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Rickettsia – obligate intracellular parasites, they belong more to bacteria.

Typhoid fever (typhus exanthemicus)[edit | edit source]

  • originator: Rickettsia prowazekii (described by prof. Prowazek, a Czech-borne)
  • symptoms: high fever, headaches and maculopapular rash
  • if the patient is reinfected, the symptoms are less sever – Brill-Zinsser disease
  • source: Blood of the infected person
  • transmission: body louse, mostly through it's bites, which itch; rickettsia are in their feces, penetrate bites or through excoriations; it can also be infected by inhaling dust with this dung
  • incubation period: 10–14 days

Patogenesis[edit | edit source]

Clinical picture[edit | edit source]

  • sudden fever, chills and severe headaches
  • tachycardia, hypotension, hearing loss, sphotophobia and dry cough
  • pharyngitis and meningeal syndrome
  • 4.–7. day the exanthema occurs, which may disappear, but more often hemorrhages, resulting in dark brown buds (first on the chest, omitting the face, palms and soles)
  • after the appearance of the rash, deterioration occurs - stupor, delirium (the patient doesn't want to lie down and often tries to escape from his bed), urinary and stool incontinence
  • 9.–19. day may end in death, otherwise the condition will improve within 14 days
  • KO: leukopenia, aneozinophilia
Typical typhoid rash

Complications[edit | edit source]

Diagnosis[edit | edit source]

  • epidemiological situation + clinical picture + Ig
  • immunity remains after infection, but the infection often persists latently in humans and later manifests itself as Brill-Zinsser disease if the patient is weakened

Prognosis[edit | edit source]

  • before the era of ATB mortality was 20–40% (high mortality was, for example, after the outbreak of the epidemic in the Terezín concentration camp[1]), with a timely administration of ATB the mortality radically fell to 1 %
  • cured does not leave consequences, in children the course is milder

Therapy[edit | edit source]

Rattle (endemic typhus)[edit | edit source]

  • originator: Rickettsia typhi
  • reservoir: rats
  • transmission: flea
  • typically an illness of people employed in warehouses and ports

Clinical course[edit | edit source]

Rocky mountain spotted fever[edit | edit source]

  • originator: Rickettsia rickettsii
  • reservoir: vertebrates
  • carrier: Tick
  • 4–8 days after tick bite, general symptoms are visible, maculopapular efflorescence on the wrists is aparent
  • the course is often severe, vascular system involvement, lethality 5%

African tick fever[edit | edit source]

  • in the Mediterranean
  • originator: Rickettsia conori
  • transmission: ticks parasitizing on dogs (often a black spot at the site of the tick's bite)

Rickettsian smallpox[edit | edit source]

A: Normal chest X-ray, B: Q fever caused atypical pneumonia
  • pathogenic agent: Rickettsia akari
  • transmission: mites
  • sources: rodents
  • general symptoms with maculopapular rash

Q fever[edit | edit source]

  • originator: Coxiella burnetii (original name Rickettsia burneti); when it was discovered, its originator was not known, so Q (query)
  • acute febrile illness, sudden onset, headaches, atypical pneumonia
  • sources: rodents, birds
  • transmission: Ticks, to another animal (sheep, goats); sick animals have rickettsiae in milk, urine, airway secretion; transmission to humans takes place either through direct contact with animals or during the processing of products from infected animals

Clinical picture[edit | edit source]

  • sudden onset with a fever and headaches
  • fifth day: dry cough, chest pain , physical findings mostly inconclusive; atypical pneumonia perihiliously visible on X -ray (can also resemble carcinoma in older patients)
  • for further details: Q fever

Summary video[edit | edit source]

Links[edit | edit source]

Related articles[edit | edit source]

References[edit | edit source]

  1. ČESKÁ TELEVIZE,. V Terezíně se umíralo i po osvobození – nacisty vystřídal tyfus [online]. [cit. 2018-03-13]. <https://ct24.ceskatelevize.cz/domaci/1526936-v-terezine-se-umiralo-i-po-osvobozeni-nacisty-vystridal-tyfus>.

Sources[edit | edit source]

Used literature[edit | edit source]

  • HAVLÍK, Jiří, et al. Infektologie. 2. edition. Praha : Avicenum, 1990. 393 pp. ISBN 80-201-0062-8.
  • LOBOVSKÁ, Alena. Infekční nemoci. 1. edition. Praha : Karolinum, 2001. vol. 263. ISBN 80-246-0116-8.

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