One lesion on the posterior aspect of his left arm (Figure 1, panel B) was suspected to be an eschar, raising the possibility of
rickettsialpox. The patient was therefore hospitalized and administered oral doxycycline.
Serologies were ordered for leptospirosis,
rickettsialpox, hepatitis, syphilis, Zika virus, Chikungunya, Epstein-Barr virus, cytomegalovirus, toxoplasmosis, and human immunodeficiency virus (HIV).
Focusing on Rickettsia bacteria, carried by chiggers, ticks, fleas and lice, which causes diseases in humans such as typhus,
rickettsialpox, Boutonneuse fever, African tick bite fever, Rocky Mountain spotted fever, Flinders Island spotted fever and Queensland tick typhus ( Australian tick typhus), the ministry has launched guidelines for the diagnosis and treatment of Rickettsial diseases.
It was misdiagnosed as mite-transmitted
rickettsialpox and treated successfully with doxycycline.
Rickettsioses may cause relatively mild disease (
rickettsialpox, cat scratch disease, and African tick-bite fever) or they may cause severe disease (epidemic typhus, RMSF, and Oroya fever).
Subsequent workup, which included complement fixation testing, excluded American Q fever, Rocky Mountain Spotted fever,
rickettsialpox, Colorado Tick fever, lymphocytic choriomeningitis, and mumps.
Rodents and their fleas are carriers of a variety of serious illnesses, including leptospirosis, lymphocytic choriomeningitis (LCMV), hantavirus pulmonary syndrome (HPS), murine typhus, rat-bite fever,
rickettsialpox, and salmonellosis.
Only biting larvae of Asian scrub typhus chiggers (Leptotrombidium species) transmit scrub typhus caused by Orientia tsutsugamushi (formerly Rickettsia tsutsugamushi); and only biting house-mouse mites (Liponyssoides sanguineus) transmit
rickettsialpox caused by Rickettsia akari.
* Liponyssoides sanguineus can transmit Rickettsia kauri (human
rickettsialpox) Trombiculidae * Dermatitis and allergic Also known as chiggers, reactions are possible.