Rickettsia: Difference between revisions

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Rickettsia
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==Background==
= ''Rickettsia'' species =

* A genus of obligate mostly-tick-borne intracellular Gram-negative bacteria
* A genus of obligate mostly-tick-borne intracellular Gram-negative bacteria


{| class="wikitable"
== Typhus Group ==
! Species
! Disease
! Vector
! Distribution
|-
! colspan=4 | Typhus Group
|-
| ''[[R. prowazekii]]'' || epidemic typhus || body louse ||
|-
| ''[[R. typhi]]'' || murine/endemic typhus || rat/cat fleas ||
|-
! colspan=4 | Spotted Fever Group
|-
| rowspan=4 | ''[[R. rickettsii]]''
| rowspan=4 | 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
|-
| rowspan=2 | ''[[R. parkeri]]''
| rowspan=2 | American tick-borne fever
| ''[[Amblyommma maculatum]]'' ticks || southern US
|-
| ''[[Amblyomma triste]]'' ticks || Uruguay, Brazil, and Argentina
|-
| ''[[R. conorii]]'' || 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 ||
|-
! colspan=4 | Transitional Group
|-
| ''[[R. akari]]'' || rickettsialpox || ''[[Liponyssoides sanguineus]]'' house mouse mites ||
|-
| ''[[R. australis]]'' || North Queensland tick typhus || ||
|-
| ''[[R. felis]]'' || flea-borne spotted fever || ||
|-
! colspan=4 | Ancestral Group
|-
| ''[[Rickettsia bellii]]'' || || ||
|-
| ''[[Rickettsia canadensis]]'' || || ||
|-
! colspan=4 | 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==
* ''R. prowazekii'': causes [epidemic typhus](Epidemic typhus (R. prowazekii).md), transmitted by the body louse
===Spotted Fever Group===
* ''R. typhi'': causes [murine/endemic typhus](Murine typhus (R. typhi).md), transmitted by rat/cat fleas
* [[Is treated by::Doxycycline]] 100 mg po bid for 7 to 10 days

** Alternatively: [[tetracycline]] 2 g/day or [[chloramphenicol]] 2 g/d
== Spotted Fever Group ==
** Alternatively: [[ciprofloxacin]] 750 mg po bid for 5 to 7 days

* ''R. rickettsii'': causes [Rocky Mountain spotted fever (RMSF)](Rocky Mountain spotted fever (RMSF) (R. rickettsii).md)
* ''R. parkeri'': carried by ''A. maculatum'' in the southern US and ''A. triste'' in Uruguay, Brazil, and Argentina
* ''R. conorii'': causes [boutonneuse fever](Boutonneuse fever (R. conorii).md)
* ''R. japonica'': causes oriental spotter fever
* ''R. heilongiangensis'': causes Far Eastern spotted fever in eastern Russia, Thailand, and China
* ''R. africae'': causes [African tick bite fever](African tick-bite fever (ATBF) (R. africae).md)
* ''R. slovaca'': causes tick-borne lymphadenopathy (TIBOLA)
** Transmitted by ''Dermacentor marginatus'' ticks

=== Transitional Group ===

* ''R. akari'': causes [rickettsialpox](Rickettsialpox (R. akari).md), transmitted by the house mouse mite, ''Liponyssoides sanguineus''
* ''R. australis'': causes North Queensland tick typhus
* ''R. felis'': causes flea-borne spotted fever
** Cats are host to the flea vector ''Ctenocephalides felis'', which has worldwide distribution
** Fevers with headache, myalgia, maculopapular rash, neurologic involvement, vomiting, abdo pain, resp involvement

=== Management ===

* 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
*** But no good evidence for this
* 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
* May use azithromycin or clarithromycin in pregnant women
* May use [[azithromycin]] or [[clarithromyci]]n in pregnant women
* ''Avoid'' Septra, which appears to ''worsen'' severity of disease!
* ''Avoid'' [[TMP-SMX]], which appears to ''worsen'' severity of disease!

== Ancestral Group ==

* ''Rickettsia bellii''
* ''Rickettsia canadensis''


== Other Rickettsiae ==


{{DISPLAYTITLE:''Rickettsia''}}
* ''Orientia tsutsugamushi'': causes [scrub typhus](Scrub typhus (O. tsutsugamushi).md), transmitted by chiggers
[[Category:Rickettsioses]]
* ''Ehrlichia'': transmitted by ticks
* ''Anaplasma'': transmitted by ticks
* ''Neorickettsia'': transmitted by helminths
* ''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

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