Rickettsia species

Typhus Group

R. prowazekii: causes [epidemic typhus](Epidemic typhus (R. prowazekii).md), transmitted by the body louse
R. typhi: causes [murine/endemic typhus](Murine typhus (R. typhi).md), transmitted by rat/cat fleas

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

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

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 Septra, which appears to worsen severity of disease!

Orientia tsutsugamushi: causes [scrub typhus](Scrub typhus (O. tsutsugamushi).md), transmitted by chiggers
Ehrlichia: transmitted by ticks
Anaplasma: transmitted by ticks
Neorickettsia: transmitted by helminths
Wolbachia: transmitted by helminths and arthropods