Last Updated: 2019-08-26

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

ICD11: -

  • Diseases caused by Rickettsia infections. Rickettsia are pleomorphic, bacteria-like cocci.

  • Transmission occurs through ticks, mites, lice and fleas. The pathogens can also be found in animal excrement. 
  • Incubation period
    • 1-2 weeks.

  • Initially, a primary lesion (eschar) and accompanying lymphadenitis may occur.
  • Locoregional lymph nodeadenopathy.
  • Febrile temperatures.
  • Maculopapular exanthema.
  • Myalgia and arthralgia.
  • Thromboses and also petechiae.

  • Medical history
  • Clinic
  • Lice infestation.
  • Blood count (leukopenia, eosinophilia), liver and kidney values, electrolytes.
  • Serology (lasts 2 weeks - therapy starts ex juvantibus).
  • From the 2nd week of the disease Weil-Felix reaction (agglutination test).
  • From the 3rd week of the disease, complement fixation reaction.
  • Indirect immunofluorescence test from the 3rd week of the disease.

  • Gastrointestinal bleeding.
  • Nephritis.
  • Encephalitis.
  • Gangrene.
  • Myocarditis.
  • Hemorrhages.

  • If necessary, intensive medical care.
  • Topical therapy
    • Loxazole Lot. 1% (reapply after 1 and 2 weeks).
    • Permethrin 5% in e.g.: Excipial U Lipolotio.
    • Prioderm® Shampoo (reapply after 1 and 2 weeks).
    • Paranix® Sprax (Dimeticon), application time: 15 min., if necessary repeat after 7 days.
    • Lausweg® foam solution, contact time: 15 min. Repeat after 7 and 14 days.
    • Rausch Laus stop® cream, application time: 20 min., repeat after 7 and 14 days.
  • Systemic therapy
    • Doxycycline p.o. 100 mg 2x per day for 8-10 days.
    • Alternative: Ciprofloxacin p.o. 500 mg 2x per day.
    • In pronounced cases intravenously glucocorticoids 100 mg/d for 2-3 days if necessary.
  • Clothes and bed linen should be washed at at least 60°C during renovation. Alternatively, they can also be placed in airtight plastic bags for 3 days.
  • 2x a week a control of all family members with the lice comb should take place.

    A cutting of the hair is not goal-prominent, since already 5 mm long have sufficient around Nissen hold to give.