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Similarities of all Rickettsiae
1) Gram negative aerobic bacilli with weak LPS activity
2) Phospholipase A to escape phagosomes
3) Predilection for endothelial cells-pathogenesis due to endothelial damage
4) Obligate intracellular organisms
5) Diagnosis involves pt history, symptoms and serology.
6) Doxycycline is DOC
R. rickettsii

Clinical disease and manifestations
1)Rocky mountain spotted fever
2) High fever, severe headache, rash spreading centripetally
R. rickettsii

Location
SE Atlantic states and South central states
R. rickettsii

Reservoir and vector
R- East-Dog tick, West-Wood tick
V-same
R. rickettsii

Key info
Most common in ages 5-9
Transovarial transmission in vector
R. rickettsii

Mortality Rate
2-5% of Treated
20-40% untreated
R akari

Clinical disease and manifestations
1) Rickettsial pox
2) Rash resembles chicken pox, eschar formation at bite site, fever severe headache
R. akari

Location
Worldwide
NE United States
R. akari

Reservoir and Vector
R- House mouse and mouse mite
V-Mouse mite
R. akari

Key Info
1) Transovarial transmission in vector
2) Self limiting disease without treatment
R. akari

Mortality
0%
R. Prowazekii

Clinical disease and manifestations
1) Epidemic or louse borne typhus
2) High fever, severe headache, rash spreading centrifugally sparing face, palms and soles;
3)Brill-zisser disease- reccurent
R. Prowazekii

Location
Worldwide
Areas of crowding
Poor sanitation
R. Prowazekii

Reservoir and Vector
R-Humans
V-Human body louse
R. Prowazekii

Key information
Transmission louse feces in wound
Vaccine available
R. Prowazekii

Mortality
Untreated: 10% young, >50 years old 60-70%
R Typhi

Disease and manifestations
1) Endemic or murine typhus
2) Similar to epidemic typhus but milder symptoms, shorter course
R Typhi

Location
Worldwide in humid areas
Urban cities/ports in US
R Typhi

Reservoir and vector
R- Rat
V- Rat Flea
R Typhi

Mortality
<1%
O. tsutsugamushi

Disease and manifestations
1) Scrub typhus
2) Eschar formation at site of bite, high fever, severe headache, rash spreading centrifugally
O. tsutsugamushi

Location
World wide but most cases in East Asia/ Pacific islands, Few US cases reported
O. tsutsugamushi

Reservoir and vector
R- Rodents and mites
V-Chigger
O. tsutsugamushi

Key info
1) Transovarial transmission in vector
2) Oftgen self limited but can be fatal if not treated
O. tsutsugamushi

Mortality rate
~7% untreated;
None with treatment