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.