Rickettsia prowazekii: Difference between revisions

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

@@ Line 1: / Line 1: @@
+==Background==
 * Cause of '''epidemic typhus'''
-==Background==
 ===Microbiology===
-* One of the [[Rickettsiae]]
+*One of the [[Rickettsiae]]
 ===Life Cycle===
-* Adult louse becomes infected when feeding on a rickettsemic patient
+*Adult louse becomes infected when feeding on a rickettsemic patient
-* The louse poops on another person
+*The louse poops on another person
-* The person scratches their skin or touches their mucous membrane, innoculating themselves with louse feces
+*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''
+*Carried by the human body louse, ''Pediculus humanus corporis''
-* Outbreaks are associated with poverty, refugee camps, jails, and cold climate
+*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
+*The only non-human reservoir is the flying squirrel (''Glaucomys volans'') in the US
-* Previously-infected patients may still have latent infection
+*Previously-infected patients may still have latent infection
-==Clinical Presentation==
+==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
+*High fever, severe headache, myalgia, non-producive cough, delirium
-* Dull, red rash starting on the trunk and spreading peripherally
+*Dull, red rash starting on the trunk and spreading peripherally
-** Spares palms and soles
+**Spares palms and soles
-** Rash not always present
+**Rash not always present
-* Delirium, hemorrhagic rash
+*Delirium, hemorrhagic rash
-* In its severe form, can progress to pulmonary edema, encephalitis, shock, and death
+*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
+*Reactivation or recrudescence of dormant typhus years after the initial infection
-* Often in the context of malnutrition, chronic illness, and poor hygeine
+*Often in the context of malnutrition, chronic illness, and poor hygeine
-* Rash may be evanescent or absent, and resolves faster
+*Rash may be evanescent or absent, and resolves faster
 ==Diagnosis==
-* Four-fold rise in indirect immunofluorescence assay for IgG
+*Four-fold rise in indirect immunofluorescence assay for IgG
-* PCR may be useful during acute illness
+*PCR may be useful during acute illness
 ==Management==
-* Need to treat even without confirmed diagnosis
+*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
+*Wash clothing to prevent outbreaks
 {{DISPLAYTITLE:''Rickettsia prowazekii''}}