Orientia tsutsugamushi: Difference between revisions

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Orientia tsutsugamushi
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* Chigger-borne rickettsial infection caused by the intracellular Gram-negative bacterium ''Orientia tsutsugamushi'' that causes '''scrub typhus'''
* Chigger-borne rickettsial infection caused by the intracellular Gram-negative bacterium ''Orientia tsutsugamushi'' that causes '''scrub typhus'''


= Life Cycle =
== Life Cycle ==


* Transmitted within mites (chiggers) transovarially
* Transmitted within mites (chiggers) transovarially


= Epidemiology =
== Epidemiology ==


* Most common in rural Asia and western Australia, as well as other parts of eastern Asia, including Russia and India
* Most common in rural Asia and western Australia, as well as other parts of eastern Asia, including Russia and India


= Clinical Presentation =
== Clinical Presentation ==


* Fever, headache, myalgia, lymphadenopathy, and an eschar
* Fever, headache, myalgia, lymphadenopathy, and an eschar
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* Infection also decreases HIV viral load and can lead to immune reconstitution
* Infection also decreases HIV viral load and can lead to immune reconstitution


= Diagnosis =
== Diagnosis ==


* Four-fold rise in immunofluorescence serology
* Four-fold rise in immunofluorescence serology
* PCR on eschar, blood, or lymph node biopsy
* PCR on eschar, blood, or lymph node biopsy


= Management =
== Management ==


* [[Doxycycline]] 100 mg po bid for 7 days
* [[Doxycycline]] 100 mg po bid for 7 days

Revision as of 20:15, 15 August 2019

  • Chigger-borne rickettsial infection caused by the intracellular Gram-negative bacterium Orientia tsutsugamushi that causes scrub typhus

Life Cycle

  • Transmitted within mites (chiggers) transovarially

Epidemiology

  • Most common in rural Asia and western Australia, as well as other parts of eastern Asia, including Russia and India

Clinical Presentation

  • Fever, headache, myalgia, lymphadenopathy, and an eschar
    • Lymphadenopathy sometimes grouped near the eschar
    • Should almost always be able to find the eschar if you look hard enough
  • Transient pale macular rash
  • May have cough
  • May have mental status changes and hepatosplenomegaly
  • In severe cases, may progress to multiorgan failure and hemorrhage
  • After treatment, may relapse
  • Infection also decreases HIV viral load and can lead to immune reconstitution

Diagnosis

  • Four-fold rise in immunofluorescence serology
  • PCR on eschar, blood, or lymph node biopsy

Management