Rickettsia prowazekii: Difference between revisions
From IDWiki
Rickettsia prowazekii
mNo edit summary |
No edit summary |
||
| (3 intermediate revisions by the same user not shown) | |||
| Line 1: | Line 1: | ||
==Background== |
|||
* Cause of '''epidemic typhus''' |
* Cause of '''epidemic typhus''' |
||
== |
===Microbiology=== |
||
*One of the [[Rickettsiae]] |
|||
===Life Cycle=== |
===Life Cycle=== |
||
* |
*Adult louse becomes infected when feeding on a rickettsemic patient |
||
* |
*The louse poops on another person |
||
* |
*The person scratches their skin or touches their mucous membrane, innoculating themselves with louse feces |
||
===Epidemiology=== |
===Epidemiology=== |
||
* |
*Carried by the human body louse, ''Pediculus humanus corporis'' |
||
* |
*Outbreaks are associated with poverty, refugee camps, jails, and cold climate |
||
* |
*The only non-human reservoir is the flying squirrel (''Glaucomys volans'') in the US |
||
* |
*Previously-infected patients may still have latent infection |
||
==Clinical |
==Clinical Manifestations== |
||
* Incubation 1 to 2 weeks |
|||
*Incubation period [[Usual incubation period::1 to 2 weeks]] |
|||
* |
*High fever, severe headache, myalgia, non-producive cough, delirium |
||
* |
*Dull, red rash starting on the trunk and spreading peripherally |
||
** |
**Spares palms and soles |
||
** |
**Rash not always present |
||
* |
*Delirium, hemorrhagic rash |
||
* |
*In its severe form, can progress to pulmonary edema, encephalitis, shock, and death |
||
===Brill-Zinsser disease (BZD)=== |
===Brill-Zinsser disease (BZD)=== |
||
* |
*Reactivation or recrudescence of dormant typhus years after the initial infection |
||
* |
*Often in the context of malnutrition, chronic illness, and poor hygeine |
||
* |
*Rash may be evanescent or absent, and resolves faster |
||
==Diagnosis== |
==Diagnosis== |
||
* |
*Four-fold rise in indirect immunofluorescence assay for IgG |
||
* |
*PCR may be useful during acute illness |
||
==Management== |
==Management== |
||
* |
*Need to treat even without confirmed diagnosis |
||
* Doxycycline 100 mg po bid for 7 to 10 days, until afebrile for 24 to 48 hours |
*[[Is treated by::Doxycycline]] 100 mg po bid for 7 to 10 days, until afebrile for 24 to 48 hours |
||
* Chloramphenicol is the alternative |
*[[Is treated by::Chloramphenicol]] is the alternative |
||
* |
*Wash clothing to prevent outbreaks |
||
{{DISPLAYTITLE:''Rickettsia prowazekii''}} |
{{DISPLAYTITLE:''Rickettsia prowazekii''}} |
||
Latest revision as of 13:49, 5 August 2020
Background
- Cause of epidemic typhus
Microbiology
- One of the Rickettsiae
Life Cycle
- Adult louse becomes infected when feeding on a rickettsemic patient
- The louse poops on another person
- The person scratches their skin or touches their mucous membrane, innoculating themselves with louse feces
Epidemiology
- Carried by the human body louse, Pediculus humanus corporis
- Outbreaks are associated with poverty, refugee camps, jails, and cold climate
- The only non-human reservoir is the flying squirrel (Glaucomys volans) in the US
- Previously-infected patients may still have latent infection
Clinical Manifestations
- Incubation period 1 to 2 weeks
- High fever, severe headache, myalgia, non-producive cough, delirium
- Dull, red rash starting on the trunk and spreading peripherally
- Spares palms and soles
- Rash not always present
- Delirium, hemorrhagic rash
- In its severe form, can progress to pulmonary edema, encephalitis, shock, and death
Brill-Zinsser disease (BZD)
- Reactivation or recrudescence of dormant typhus years after the initial infection
- Often in the context of malnutrition, chronic illness, and poor hygeine
- Rash may be evanescent or absent, and resolves faster
Diagnosis
- Four-fold rise in indirect immunofluorescence assay for IgG
- PCR may be useful during acute illness
Management
- Need to treat even without confirmed diagnosis
- Doxycycline 100 mg po bid for 7 to 10 days, until afebrile for 24 to 48 hours
- Chloramphenicol is the alternative
- Wash clothing to prevent outbreaks
