Rickettsia prowazekii: Difference between revisions

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Rickettsia prowazekii
m (Aidan moved page Epidemic typhus to Rickettsia prowazekii)
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* Cause of '''epidemic typhus'''
= Epidemic typhus (''R. prowazekii'') =
 
   
== Life Cycle ==
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= Life Cycle =
   
 
* Adult louse becomes infected when feeding on a rickettsemic patient
 
* Adult louse becomes infected when feeding on a rickettsemic patient
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* 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 ==
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= Epidemiology =
   
 
* Carried by the human body louse, ''Pediculus humanus corporis''
 
* Carried by the human body louse, ''Pediculus humanus corporis''
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* Previously-infected patients may still have latent infection
 
* Previously-infected patients may still have latent infection
   
== Clinical Presentation ==
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= Clinical Presentation =
   
 
* Incubation 1 to 2 weeks
 
* Incubation 1 to 2 weeks
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* 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) ===
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== 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
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* Rash may be evanescent or absent, and resolves faster
 
* Rash may be evanescent or absent, and resolves faster
   
== Diagnosis ==
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= 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 ==
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= Management =
   
 
* Need to treat even without confirmed diagnosis
 
* Need to treat even without confirmed diagnosis
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* Chloramphenicol is the alternative
 
* Chloramphenicol is the alternative
 
* Wash clothing to prevent outbreaks
 
* Wash clothing to prevent outbreaks
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{{DISPLAYTITLE:''Rickettsia prowazekii''}}
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[[Category:Rickettsioses]]

Revision as of 20:31, 14 August 2019

  • Cause of epidemic typhus

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 Presentation

  • Incubation 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