(Scrub typhus; mite-induced fever; tropical fever)
Busch fever is transmitted by ticks and Orientia tsutsugamushi (formerly Rickettsia tsutsugamushi) induced disease. The symptoms consist of fever, a primary lesion, a macular rash and lymphadenopathy.
Scrub typhus is related to Rickettsioses.
Busch fever is transmitted by ticks and Orientia tsutsugamushi (formerly Rickettsia tsutsugamushi) induced disease. The symptoms consist of fever, a primary lesion, a macular rash and lymphadenopathy. Scrub typhus is related to Rickettsioses. O. tsutsugamushi is transmitted by Trombiculidae -Milben that feed on rodents of the forest and rural areas, including rats, voles and field mice. An infection of humans occurs after the bite of a mite larva ( “Chigger”). Symptoms and complaints After an incubation period of 6-21 days (10-12 days), there is a sudden fever, chills, headache and generalized lymphadenopathy. With the beginning of the fever is often a scabby crust at the site of the mite larvae bite developed. The typical lesion is more common in Caucasians than in Asians and starts with a red, indurated lesion of about 1 cm in diameter, eventually forming bubbles ruptured and is covered by a black crust. This leads to an increase in the regional lymph nodes. The fever increases during the first week, often at 40 to 40.5 ° C. There are often severe headaches, as a conjunctival injection. During the 5th-8th Fever Tags macular rash that often spreads to the arms and legs develops on the trunk. It can quickly disappear or be colored maculopapular and intense. During the first week of the fever patient coughs, and during the second week of illness pneumonitis may develop. In severe cases, the pulse rate increases; the blood pressure drops and there is delirium, stupor and muscle twitching. Splenomegaly may occur, and an interstitial myocarditis is more common than other rickettsial infections. In the absence of therapy for ? 2 weeks high fever can be made, which then falls slowly over several days. Under therapy, defervescence usually begins within 36 hours. The recovery is done promptly and without special events. Diagnosis Clinical symptoms biopsy of skin rash with fluorescent antibody staining, Acute to recognize the pathogen and current serological tests (serological tests are not acutely sense) PCR Details diagnosis, overview of Rickettsia infections: diagnosis. Doxycycline therapy The primary therapy is carried out with doxycycline 200 mg p.o. 1 times a day, followed by 100 mg 2 times daily until clinical improvement occurs, the patient 48 h is afebrile and at least 7 days has received therapy. Means of the second choice is Chloramphenicol 500 mg p.o. or iv 4 times daily for 7 days. Elimination or reduction of mite populations bushes should be reduced and affected areas with insecticide treated. In a likely exposure repellents (z. B. diethyltoluamide [DEET]) should be applied.