Tsutsugamushifieber

Kedami-Fieber, japanisches Flussfieber, river fever, Scrub typhus.

Rickettsiose, welche durch R. tsutsugamushi ausgelöst wird.

Insbesondere in Asien, Pazifikinseln und Australien vorkommend.

• Erreger
  • Rickettsia tsutsugamushi.
• R. tsutsugamuschi wird durch Milben übertragen.

• Lokalisationen
• Axillen, Stamm, Leisen, Oberschenkel.
• Die Primärläsion (Eschar) ist durch eine erythematöse Papulovesikel, welche ulzerieren kann gekennzeichnet.
• Lokoregionäre Lymphknotenadenopathie.
• Makulopapulöses Exanthem (ab dem 6.-10. Krankheitstag), Enantheme.

• Reiseanamnese.
• Klinik.
• Läusebefall.
• BB (Leukopenie, Eosinophilie, Thrombopenie, BSG ↑), Leber- und Nierenwerte (Transaminasen↑).
• Elektrolyte.
• Ab der 2. Krankheitswoche Weil-Felix-Reaktion (Agglutinationstest).
• Ab der 3. Krankheitswoche Komplementbindungsreaktion.
• Ab der 3. Krankheitswoche indirekter Immunfluoreszenztest.

• Atypische Pneumonien.
• Disseminierte intravaskuläre Koagulation.
• Myokarditis.

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