Table
3–17. Epidemiologic features, symptoms, and treatment of rickettsial
diseases
Typhus fevers |
Epidemic typhus |
Rickettsia prowazekii
|
Headache, chills, fever, prostration,
confusion, photophobia, vomiting, rash (generally starting
on trunk) |
Human body louse |
Humans, Eastern flying squirrels
(US) |
Cool mountainous regions of Africa,
Asia, and Central and South America |
Doxycycline (continue until patient
afebrile for >72 hours) |
Murine typhus |
R. typhi |
As above, generally less severe
|
Rat flea |
Rats, mice |
Worldwide |
As above |
Spotted fevers‡ |
Rocky Mountain spotted
fever |
R. rickettsii |
Headache, fever, abdominal
pain, rash (generally starting on extremities) |
Tick |
Rodents |
North, Central, and
South America |
As above |
Mediterranean spotted fever§
|
R. conorii |
Fever, eschar, regional adenopathy,
rash on extremities |
Tick |
Rodents |
Africa, India, Europe, Middle
East, Mediterranean |
As above |
African tick-bite fever |
R. africae |
Fever, eschar(s), regional adenopathy,
rash subtle or absent |
Tick |
Rodents |
Sub-Saharan Africa |
As above |
Queensland tick typhus |
R. australis |
Fever, eschar, regional adenopathy,
rash on extremities |
Tick |
Rodents |
Australia, Tasmania |
As above |
North Asian tick fever |
R. sibirica |
As above |
Tick |
Rodents |
Russia, China, Mongolia |
As above |
Oriental spotted fever |
R. japonica |
As above |
Tick |
Rodents |
Japan |
As above |
Rickettsialpox |
R. akari |
Fever, eschar, adenopathy, disseminated
vesicular rash |
Mite |
House mice |
Russia, South Africa, Korea |
As above |
Cat flea typhus |
R. felis |
As above, generally less severe
|
Cat flea |
Domestic cats, opossums |
Europe, South America |
As above |
Orientia |
Scrub typhus |
Orientia tsutsugamushi |
Fever, headache, sweating, conjunctival
injection, adenopathy, eschar, rash (starting on trunk),
respiratory distress |
Mite |
Rodents |
Central, Eastern, and Southeast
Asia |
As above, but if treatment begins
early, a second cycle of treatment may be necessary |
Q Fever |
Q fever |
Coxiella burnetii |
Fever, headache, chills, sweating,
pneumonia, hepatitis, endocarditis |
Most human infections are acquired
by inhalation of infectious aerosols |
Goats, sheep, cattle, domestic
cats, other |
Worldwide |
Doxycycline, 2–3 weeks
for acute illness |
Bartonellosis
|
Cat-scratch disease |
Bartonella henselae
|
Fever, adenopathy, neuroretinitis,
encephalitis |
Cat flea (zoonotic) |
Domestic cats |
Worldwide |
Rifampin, erythromycin, doxycycline,
azithromycin |
Trench fever |
B. quintana |
Fever, headache, pain in the
shins, splenomegaly, disseminated rash |
Human body louse |
Humans |
Worldwide |
Doxycycline, 2–4 weeks
for acute illness |
Oroya fever/ Verruga peruana
|
B. bacilliformis |
Fever, headache, anemia, shifting
joint and muscle pain, nodular dermal eruption |
Sand fly |
Unknown |
Peru, Ecuador, Colombia |
Chloramphenicol, penicillin,
doxycycline |
Ehrlichiosis
|
Ehrlichosis |
Ehrlichia chaffeensis#
Anaplasma phagacytophilum# |
Fever, headache, nausea, occasionally
rash |
Tick |
Various large and small mammals,
including deer and rodents |
Worldwide |
Doxycycline (continue until patient
afebrile for >48 hours) |
Sennetsu fever |
Neorickettsia sennetsu
|
Fever, chills, headache, sore
throat, insomnia |
Unknown |
Unknown |
Japan, Malaysia |
As above |
|
|