella tularensis Tularemia Vibrionaceae Vibrio cholerae Cholera Vibrio vulnificus Vibrio parahaemolyticus Vibrio alginolyticus Plesiomonas shigelloides Pseudomonadales Pseudomonas aeruginosa Pseudomonas infection [en.wikipedia.org]
It is found around the world and is caused by bacteria Coxiella burnetii. It usually takes about 20 days after exposure to the bacteria for symptoms to occur. [e-ijd.org]
Raoult. 1995, Prevalence of antibodies to Coxiella burnetii, Rickettsia conorii, and Rickettsia typhi in seven African countries. Clin. Infect. Dis. 21 : 1126 – 1133. 80. Tselentls, Y., , E. Edlinger, , G. Alexious, , D. Chrysanlis, , and A. [asmscience.org]
Treatment
The disease can be severe with a mortality of up to 60% without antibiotic treatment. But this can be reduced to below 5% with antibiotic and supportive treatment [1]. [ecdc.europa.eu]
Defervescence was reported to occur rapidly following treatment in all cases. Three cases reported treatment with Coartem (Artemether-Lumefantrine) at local clinics before treatment at the hospital. [ojs.wpro.who.int]
The following guidelines for treatment cover the most common infection, scrub typhus, murine typhus, and ITT and do not cover acute Q fever though the treatment of Q fever is on the similar lines. [e-ijd.org]
Following prompt antimicrobial treatment, titers generally decline below detectable levels within 8 to 11 months. With relapse, prior immunization, or delayed antibiotic treatment, IgG levels may remain elevated for more than a year postonset. [mayomedicallaboratories.com]
Prognosis
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]
[…] infections should be included in differential diagnosis of aseptic meningitis and encephalitis in patients exposed to endemic areas, especially when accompanied by renal insufficiency and/or jaundice Renal: Acute renal failure is associated with bad prognosis [e-ijd.org]
Suppurative parotiditis claims an unfavorable prognosis and require surgical treatment as early as possible [ 24, 31 ]. [ncbi.nlm.nih.gov]
Etiology
You are here › All Topics › Rickettsia typhi - Typhus Fever Rickettsia typhi is the etiologic agent of both epidemic and endemic typhus. Serologic testing is used to confirm the diagnosis and requires acute- and convalescent-phase serum samples. [arupconsult.com]
Finding of an eschar on examination of some of the cases suggested that rickettsial or related infections may be the disease etiology. [ojs.wpro.who.int]
Uchida, T. 1993, Rickettsia japanica, the etiologic agent of Oriental spotted fever, Microbiol. Immunol. 37 : 91 – 102. 82. Uchida, T., R Tashiro, T. Funato, and Y. Kitamura. 1986. [asmscience.org]
[…] including R. rickettsii (Rocky Mountain spotted fever, RMSF) and R. conorii (Mediterranean spotted fever, MSF) are pathogenic organisms transmitted to humans through tick salivary contents during the blood meal The TG rickettsiae include R. prowazekii, the etiologic [mgc.ac.cn]
[…] typhi ( R. mooseri ), Orientia ( Rickettsia ) tsutsugamushi and the Spotted Fever Group agents of human disease ( Rickettsia rickettsii, Rickettsia conorii, Rickettsia akari, Rickettsia australis, Rickettsia siberica, and Rickettsia japonicum ) are the etiologic [ehs.unc.edu]
Epidemiology
Abstract We characterized the epidemiology of typhus group rickettsiosis in Texas, USA. During 2003-2013, a total of 1,762 cases were reported to the state health department. [ncbi.nlm.nih.gov]
Discussion of each genus includes immunology and molecular biology of host-pathogen interactions, epidemiology and diagnosis, and vaccination strategies and therapies. [books.google.com]
Tabs Content Clinical Overview Background Epidemiology Incidence – Transmission – louse or flea Organism Gram-negative coccobacilli of the Rickettsiaceae family (obligate intracellular organisms) Characteristic feature of Rickettsia – life cycle requires [arupconsult.com]
The importance for human epidemiology is expected to be limited. Late relapse of epidemic typhus (Brill–Zinsser disease) might be the source of a re-emerging outbreak. [ecdc.europa.eu]
Pathophysiology
Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test Species of Rickettsia are small (0.3-0.5 mcm x 1-2 mcm) obligately intracellular bacteria (Proteobacteria). [mayomedicallaboratories.com]
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
“This is best achieved by removing and preventing entry of rodents or other small mammals from homes and using flea prevention products on pets to prevent infestations.” [contagionlive.com]
Prevention Freedom from louse infestation is the most effective protection against typhus. Maintain good personal hygiene. Wear protective clothing, including long sleeves, pants, and shoes. [iamat.org]
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]
It is situated near Ukraine – a highly contaminated area, with poor hygiene conditions; roads became impassable in winter, preventing application of preventive measures. [ncbi.nlm.nih.gov]