Orientia tsutsugamushi: Difference between revisions
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Orientia tsutsugamushi
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* Chigger-borne rickettsial infection caused by the intracellular Gram-negative bacterium ''Orientia tsutsugamushi'' that causes '''scrub typhus''' |
* Chigger-borne [[Ricketssioses|rickettsial infection]] caused by the intracellular [[Has Gram stain::Gram-negative]] bacterium ''Orientia tsutsugamushi'' that causes '''scrub typhus''' |
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== Background == |
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=== Life Cycle === |
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* The entire life cycle is maintained within [[Is transmitted by::Leptotrombidium]] mites by vertical/transovarial transmission |
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* Transmitted within mites (chiggers) transovarially |
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* [[Leptotrombidium]] larvae (called '''chiggers''') normally feed on rodents, and occasionally humans, who are dead-end hosts |
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* Most common in rural Asia and western Australia, as well as other parts of eastern Asia, including Russia and India |
* Most common in rural Asia and western Australia, as well as other parts of eastern Asia, including Russia and India |
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== Clinical Presentation == |
== Clinical Presentation == |
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* Fever, headache, myalgia, lymphadenopathy, and an eschar |
* Fever, headache, myalgia, lymphadenopathy, and an eschar |
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** Lymphadenopathy sometimes grouped near the eschar |
** Lymphadenopathy sometimes grouped near the eschar |
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== Diagnosis == |
== Diagnosis == |
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* Four-fold rise in immunofluorescence serology |
* Four-fold rise in immunofluorescence serology |
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* PCR on eschar, blood, or lymph node biopsy |
* PCR on eschar, blood, or lymph node biopsy |
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== Management == |
== Management == |
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* [[Doxycycline]] 100 mg po bid for 7 days |
* [[Doxycycline]] 100 mg po bid for 7 days |
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Revision as of 17:10, 20 November 2019
- Chigger-borne rickettsial infection caused by the intracellular Gram-negative bacterium Orientia tsutsugamushi that causes scrub typhus
Background
Life Cycle
- The entire life cycle is maintained within Leptotrombidium mites by vertical/transovarial transmission
- Leptotrombidium larvae (called chiggers) normally feed on rodents, and occasionally humans, who are dead-end hosts
Epidemiology
- Most common in rural Asia and western Australia, as well as other parts of eastern Asia, including Russia and India
Clinical Presentation
- Fever, headache, myalgia, lymphadenopathy, and an eschar
- Lymphadenopathy sometimes grouped near the eschar
- Should almost always be able to find the eschar if you look hard enough
- Transient pale macular rash
- May have cough
- May have mental status changes and hepatosplenomegaly
- In severe cases, may progress to multiorgan failure and hemorrhage
- After treatment, may relapse
- Infection also decreases HIV viral load and can lead to immune reconstitution
Diagnosis
- Four-fold rise in immunofluorescence serology
- PCR on eschar, blood, or lymph node biopsy
Management
- Doxycycline 100 mg po bid for 7 days
