Rickettsia: Difference between revisions
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Rickettsia
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==Background== |
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= ''Rickettsia'' species = |
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* A genus of obligate mostly-tick-borne intracellular Gram-negative bacteria |
* A genus of obligate mostly-tick-borne intracellular Gram-negative bacteria |
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{| class="wikitable" |
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== Typhus Group == |
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! Species |
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! Disease |
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! Vector |
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! Distribution |
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|- |
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! colspan=4 | Typhus Group |
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|- |
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| ''[[R. prowazekii]]'' || epidemic typhus || body louse || |
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|- |
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| ''[[R. typhi]]'' || murine/endemic typhus || rat/cat fleas || |
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|- |
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! colspan=4 | Spotted Fever Group |
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|- |
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| rowspan=4 | ''[[R. rickettsii]]'' |
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| rowspan=4 | Rocky Mountain spotted fever (RMSF) |
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| ''[[Dermacentor variabilis]]'' ticks || eastern, central, and Pacific coast of US |
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|- |
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| ''[[Dermacentor andersoni]]'' ticks || western US |
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|- |
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| ''[[Rhipicephalus sanguineus]]'' ticks || Mexico and southern US |
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|- |
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| ''[[Amblyomma cajennense]]'' ticks || Central and South America |
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|- |
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| rowspan=2 | ''[[R. parkeri]]'' |
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| rowspan=2 | American tick-borne fever |
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| ''[[Amblyommma maculatum]]'' ticks || southern US |
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|- |
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| ''[[Amblyomma triste]]'' ticks || Uruguay, Brazil, and Argentina |
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|- |
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| ''[[R. conorii]]'' || Mediterranean spotted fever || ''[[Rhipicephalus sanguineus]]'' ticks || |
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|- |
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| ''[[R. japonica]]'' || Oriental spotter fever || || |
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|- |
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| ''[[R. heilongiangensis]]'' || Far Eastern spotted fever || || eastern Russia, Thailand, and China |
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|- |
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| ''[[R. africae]]'' || African tick bite fever || ''[[Amblyomma]]'' ticks || |
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|- |
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| ''[[R. slovaca]]'' || tick-borne lymphadenopathy (TIBOLA) || ''[[Dermacentor marginatus]]'' ticks || |
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! colspan=4 | Transitional Group |
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|- |
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| ''[[R. akari]]'' || rickettsialpox || ''[[Liponyssoides sanguineus]]'' house mouse mites || |
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|- |
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| ''[[R. australis]]'' || North Queensland tick typhus || || |
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|- |
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| ''[[R. felis]]'' || flea-borne spotted fever || || |
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|- |
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! colspan=4 | Ancestral Group |
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|- |
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| ''[[Rickettsia bellii]]'' || || || |
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|- |
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| ''[[Rickettsia canadensis]]'' || || || |
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|- |
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! colspan=4 | Other Rickettsiae |
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|- |
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| ''[[Orientia tsutsugamushi]]'' || scrub typhus || chiggers || |
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|- |
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| ''[[Ehrlichia]]'' species || human monocytotropic ehrlichiosis || ''[[Amblyomma americanum]]'' and other ticks || |
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|- |
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| ''[[Anaplasma]]'' species || human granulocytic anaplasmosis || ''[[Ixodes scapularis]]'' and ''[[Ixodes pacificus]]'' ticks || |
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|- |
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| ''[[Neorickettsia]]'' || || helminths || |
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|- |
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| ''[[Wolbachia]]'' || || helminths and arthropods || |
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|} |
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==Management== |
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* ''R. prowazekii'': causes [epidemic typhus](Epidemic typhus (R. prowazekii).md), transmitted by the body louse |
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===Spotted Fever Group=== |
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* ''R. typhi'': causes [murine/endemic typhus](Murine typhus (R. typhi).md), transmitted by rat/cat fleas |
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* [[Is treated by::Doxycycline]] 100 mg po bid for 7 to 10 days |
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** Alternatively: [[tetracycline]] 2 g/day or [[chloramphenicol]] 2 g/d |
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== Spotted Fever Group == |
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** Alternatively: [[ciprofloxacin]] 750 mg po bid for 5 to 7 days |
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* ''R. rickettsii'': causes [Rocky Mountain spotted fever (RMSF)](Rocky Mountain spotted fever (RMSF) (R. rickettsii).md) |
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* ''R. parkeri'': carried by ''A. maculatum'' in the southern US and ''A. triste'' in Uruguay, Brazil, and Argentina |
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* ''R. conorii'': causes [boutonneuse fever](Boutonneuse fever (R. conorii).md) |
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* ''R. japonica'': causes oriental spotter fever |
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* ''R. heilongiangensis'': causes Far Eastern spotted fever in eastern Russia, Thailand, and China |
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* ''R. africae'': causes [African tick bite fever](African tick-bite fever (ATBF) (R. africae).md) |
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* ''R. slovaca'': causes tick-borne lymphadenopathy (TIBOLA) |
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** Transmitted by ''Dermacentor marginatus'' ticks |
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=== Transitional Group === |
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* ''R. akari'': causes [rickettsialpox](Rickettsialpox (R. akari).md), transmitted by the house mouse mite, ''Liponyssoides sanguineus'' |
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* ''R. australis'': causes North Queensland tick typhus |
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* ''R. felis'': causes flea-borne spotted fever |
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** Cats are host to the flea vector ''Ctenocephalides felis'', which has worldwide distribution |
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** Fevers with headache, myalgia, maculopapular rash, neurologic involvement, vomiting, abdo pain, resp involvement |
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=== Management === |
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* Doxycycline 100 mg po bid for 7 to 10 days |
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** Alternatively: tetracycline 2 g/day or chloramphenicol 2 g/d |
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** Alternatively: ciprofloxacin 750 mg po bid for 5 to 7 days |
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*** But no good evidence for this |
*** But no good evidence for this |
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* Can use doxycycline safely for these duration in children <8 years, and is strongly indicated for rickettsioses |
* Can use [[doxycycline]] safely for these duration in children <8 years, and is strongly indicated for rickettsioses |
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* May use azithromycin or |
* May use [[azithromycin]] or [[clarithromyci]]n in pregnant women |
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* ''Avoid'' |
* ''Avoid'' [[TMP-SMX]], which appears to ''worsen'' severity of disease! |
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== Ancestral Group == |
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* ''Rickettsia bellii'' |
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* ''Rickettsia canadensis'' |
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== Other Rickettsiae == |
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{{DISPLAYTITLE:''Rickettsia''}} |
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* ''Orientia tsutsugamushi'': causes [scrub typhus](Scrub typhus (O. tsutsugamushi).md), transmitted by chiggers |
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[[Category:Rickettsioses]] |
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* ''Ehrlichia'': transmitted by ticks |
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* ''Anaplasma'': transmitted by ticks |
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* ''Neorickettsia'': transmitted by helminths |
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* ''Wolbachia'': transmitted by helminths and arthropods |
Latest revision as of 16:47, 25 January 2022
Background
- A genus of obligate mostly-tick-borne intracellular Gram-negative bacteria
Species | Disease | Vector | Distribution |
---|---|---|---|
Typhus Group | |||
R. prowazekii | epidemic typhus | body louse | |
R. typhi | murine/endemic typhus | rat/cat fleas | |
Spotted Fever Group | |||
R. rickettsii | Rocky Mountain spotted fever (RMSF) | Dermacentor variabilis ticks | eastern, central, and Pacific coast of US |
Dermacentor andersoni ticks | western US | ||
Rhipicephalus sanguineus ticks | Mexico and southern US | ||
Amblyomma cajennense ticks | Central and South America | ||
R. parkeri | American tick-borne fever | Amblyommma maculatum ticks | southern US |
Amblyomma triste ticks | Uruguay, Brazil, and Argentina | ||
R. conorrii | Mediterranean spotted fever | Rhipicephalus sanguineus ticks | |
R. japonica | Oriental spotter fever | ||
R. heilongiangensis | Far Eastern spotted fever | eastern Russia, Thailand, and China | |
R. africae | African tick bite fever | Amblyomma ticks | |
R. slovaca | tick-borne lymphadenopathy (TIBOLA) | Dermacentor marginatus ticks | |
Transitional Group | |||
R. akari | rickettsialpox | Liponyssoides sanguineus house mouse mites | |
R. australis | North Queensland tick typhus | ||
R. felis | flea-borne spotted fever | ||
Ancestral Group | |||
Rickettsia bellii | |||
Rickettsia canadensis | |||
Other Rickettsiae | |||
Orientia tsutsugamushi | scrub typhus | chiggers | |
Ehrlichia species | human monocytotropic ehrlichiosis | Amblyomma americanum and other ticks | |
Anaplasma species | human granulocytic anaplasmosis | Ixodes scapularis and Ixodes pacificus ticks | |
Neorickettsia | helminths | ||
Wolbachia | helminths and arthropods |
Management
Spotted Fever Group
- Doxycycline 100 mg po bid for 7 to 10 days
- Alternatively: tetracycline 2 g/day or chloramphenicol 2 g/d
- Alternatively: ciprofloxacin 750 mg po bid for 5 to 7 days
- But no good evidence for this
- Can use doxycycline safely for these duration in children <8 years, and is strongly indicated for rickettsioses
- May use azithromycin or clarithromycin in pregnant women
- Avoid TMP-SMX, which appears to worsen severity of disease!