Last Updated: 2019-08-26
Kedami-Fieber, japanisches Flussfieber, river fever, Scrub typhus.
Rickettsiosis caused by R. tsutsugamushi.
Especially in Asia, Pacific Islands and Australia.
- Causative organism
- Rickettsia tsutsugamushi.
- R. tsutsugamuschi is transmitted by mites.
- Axils, trunk, groins, thighs.
- The primary lesion (eschar) is characterized by an erythematous papulovesicle, which can ulcerate.
- Locoregional lymph node adenopathy.
- Maculopapular exanthema (from the 6th-10th day of illness), enanthema.
- Travel history.
- Lice infestation.
- Blood count (leukopenia, eosinophilia, thrombopenia, ESR ↑), liver and kidney values (Transaminasen↑).
- From the 2nd week of disease Weil-Felix reaction (agglutination test).
- Complement fixation reaction from the 3rd week of the disease.
- Indirect immunofluorescence test after the 3rd week of the disease.
- Atypical pneumonia.
- Disseminated intravascular coagulation.
- If necessary, intensive care measures and transfer to the intensive care unit.
- Control of vital parameters, fluid balance, electrolytes and protein replacement.
- Loxazole solder. 1% (reapply after 1 and 2 weeks).
- Permethrin 5% in e.g.: Excipial U Lipolotio.
- Prioderm® Shampoo (use again after 1 and 2 weeks).
- Paranix® Sprax (Dimeticon), application time: 15 min., possibly repeated after 7 days
- Lausweg® foam solution, reaction time: 15 min. Repeat after 7 and 14 days.
- Rausch Laus stop® cream, application time: 20 min., repeated after 7 and 14 days.
- Doxycycline p.o. 100 mg 2x daily for 8-10 days.
- Alternative: Ciprofloxacin p.o 500 mg 2x daily.
- In pronounced cases, intravenously glucocorticoids 100 mg/d for 2-3 days.
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