When Should We Consider A Rickettsial Disease?
Discussion
Rickettsioses are “small, obligate intracellular, gram-negative, aerobic coccobacillary α-proeobacteria” from the genuses Rickettsia, Anaplasma, Coxiella, Ehrlichia, and Orientia genuses. Often they cause limited health problems but can cause severe disease and death. They present with a fever and other non-specific signs and symptoms, usually with a rash and lymphadenopathy. Other problems can include:
Cardiac – endocarditis, myocarditis, pericarditis
Gastrointestinal – abdominal pain, acute abdomen, cholecystitis, hepatitis, pancreatitis
Heme/Lymph – hemophagocytosis, lymphangitis
Ocular – papilledema, retinitis, uveitis
Pulmonary problems including pneumonitis, Acute Respiratory Distress Syndrome
Renal – acute kidney injury
Laboratory testing can be very non-specific especially early in the disease process and points towards viral diseases (e.g. mild anemia, leucopenia, thrombocytosis, mildly elevated acute phase reactants and transaminases). Diagnosis can be made with indirect immunofluorescence antibody assays made after 7-15+ days of illnesses. Weil-Felix test is basically no longer used. Doxycycline is the drug of choice for most patients of any age including the pediatric age group.
Rickettsial disease are one of the more common causes of fever without a source or fever of unknown origin. The differential diagnosis for rickettsioses includes:
Drug allergy
Infectious mononucleosis**
Kawasaki disease**
Men...
Source: PediatricEducation.org - Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
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