Rickettsiosis

Borrelia burgdorferi, the cause of Lyme disease, is just one of many harmful bacteria that ticks can transmit. A tick bite can also cause rickettsiosis. This is a nasty infection caused by a bacterium from the Rickettsia group. Examples of such infections are spotted typhus and Q fever. Reason enough to wear tick-repellent clothing when going for a nature walk. Below you will find more information about Ricketssia bacteria and the diseases they can cause.

What are Rickettsia bacteria?

Rickettsia is the collective name for a group of bacteria that can only live in the cells of another organism. In order to multiply, these bacteria also need the cells of a host. For some Rickettsia, humans are the most important host. However, most Rickettsia parasitize animals. Rickettsia are transmitted from these animals to humans via, among other things, the bites of ticks, mites, fleas, lice and rats (the so-called vectors).

Each Rickettsia bacterium has its own host and its own vector. This also applies to Ehrlichia, a group of bacteria that closely resemble Rickettsia and cause similar diseases.

Examples of specific Rickettsia bacteria include:

Rickettsia Felis
Rickettsia Japonica
Rickettsia Akari
Rickettsia Africae
Rickettsia Australis
Rickettsia Burnetii
Rickettsia Quintana
Rickettsia Massilae.

What is Rickettsiosis?

Rickettsiosis is an infection by a Rickettsia bacterium. The term stands for all diseases that such an infection can cause, regardless of which Rickettsia bacterium it is. The following diseases are examples of Rickettsiosis:

(epidemic) spotted typhus
Rocky Mountain spotted fever
Brill-Zinsser
Fievre Boutonneuse.

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What are the symptoms of Rickettsiosis?

In humans, Rickettsia bacteria infect the cells lining the small blood vessels. These blood vessels become blocked or inflamed. They can also bleed. The blood then leaks into the surrounding tissue. The location of the infection in the body determines the symptoms.

All Rickettsia infections initially have the following characteristic symptoms:

fever
severe headache
skin rash
feeling sick.
Later on the following symptoms may also occur:

confusion
coughing
breathing problems
vomiting
diarrhea
In some patients, the spleen or liver becomes enlarged, the kidneys stop working and the blood pressure drops dangerously. If Rickettsiosis is not detected and/or treated in time, it can be fatal.

How is Rickettsiosis diagnosed?

The first symptoms of Rickettsiosis resemble those of the flu. In order to determine whether there is more going on than a harmless viral infection such as the flu, it is important to check whether the patient has been bitten by a vector of a Rickettsia bacterium. Such as a tick, mite or flea. Such a bite can be an indication of a Rickettsia infection, especially in areas where this infection is common. Unfortunately, most people cannot remember a bite. If the patient gets a rash, this is also an indication of Rickettsiosis.

There is (as yet) no laboratory test that can quickly and unambiguously identify a Rickettsia bacterium in the blood. The patient cannot wait for long-term (blood) examination. Treatment cannot be delayed and must therefore be based on a suspected diagnosis of Rickettsiosis.

How is Rickettsiosis treated?

Rickettsia is an obligate intracellular bacterium. This means that it hides in the cells of its host. This makes it difficult for our immune system to reach and fight the bacterium. For the same reason, not all antibiotics work for Rickettsiosis.

Rickettsiosis is best treated early with one of the following three antibiotics:

tetracycline
doxycycline
chloramphenicol
These antibiotics can be taken orally. If the patient is so ill that oral administration is not possible, these drugs can be given intravenously.

After treatment with one of these antibiotics, the patient will feel better very quickly and the fever will disappear within three days. The course of antibiotics will last for at least a week and longer if the fever persists. The later treatment is started, the slower the improvement will occur and the longer the fever will persist.

Failure to start treatment or starting it too late can have fatal consequences for a patient with rickettsiosis.

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