Rickettsioses: Difference between revisions

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{| class="wikitable"
{| class="wikitable"
! Species
!Species
! Disease
!Disease
! Vector
!Vector
! Clinical Clues
!Clinical Clues
|-
|-
! colspan=4 | Rickettsiae: Spotted fever group
! colspan="4" |Rickettsiae: Spotted fever group
|-
|-
| ''[[Rickettsia rickettsii]]''
|''[[Rickettsia rickettsii]]''
| 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
|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
|Rash with eschar, predominantly Mediterranean and Black Sea
|-
|-
| ''[[Rickettsia japonica]]''
|''[[Rickettsia japonica]]''
| Oriental spotter fever
|Oriental spotter fever
| ''[[Dermacentor]]'', ''[[Haemaphysalis]]'', or ''[[Ixodes]]'' ticks
|''[[Dermacentor]]'', ''[[Haemaphysalis]]'', or ''[[Ixodes]]'' ticks
| Rash with eschar, acquired in Asia
|Rash with eschar, acquired in Asia
|-
|-
| ''[[Rickettsia sibirica]] mongolitimonae''
|''[[Rickettsia sibirica]] mongolitimonae''
|
|
| ''[[Rickettsia sanguineus]]''
|[[Rhipicephalus sanguineus]]
| Rash with eschar, acquired in Europe, Africa, or Asia
|Rash with eschar, acquired in Europe, Africa, or Asia
|-
|-
| ''[[Rickettsia sibirica]] sibirica''
|''[[Rickettsia sibirica]] sibirica''
|
|
| ''[[Dermacentor]]'' ticks
|''[[Dermacentor]]'' ticks
| Rash with eschar, acquired in Asia or southern Russia
|Rash with eschar, acquired in Asia or southern Russia
|-
|-
| ''[[Rickettsia australis]]''
|''[[Rickettsia australis]]''
|
|
| ''[[Ixodes]]'' ticks
|''[[Ixodes]]'' ticks
| Vesicular rash with eschar, acquired in Australia
|Vesicular rash with eschar, acquired in Australia
|-
|-
| ''[[Rickettsia slovaca]]
|''[[Rickettsia slovaca]]''
| Tick-borne lymphadenopathy
|Tick-borne lymphadenopathy
| ''[[Dermacentor marginatus]]''
|''[[Dermacentor marginatus]]''
| Eschar (often scalp) with regional lymphadenopathy, acquired in Europe
|Eschar (often scalp) with regional lymphadenopathy, acquired in Europe
|-
|-
| ''[[Rickettsia africae]]''
|''[[Rickettsia africae]]''
| African tick-bite fever
|African tick-bite fever
| ''[[Amblyomma hebraeum]]'' and ''[[Amblyomma variegatum]]''
|''[[Amblyomma hebraeum]]'' and ''[[Amblyomma variegatum]]''
| Vesicular rash with eschar, acquired in Africa or the Caribbean
|Vesicular rash with eschar, acquired in Africa or the Caribbean
|-
|-
| ''[[Rickettsia honei]]''
|''[[Rickettsia honei]]''
|
|
| ''[[Bothriocroton]]'', ''[[Haemaphysalis]]'', ''[[Ixodes]]'', or ''[[Rhipicephalus]]'' ticks
|''[[Bothriocroton]]'', ''[[Haemaphysalis]]'', ''[[Ixodes]]'', or ''[[Rhipicephalus]]'' ticks
| Rash with eschar acquired in Flinders Islands, eastern Australia, Thailand, or Nepal
|Rash with eschar acquired in Flinders Islands, eastern Australia, Thailand, or Nepal
|-
|-
| ''[[Rickettsia aeschlimanii]]''
|''[[Rickettsia aeschlimanii]]''
|
|
| ''[[Hyalomma]]'' or ''[[Rhipicephalus]]'' ticks
|''[[Hyalomma]]'' or ''[[Rhipicephalus]]'' ticks
| Rash with eschar, acquired in Africa or Europe
|Rash with eschar, acquired in Africa or Europe
|-
|-
| ''[[Rickettsia helvetica]]'' || || Tick ||
|''[[Rickettsia helvetica]]''|| ||Tick||
|-
|-
| ''[[Rickettsia parkeri]]''
|''[[Rickettsia parkeri]]''
|
|
| ''[[Amblyomma maculatum]]'' ticks
|''[[Amblyomma maculatum]]'' ticks
| Rash with eschar, acquired in the Americas
|Rash with eschar, acquired in the Americas
|-
|-
| ''[[Rickettsia heilongjianghensis]]''
|''[[Rickettsia heilongjianghensis]]''
|
|
| ''[[Dermacentor]]'' or ''[[Haemaphysalis]]'' ticks
|''[[Dermacentor]]'' or ''[[Haemaphysalis]]'' ticks
| Rash with eschar, acquired in Asia
|Rash with eschar, acquired in Asia
|-
|-
| ''[[Rickettsia raoultii]]''
|''[[Rickettsia raoultii]]''
|
|
| ''[[Dermacentor]]'' ticks
|''[[Dermacentor]]'' ticks
| Eschar (often scalp) with regional lymphadenopathy, acquired in Europe
|Eschar (often scalp) with regional lymphadenopathy, acquired in Europe
|-
|-
| ''[[Rickettsia massiliae]]''
|''[[Rickettsia massiliae]]''
|
|
|[[Rhipicephalus sanguineus]]
| ''[[Rickettsia sanguineous]]''
| Rash with eschar, acquired in Europe, Africa, and the Americas
|Rash with eschar, acquired in Europe, Africa, and the Americas
|-
|-
| ''[[Rickettsia amblyommii]]'' || || Tick ||
|''[[Rickettsia amblyommii]]''|| ||Tick||
|-
|-
| ''[[Rickettsia monacensis]]'' || || Tick ||
|''[[Rickettsia monacensis]]''|| ||Tick||
|-
|-
| ''[[Rickettsia philipii]]'' strain 364D
|''[[Rickettsia philipii]]'' strain 364D
|
|
| ''[[Dermcentor occidentalis]]''
|''[[Dermcentor occidentalis]]''
| Eschar (often scalp) with regional lymphadenopathy, acquired in California
|Eschar (often scalp) with regional lymphadenopathy, acquired in California
|-
|-
| ''[[Rickettsia felis]]''
|''[[Rickettsia felis]]''
|
|
| Flea
|Flea
| Rash with eschar and flea exposure
|Rash with eschar and flea exposure
|-
|-
| ''[[Rickettsia akari]]''
|''[[Rickettsia akari]]''
| Rickettsialpox
|Rickettsialpox
| ''[[Liponyssoides sanguineus]]'' house mouse mites
|''[[Liponyssoides sanguineus]]'' house mouse mites
| Vesicular rash with eschar, worldwide
|Vesicular rash with eschar, worldwide
|-
|-
! colspan=4 | Rickettiae: Typhus group
! colspan="4" |Rickettiae: Typhus group
|-
|-
| ''[[Rickettsia typhi]]''
|''[[Rickettsia typhi]]''
| 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
|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
|Centrifugal rash without eschar, with exposure to flying squirrel or other
|-
|-
! colspan=4 | Rickettsiae: Scrub typhus group
! colspan="4" |Rickettsiae: Scrub typhus group
|-
|-
| ''[[Orientia tsutsugamushi]]''
|''[[Orientia tsutsugamushi]]''
| Scrub typhus
|Scrub typhus
| [[Leptotrombidium]] mites (chiggers, trombiculid mites)
|[[Leptotrombidium]] mites (chiggers, trombiculid mites)
| Rash with eschar, acquired in Asian Pacific, Chile, or Dubai
|Rash with eschar, acquired in Asian Pacific, Chile, or Dubai
|-
|-
! colspan=4 | Anaplasma
! colspan="4" |Anaplasma
|-
|-
| ''[[Amblyomma phagocytophilum]]''
|''[[Amblyomma phagocytophilum]]''
| Human granulocytotropic anaplasmosis
|Human granulocytotropic anaplasmosis
| Tick
|Tick
|
|
|-
|-
! colspan=4 | Ehrlichia
! colspan="4" |Ehrlichia
|-
|-
| ''[[Ehrlichia chaffeensis]]''
|''[[Ehrlichia chaffeensis]]''
| Human granulocytotropic anaplasmosis
|Human granulocytotropic anaplasmosis
| ''[[Amblyomma americanum]]'' ticks (the Lone Star tick)
|''[[Amblyomma americanum]]'' ticks (the Lone Star tick)
|
|
|-
|-
| ''[[Ehrlichia ewingii]]''
|''[[Ehrlichia ewingii]]''
| Human granulocytotropic anaplasmosis
|Human granulocytotropic anaplasmosis
| ''[[Amblyomma americanum]]'' and ''[[Dermacentor variabilis]]'' ticks
|''[[Amblyomma americanum]]'' and ''[[Dermacentor variabilis]]'' ticks
|
|
|-
|-
| ''[[Ehrlichia canis]]'' || || Tick ||
|''[[Ehrlichia canis]]''|| ||Tick||
|-
|-
! colspan=4 | Other
! colspan="4" |Other
|-
|-
| ''[[Neoehrlichia mikurensis]]'' || || Tick ||
|''[[Neoehrlichia mikurensis]]''|| ||Tick||
|-
|-
| ''[[Neorickettsia sennetsu]]'' || || Raw fish ||
|''[[Neorickettsia sennetsu]]''|| ||Raw fish||
|-
|-
| ''[[Wolbachia species]]'' || || Helminths ||
|''[[Wolbachia species]]''|| ||Helminths||
|}
|}


== Management ==
==Management==

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

⚫
==Further Reading==


⚫
*Syndromic classification of rickettsioses: an approach for clinical practice. ''Int J Infect Dis''. 2014;28:126-39. doi: [https://doi.org/10.1016/j.ijid.2014.05.025 10.1016/j.ijid.2014.05.025]
⚫
== Further Reading ==
⚫
* Syndromic classification of rickettsioses: an approach for clinical practice. ''Int J Infect Dis''. 2014;28:126-39. doi: [https://doi.org/10.1016/j.ijid.2014.05.025 10.1016/j.ijid.2014.05.025]


[[Category:Rickettsioses]]
[[Category:Rickettsioses]]

Revision as of 00:42, 29 October 2020

Species Disease Vector Clinical Clues
Rickettsiae: Spotted fever group
Rickettsia rickettsii Rocky Mountain spotted fever Multiple Dermacentor, Amblyomma, and Rhipicephalus ticks Centripetal rash without eschar in the Americas
Rickettsia conorii Boutonneuse fever, Mediterranean spotted fever Rhipicephalus sanguineus ticks Rash with eschar, predominantly Mediterranean and Black Sea
Rickettsia japonica Oriental spotter fever Dermacentor, Haemaphysalis, or Ixodes ticks Rash with eschar, acquired in Asia
Rickettsia sibirica mongolitimonae Rhipicephalus sanguineus Rash with eschar, acquired in Europe, Africa, or Asia
Rickettsia sibirica sibirica Dermacentor ticks Rash with eschar, acquired in Asia or southern Russia
Rickettsia australis Ixodes ticks Vesicular rash with eschar, acquired in Australia
Rickettsia slovaca Tick-borne lymphadenopathy Dermacentor marginatus Eschar (often scalp) with regional lymphadenopathy, acquired in Europe
Rickettsia africae African tick-bite fever Amblyomma hebraeum and Amblyomma variegatum Vesicular rash with eschar, acquired in Africa or the Caribbean
Rickettsia honei Bothriocroton, Haemaphysalis, Ixodes, or Rhipicephalus ticks Rash with eschar acquired in Flinders Islands, eastern Australia, Thailand, or Nepal
Rickettsia aeschlimanii Hyalomma or Rhipicephalus ticks Rash with eschar, acquired in Africa or Europe
Rickettsia helvetica Tick
Rickettsia parkeri Amblyomma maculatum ticks Rash with eschar, acquired in the Americas
Rickettsia heilongjianghensis Dermacentor or Haemaphysalis ticks Rash with eschar, acquired in Asia
Rickettsia raoultii Dermacentor ticks Eschar (often scalp) with regional lymphadenopathy, acquired in Europe
Rickettsia massiliae Rhipicephalus sanguineus Rash with eschar, acquired in Europe, Africa, and the Americas
Rickettsia amblyommii Tick
Rickettsia monacensis Tick
Rickettsia philipii strain 364D Dermcentor occidentalis Eschar (often scalp) with regional lymphadenopathy, acquired in California
Rickettsia felis Flea Rash with eschar and flea exposure
Rickettsia akari Rickettsialpox Liponyssoides sanguineus house mouse mites Vesicular rash with eschar, worldwide
Rickettiae: Typhus group
Rickettsia typhi Endemic (murine) typhus Xenopsylla cheopis (rat flea) and Ctenocephalides felis (cat flea) Centrifugal rash without eschar in the tropics or subtropics, with flea exposure
Rickettsia prowazekii Epidemic (louse-borne) typhus Pediculus humanus humanus (human body louse) Centrifugal rash without eschar, with exposure to flying squirrel or other
Rickettsiae: Scrub typhus group
Orientia tsutsugamushi Scrub typhus Leptotrombidium mites (chiggers, trombiculid mites) Rash with eschar, acquired in Asian Pacific, Chile, or Dubai
Anaplasma
Amblyomma phagocytophilum Human granulocytotropic anaplasmosis Tick
Ehrlichia
Ehrlichia chaffeensis Human granulocytotropic anaplasmosis Amblyomma americanum ticks (the Lone Star tick)
Ehrlichia ewingii Human granulocytotropic anaplasmosis Amblyomma americanum and Dermacentor variabilis ticks
Ehrlichia canis Tick
Other
Neoehrlichia mikurensis Tick
Neorickettsia sennetsu Raw fish
Wolbachia species Helminths

Management

Further Reading

  • Syndromic classification of rickettsioses: an approach for clinical practice. Int J Infect Dis. 2014;28:126-39. doi: 10.1016/j.ijid.2014.05.025
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