Rickettsia typhi Domina Petric MD Etiology Rickettsia typhi

Rickettsia typhi Domina Petric, MD

Etiology • Rickettsia typhi is obligate intracellular parasite. • Transmission vector is rat flea. • Disease is called murine typhus (endemic typhus).

Patology This bacteria affects endotel cells of small blood vessels: focal lymphohistiocytic vasculitis.

Clinical presentation • Incubation period: 7 to 14 days (usually 12 days). • Abrupt onset: high temperature, headache, shivering, nausea, myalgias. • Symptoms can progress to vomit and anorexia.

Clinical presentation Rash can occur immediately or after few days from the first symptoms: • maculopapular rash (78%) • petechiae (10%) • on the trunk mostly

Clinical presentation • Disease is usually mild, but in 4% of the patients there can be severe form (treatment in ICU). • Rare clinical presentations: affection of CNS, renal, hepatal and respiratory insufficiency, hematemesis.

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Laboratory findings • leukopenia and thrombocytopenia during first week of the disease • leukocytosis later on • ALT, AST, LDH, ALP levels are elevated • PV can be low • hypoproteinemia, hyponatremia, hypocalcemia • pleocytosis in CSF

Treatment • Doxycycline 100 mg twice a day per os. • Treatment duration: 48 to 72 hours after body temperature drops.

Literature • www. bestonlinemd. com • Begovac J. Božinović D. Lisić M. Baršić B. Schönwald S. Infectology, Profil.