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What is Rickettsial Disease?

By D. Jeffress
Updated May 17, 2024
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Rickettsial disease can refer to one of many different illnesses that is caused by a bacteria-like parasite from the Rickettsia genus. The parasites are carried by ticks, lice, fleas, and other insect hosts, and passed on to humans through direct exposure. Symptoms depend on the type of infection, but most cases of rickettsial disease result in skin rashes, headaches, and fever. Doctors can usually treat infection with oral antibiotics and topical skin rash creams. A serious or untreated case of rickettsial disease can be fatal.

Doctors recognize three main categories of rickettsial disease based on the particular species of parasite involved and the resulting symptoms. Microbes in the typhus group, which are usually carried by lice and fleas, typically cause a mild skin rash on the torso about four days after infection. The rash is painless at first, but usually becomes itchy and painful as it spreads to the arms and legs. The typhus variety of rickettsial disease is rarely life-threatening, though it still needs to be evaluated and treated by a doctor.

Rickettsia microbes in the spotted fever category typically cause more severe symptoms. Infected ticks and mites can transfer microbes to human hosts, resulting in painful rashes that spread from the bite locations. A person is likely to experience fever, chills, muscle pain, and headaches that get worse over the course of about a week. Diarrhea, nausea, and vomiting may also occur as microbes spread from the skin to the gastrointestinal tract.

The third category of microbes, the scrub typhus group, is generally isolated to regions of Southeast Asia and the Middle East. Symptoms can vary considerably, but most people experience widespread rashes, confusion, and headaches. Scrub typhus microbes may spread to the lungs, kidneys, or brain, leading to potentially life-threatening inflammation and organ damage.

An individual who experiences possible symptoms of rickettsial disease should be brought to a doctor's office or emergency room as soon as possible. Early diagnosis and treatment is essential to provide the best possible chances for recovery. Blood samples are taken and analyzed to check for the presence of specific natural antibodies, or chemicals released by the immune system to combat infection. Further testing can confirm the specific parasite responsible for symptoms.

Treatment for mild infections usually involves a course of antibiotics, anti-inflammatory drugs, and pain relievers. A patient may also be given a topical anti-itch cream to alleviate painful skin rashes. Severe symptoms typically require hospitalization and intravenous medications and fluids. Doctors carefully monitor a patient's condition over the course of several days to make sure the infection does not worsen. Heart and lung complications can be avoided in most cases with acute care, and most patients are able to make full recoveries within about a month.

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