View source for Rickettsia conorii

* A tickborne rickettsial species that causes '''boutonneuse fever''', the most severe form of rickettsial spotted fever next to [[Rocky Mountain spotted fever]]
* Also known as Marseilles fever, Mediterranean spotted fever, Kenya tick typhus, Israeli tick typhus, Astrakhan spotted fever, and Indian tick typhus

== Background ==
=== Microbiology ===
* Species of ''[[Rickettsia]]'' within the spotted fever group

=== Life Cycle ===
* Maintained transovarially within the tick species

=== Epidemiology ===
* Transmitted by ''[[Rhipicephalus sanguineus]]'' ticks
* Founds in India, Pakistan, Israel, Russia, Georgia, Bulgaria, Turkey, Ukraine, Ethiopia, Kenya, South Africa, Morocco, and southern Europe
* More cases occur during the warm months (July through September in the Mediterranean)

== Clinical Manifestations ==
* Incubation period of [[Usual incubation period::7 days]]
* Initial symptoms include fever, myalgias, and headache
* Often has an eschar at the site of tick bit inoculation ('''"tache noir"'''), but not always
* Petechial rash, GI symptoms, obtundation, tachypnea, hepatomegaly, leukocytosis, coagulopathy, AKI, bilirubin elevation, AST elevation, and CK elevation
* Procoagulant, and 10% develop DVT
* Can present as acute pancreatitis
* Can be quite severe with higher mortality than others in the spotted fever group

== Management ==
* First-line: [[Is treated by::doxycycline]] 100 mg po bid for 7 days (at least 5-7 days and resolution of symptoms for 3 days)
** May be able to shorten to a single day of two doses of 200 mg each in one small study
** Could use [[Is treated by::minocycline]]
* [[Is treated by::Ciprofloxacin]] is associated with a more severe course and should be avoided
* [[Is treated by::Azithromycin]] or [[Is treated by::clarithromycin]] may be considered in pregnant women or children

{{DISPLAYTITLE:''Rickettsia conorii''}}
[[Category:Rickettsioses]]