Rickettsioses - Revision history

Aidan: Text replacement - " species]]" to "]]"

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Text replacement - " species]]" to "]]"

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	\|''[[Wolbachia ~~species~~]]''\|\| \|\|helminths		\|''[[Wolbachia]]''\|\| \|\|helminths
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 |''[[Wolbachia species]]''|| ||Helminths||
 |}
 ==Management==

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Aidan: /* Further Reading */

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typo

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	\| ''[[R. heilongjianghensis]]''		\| ''[[R. heilongjianghensis]]''
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	\| ''[[Dermacentor]]' or ''[[Haemaphysalis]]'' ticks		\| ''[[Dermacentor]]'' or ''[[Haemaphysalis]]'' ticks
	\| Rash with eschar, acquired in Asia		\| Rash with eschar, acquired in Asia
	\|-		\|-

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	\| Eschar (often scalp) with regional lymphadenopathy, acquired in Europe		\| Eschar (often scalp) with regional lymphadenopathy, acquired in Europe
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	\| ''R. massiliae''		\| ''[[R. massiliae]]''
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	\| ''[[R. sanguineous]]''		\| ''[[R. sanguineous]]''
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	\| ''E. canis'' \|\| \|\| Tick \|\|		\| ''[[E. canis]]'' \|\| \|\| Tick \|\|
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	! colspan=4 \| Other		! colspan=4 \| Other

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	\| ''[[Wolbachia species]]'' \|\| \|\| Helminths \|\|		\| ''[[Wolbachia species]]'' \|\| \|\| Helminths \|\|
	\|}		\|}

			== Management ==
			* First-line for essentially all infections is [[Is treated by::doxycycline]] 100 mg po BID, continue for 3 days following resolution of symptoms
			* Alternatives include [[Is treated by::azithromycin]] and [[Is treated by::chloramphenicol]]

	== Further Reading ==		== Further Reading ==

← Older revision		Revision as of 14:03, 29 October 2020
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	\|Rocky Mountain spotted fever		\|Rocky Mountain spotted fever
	\|Multiple ''[[Dermacentor]]'', ''[[Amblyomma]]'', and ''[[Rhipicephalus]]'' ticks		\|Multiple ''[[Dermacentor]]'', ''[[Amblyomma]]'', and ''[[Rhipicephalus]]'' ticks
	\|Centripetal rash without eschar in the Americas		\|More severe disease. Centripetal rash without eschar in the Americas
	\|-		\|-
	\|''[[Rickettsia conorii]]''		\|''[[Rickettsia conorii]]''
	\|Boutonneuse fever, Mediterranean spotted fever		\|Boutonneuse fever, Mediterranean spotted fever
	\|''[[Rhipicephalus sanguineus]]'' ticks		\|''[[Rhipicephalus sanguineus]]'' ticks
	\|Rash with eschar, predominantly Mediterranean and Black Sea		\|More severe disease. Rash with eschar, predominantly Mediterranean and Black Sea
	\|-		\|-
	\|''[[Rickettsia japonica]]''		\|''[[Rickettsia japonica]]''
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	\|Endemic (murine) typhus		\|Endemic (murine) typhus
	\|''[[Xenopsylla cheopis]]'' (rat flea) and ''[[Ctenocephalides felis]]'' (cat flea)		\|''[[Xenopsylla cheopis]]'' (rat flea) and ''[[Ctenocephalides felis]]'' (cat flea)
	\|~~Centrifugal~~ rash without eschar in the tropics or subtropics, with flea exposure		\|May have centrifugal rash without eschar in the tropics or subtropics, with flea exposure
	\|-		\|-
	\|''[[Rickettsia prowazekii]]''		\|''[[Rickettsia prowazekii]]''
	\|Epidemic (louse-borne) typhus		\|Epidemic (louse-borne) typhus
	\|''[[Pediculus humanus humanus]]'' (human body louse)		\|''[[Pediculus humanus humanus]]'' (human body louse)
	\|~~Centrifugal~~ rash without eschar, with exposure to flying squirrel or other		\|More common in homeless shelters. May have centrifugal rash without eschar, with exposure to flying squirrel or other
	\|-		\|-
	! colspan="4" \|Rickettsiae: Scrub typhus group		! colspan="4" \|Rickettsiae: Scrub typhus group
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	\|}		\|}

	== Diagnosis ==		==Diagnosis==

	* The mainstay of diagnosis is '''serology'''		*The mainstay of diagnosis is '''serology'''
	** Indirect immunofluorescence antibody assays of IgG antibodies		**Indirect immunofluorescence antibody assays of IgG antibodies
	*** IgM do not appear any earlier in the course of disease and are less specific		***IgM do not appear any earlier in the course of disease and are less specific
	** Usually as acute and convalescent titres drawn 2 to 4 weeks apart showing a 4-fold increase in titres		**Usually as acute and convalescent titres drawn 2 to 4 weeks apart showing a 4-fold increase in titres
	*** [[Rickettsia africae]] may take up to 4 weeks after onset of illness to seroconvert		***[[Rickettsia africae]] may take up to 4 weeks after onset of illness to seroconvert
	** Cross-reactivity is common within each group		**Cross-reactivity is common within each group
	*** Serologic tests for [[Rickettsia conorii]] or [[Rickettsia rickettsii]] may be used to diagnosis other spotted fever group diseases such as [[Rickettsia africae]], [[Rickettsia akari]], [[Rickettsia australis]], and [[Rickettsia sibirica]]		***Serologic tests for [[Rickettsia conorii]] or [[Rickettsia rickettsii]] may be used to diagnosis other spotted fever group diseases such as [[Rickettsia africae]], [[Rickettsia akari]], [[Rickettsia australis]], and [[Rickettsia sibirica]]
	*** Serologic tests for [[Rickettsia typhi]] may be used to diagnose other typhus group diseases such as [[Rickettsia prowazekii]]		***Serologic tests for [[Rickettsia typhi]] may be used to diagnose other typhus group diseases such as [[Rickettsia prowazekii]]
	*** Cross-reactivity also common between the two groups, but the titres will usually be highest in the group containing the causative organism		***Cross-reactivity also common between the two groups, but the titres will usually be highest in the group containing the causative organism
	* '''PCR''' is becoming more widely available		*'''PCR''' is becoming more widely available
			**Blood and tissue (e.g. eschar biopsy)
			**Done as PCR for the group followed by species-specific sequencing

	==Management==		==Management==