Rickettsiosis

Last Updated: 2023-07-07

Author(s): Anzengruber F., Navarini A.

ICD11: -

  • Diseases caused by rickettsial infections
  • Rickettsiae are pleomorphic, bacteria-like cocci
  • Transmission occurs through ticks, mites, lice and fleas. The pathogens can also be found in animal faeces
  • Incubation period: 1-2 weeks
  • Initially, there may be a primary lesion (eschar) and concomitant lymphadenitis
  • Locoregional lymph node adenopathy
  • Febrile temperatures
  • Maculopapular exanthema
  • Myalgias and arthralgias
  • Thromboses and also petechiae
  • Anamnesis
  • Clinic
  • Lice infestation
  • BB (leucopenia, eosinophilia), liver and kidney values, electrolytes
  • Serology (takes 2 weeks- start therapy ex juvantibus)
  • From the 2nd week of illness Weil-Felix reaction (agglutination test)
  • From the 3rd week of illness Complement fixation reaction
  • From the 3rd week of illness indirect immunofluorescence test
  • Gastrointestinal bleeding
  • Nephritis
  • Encephalitis
  • Gangrene
  • Myocarditis
  • Hemorrhages
  • Intensive medical care
    • if necessary
  • Topical therapy
    • Lindane gel 0.3%. Use not recommended due to neurotoxicological side effects. Lindane is no longer on the market in Switzerland and the EU.
    • Permethrin 1% (reapply after 1 and 2 weeks)
    • Permethrin 5%
    • Malathion shampoo (reapply after 1 and 2 weeks)
    • Dimeticon spray, exposure time: 15 min., repeat after 7 days if necessary
    • Lausweg® foam solution, exposure time: 15 min. , repeat after 7 and 14 days
    • Rausch Laus stop® cream, contact time: 20 min., repeat after 7 and 14 days.
  • Systemic therapy
    • Doxycycline p.o. 100 mg 2x tgl. for 8-10 days.
    • Alternatively: Ciprofloxacin p.o 500 mg 2x tgl.
    • In severe cases, if necessary, i.v. glucocorticoids 100 mg/d for 2-3 days.
  • Dresses and bed linen should be washed at a minimum of 60°C as part of the sanitation process. Alternatively, these can be placed in airtight plastic bags for 3 days
  • A check of all family members with a lice comb should be done 2 times a week
  • Cutting the hair is not effective, as even 5 mm long hairs are sufficient to give nits a hold

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