Rickettsia akari: Difference between revisions

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Rickettsia akari
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==Background==

* Causes '''rickettsialpox'''
* Causes '''rickettsialpox'''


== Microbiology ==
===Microbiology===


* Disease caused by ''Rickettsia akari'', an intracellular Gram-negative bacterium
*Disease caused by ''Rickettsia akari'', an intracellular Gram-negative bacterium
* Unlike most rickettsiae, it has a plasmid
*Unlike most rickettsiae, it has a plasmid


== Epidemiology ==
===Epidemiology===


* Transmitted by the house mouse mite (''Liponyssoides sanguineus'')
*Transmitted by the house mouse mite (''Liponyssoides sanguineus'')
** Rodents are the reservoir
**Rodents are the reservoir
* Most cases are in New York, but it is found worldwide
*Most cases are in New York, but it is found worldwide
* Most likely rickettsiosis to be found in Ontario
*Most likely rickettsiosis to be found in Ontario
* Homelessness and IV drug use are risk factors
*Homelessness and IV drug use are risk factors


== Clinical Presentation ==
==Clinical Manifestations==


* Incubation period of 7 to 14 days
*Incubation period of [[Usual incubation period::7 to 14 days]]
* Present with fever, vesicular rash, and eschar
*Present with [[Causes::fever]], [[Causes::vesicular rash]], and [[Causes::eschar]]
** Headache also common
**Headache also common
* The eschar is painless, and appears as a papule about a week after innoculation, followed by vesicle that dries and leaves a brown or black eschar
*The [[Causes::eschar]] is painless, and appears as a papule about a week after innoculation, followed by vesicle that dries and leaves a brown or black eschar
* The rash is vesicular, but may be papulovesicular or any other type of rash
*The rash is vesicular, but may be papulovesicular or any other type of rash
** Lesions leaves black crust and heal without scarring
**Lesions leaves black crust and heal without scarring
** Spares palms and soles
**Spares palms and soles
** Resolves in two to three weeks
**Resolves in two to three weeks
* May find leukocytosis
*May find leukocytosis


== Diagnosis ==
==Diagnosis==


* Detection of a four-fold rise in convalescent titres by complement fixation or indirect fluorescent antibodies
*Detection of a four-fold rise in convalescent titres by complement fixation or indirect fluorescent antibodies


== Management ==
==Management==


* Usually self-limited, resolving in 7 to 10 days, though antibiotics help
*Usually self-limited, resolving in 7 to 10 days, though antibiotics help
* Doxycycline 100 mg po bid for 2 to 5 days and 48 h after fever resolves
*[[Is treated by::Doxycycline]] 100 mg po bid for 2 to 5 days and 48 h after fever resolves


{{DISPLAYTITLE:''Rickettsia akari''}}
{{DISPLAYTITLE:''Rickettsia akari''}}

Latest revision as of 14:08, 15 October 2020

Background

  • Causes rickettsialpox

Microbiology

  • Disease caused by Rickettsia akari, an intracellular Gram-negative bacterium
  • Unlike most rickettsiae, it has a plasmid

Epidemiology

  • Transmitted by the house mouse mite (Liponyssoides sanguineus)
    • Rodents are the reservoir
  • Most cases are in New York, but it is found worldwide
  • Most likely rickettsiosis to be found in Ontario
  • Homelessness and IV drug use are risk factors

Clinical Manifestations

  • Incubation period of 7 to 14 days
  • Present with fever, vesicular rash, and eschar
    • Headache also common
  • The eschar is painless, and appears as a papule about a week after innoculation, followed by vesicle that dries and leaves a brown or black eschar
  • The rash is vesicular, but may be papulovesicular or any other type of rash
    • Lesions leaves black crust and heal without scarring
    • Spares palms and soles
    • Resolves in two to three weeks
  • May find leukocytosis

Diagnosis

  • Detection of a four-fold rise in convalescent titres by complement fixation or indirect fluorescent antibodies

Management

  • Usually self-limited, resolving in 7 to 10 days, though antibiotics help
  • Doxycycline 100 mg po bid for 2 to 5 days and 48 h after fever resolves