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| __NOTOC__ | | __NOTOC__ |
| {{Rocky Mountain spotted fever}} | | {{Rocky Mountain spotted fever}} |
| {{Siren|Rocky Mountain Spotted Fever}}
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| {{CMG}}; {{AE}} {{IMD}} | | {{CMG}}; {{AE}} {{IMD}} |
| ==Overview== | | ==Overview== |
| ''Rocky Mountain Spotted Fever'' infection may be classified based on the organism causing the disease. The bacterial family of Rickettsiaceae hosts the genus rickettsia, a genus of organisms responsible for thyphus fevers. The rickettsia organism causing infection dictates the choice of [[Rocky Mountain Spotted Fever infection medical therapy|antimicrobial therapy]]. Rocky Mountain Spotted Fever is caused by R. rickettsii.
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| ==Classification== | | ==Classification== |
| Shown below is a table that classifies ''Rocky Mountain Spotted Fever'' infection based on the specific rickettsia organism responsible for infection. The classification of the organism responsible for infection dictates the choice of antimicrobial therapy.
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| {| style="font-size: 85%;"
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| ! style="width: 80px; background: #4479BA; text-align: center;" |{{fontcolor|#FFF|Disease}}
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| ! style="width: 720px; background: #4479BA; text-align: center;" | {{fontcolor|#FFF|Organism}}
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| ! style="width: 720px; background: #4479BA; text-align: center;" | {{fontcolor|#FFF|Vector}}
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| ! style="width: 720px; background: #4479BA; text-align: center;" | {{fontcolor|#FFF|Endemic Regions}}
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| | style="background: #F5F5F5; padding: 5px; text-align: center;" | '''[[Rocky Mountain Spotted Fever]]''' <ref name="RMSF CDC”> Rocky Mountain Spotted Fever Information. Centers for Disease Control and Prevention (2015). http://www.cdc.gov/rmsf/ Accessed on December 30, 2015</ref>
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| | style="background: #DCDCDC; padding: 5px;" |''Rickettsia Rickettsii''
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| | style="background: #DCDCDC; padding: 5px;" |''Wood Tick (Dermacentor Variabilis), D. andersoni''
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| | style="background: #DCDCDC; padding: 5px;" |'''United States:'''
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| *Eastern Region
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| *Southwest Region
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| |-
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| | style="background: #F5F5F5; padding: 5px; text-align: center;" | '''[[Helvetica Spotted Fever]]'''<ref name="Other Tick-borne Spotted Fever ”">Disease Index General Information, Rickettsia (2015). http://www.cdc.gov/otherspottedfever / Accessed on December 30, 2015</ref>
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| | style="background: #DCDCDC; padding: 5px;" | ''Rickettsia Helvetica''
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| | style="background: #DCDCDC; padding: 5px;" | ''Ixodes Ricinus (European)''
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| | style="background: #DCDCDC; padding: 5px;" |'''Europe:'''
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| *Sweden
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| *Switzerland
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| *France
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| *Laos
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| |-
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| | style="background: #F5F5F5; padding: 5px; text-align: center;" | '''[[Ehrlichiosis Anaplasmosis]]''' <ref name="Ehrlichiosis CDC”">Disease index General Information (2015). http://www.cdc.gov/parasites/babesiosis/health_professionals/index.html Accessed on December 30, 2015</ref>
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| | style="background: #DCDCDC; padding: 5px;" | ''Ehrlichia Chaffeensis, E. Equi''
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| | style="background: #DCDCDC; padding: 5px;" | ''Lone Star Tick (Amblyomma Americanum), Ixodes Scapularis''
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| | style="background: #DCDCDC; padding: 5px;" | '''United States:'''
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| *South Atlantic Regions
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| *South-central Regions
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| |-
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| | style="background: #F5F5F5; padding: 5px; text-align: center;" | '''[[Tularemia]]''' <ref name="Tulameria CDC”> Rocky Mountain Spotted Fever Information. Centers for Disease Control and Prevention (2015). \http://www.cdc.gov/tularemia/index.html Accessed on December 30, 2015</ref>
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| | style="background: #DCDCDC; padding: 5px;" | ''Francisella Tularensis''
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| | style="background: #DCDCDC; padding: 5px;" | ''D. Andersoni, D. Variabilis''
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| | style="background: #DCDCDC; padding: 5px;" | '''United States:'''
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| *Widespread throughout the region, including higher populations in the Southeast, South-central, and the West.
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| |-
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| | style="background: #F5F5F5; padding: 5px; text-align: center;" |'''Human neoehrlichiosis''' <ref name="Ehrlichiosis CDC”">Disease index General Information (2015). http://www.cdc.gov/parasites/babesiosis/health_professionals/index.html Accessed on December 30, 2015</ref> <ref name="Other Tick-borne Spotted Fever ”">Disease Index General Information, Rickettsia (2015). http://www.cdc.gov/otherspottedfever / Accessed on December 30, 2015</ref>
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| | style="background: #DCDCDC; padding: 5px;" | ''Neoehrlichia mikurensis''
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| | style="background: #DCDCDC; padding: 5px;" | ''Lone Star Tick (''Amblyomma Americanum)'
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| | style="background: #DCDCDC; padding: 5px;" |'''Widespread:'''
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| *Europe
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| *Asia
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| |-
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| | style="background: #F5F5F5; padding: 5px; text-align: center;" |'''Rickettsiosis''' <ref name="Other Tick-borne Spotted Fever ”">Disease Index General Information, Rickettsia (2015). http://www.cdc.gov/otherspottedfever / Accessed on December 30, 2015</ref>
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| | style="background: #DCDCDC; padding: 5px;" | ''Rickettsia''
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| | style="background: #DCDCDC; padding: 5px;" | ''No specific species identified''
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| | style="background: #DCDCDC; padding: 5px;" |'''Widespread:'''
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| *South Africa
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| *Morocco
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| *Mediterranean
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| |-
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| | style="background: #F5F5F5; padding: 5px; text-align: center;" |'''African tick-bite fever''' <ref name="Other Tick-borne Spotted Fever ”">Disease Index General Information, Rickettsia (2015). http://www.cdc.gov/otherspottedfever / Accessed on December 30, 2015</ref>
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| | style="background: #DCDCDC; padding: 5px;" | ''Rickettsia africae''
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| | style="background: #DCDCDC; padding: 5px;" | ''Amblyomma, Dermacentor, and Rhipicephalus species''
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| | style="background: #DCDCDC; padding: 5px;" |'''Africa:'''
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| *Sub-Saharan
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| *West Indies
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| |-
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| | style="background: #F5F5F5; padding: 5px; text-align: center;" |'''[[Queensland tick typhus]]''' <ref name="ATI”">Australian Tick Index http://www.karlmcmanusfoundation.org.au/ticks-in-oz Accessed on December 30, 2015</ref> <ref name="Other Tick-borne Spotted Fever ”">Disease Index General Information, Rickettsia (2015). http://www.cdc.gov/otherspottedfever / Accessed on December 30, 2015</ref>
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| | style="background: #DCDCDC; padding: 5px;" | ''Rickettsia austalis''
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| | style="background: #DCDCDC; padding: 5px;" | ''Ixodes species''
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| | style="background: #DCDCDC; padding: 5px;" |'''Widespread:'''
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| *Australia
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| *Tasmania
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| |-
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| | style="background: #F5F5F5; padding: 5px; text-align: center;" |'''[[Q-fever (Typhus-like infection)]]''' <ref name="ATI”">Australian Tick Index http://www.karlmcmanusfoundation.org.au/ticks-in-oz Accessed on December 30, 2015</ref>
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| | style="background: #DCDCDC; padding: 5px;" | ''Coxiella burnetii (mimics the mechanisms of Rickettsia) ''
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| | style="background: #DCDCDC; padding: 5px;" | ''Ixodes holocyclus and Amblyomma triguttatum''
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| | style="background: #DCDCDC; padding: 5px;" |'''Australia'''
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| *Widespread throughout Australia
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| |-
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| | style="background: #F5F5F5; padding: 5px; text-align: center;" |'''Mediterranean spotted fever (Boutonneuse fever)''' <ref name="MSF”">Oztoprak N, Celebi G, Aydemir H, et al. [Mediterranean spotted fever due to contact with dog-tick]. Mikrobiyol Bul. 2008;42(4):7016.http:// http://www.ncbi.nlm.nih.gov/pubmed/19149095 Accessed on December 30, 2015</ref> <ref name="Other Tick-borne Spotted Fever ”">Disease Index General Information, Rickettsia (2015). http://www.cdc.gov/otherspottedfever / Accessed on December 30, 2015</ref>
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| | style="background: #DCDCDC; padding: 5px;" | ''Rickettsia conorii''
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| | style="background: #DCDCDC; padding: 5px;" | ''Brown Dog Tick (Rhipicephalus sanguineus)''
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| | style="background: #DCDCDC; padding: 5px;" |'''Widespread:'''
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| *Southern Europe
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| *Southern and Western Asia
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| *Africa
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| *India
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| | style="background: #F5F5F5; padding: 5px; text-align: center;" |'''Far Eastern spotted fever''' <ref name="Other Tick-borne Spotted Fever ”">Disease Index General Information, Rickettsia (2015). http://www.cdc.gov/otherspottedfever / Accessed on December 30, 2015</ref>
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| | style="background: #DCDCDC; padding: 5px;" | ''Rickettsia heilong-jiangensis''
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| | style="background: #DCDCDC; padding: 5px;" | ''Tick''
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| | style="background: #DCDCDC; padding: 5px;" |'''Widespread:'''
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| *Far portions of Eastern Russia
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| *Northern portions of China
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| *Eastern Asia
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| |-
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| | style="background: #F5F5F5; padding: 5px; text-align: center;" |'''Aneruptive fever''' <ref name="Other Tick-borne Spotted Fever ”">Disease Index General Information, Rickettsia (2015). http://www.cdc.gov/otherspottedfever / Accessed on December 30, 2015</ref> <ref name="Aneruptive Fever”">Fournier PE, Allombert C, Supputamongkol Y, Caruso G, Brouqui P, Raoult D. Aneruptive fever associated with antibodies to Rickettsia helvetica in Europe and Thailand. J Clin Microbiol. 2004;42(2):816-8. http://http://www.ncbi.nlm.nih.gov/pmc/articles/PMC344501/ Accessed on December 30, 2015</ref>
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| | style="background: #DCDCDC; padding: 5px;" | ''Rickettsia helvetica''
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| | style="background: #DCDCDC; padding: 5px;" | ''Ixodes species''
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| | style="background: #DCDCDC; padding: 5px;" |'''Widespread:'''
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| *Northern and Central portions of Europe
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| *Non-specific portions of Asia
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| |-
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| | style="background: #F5F5F5; padding: 5px; text-align: center;" |'''Flinders Island spotted fever (Thai tick typhus)''' <ref name="Other Tick-borne Spotted Fever ”">Disease Index General Information, Rickettsia (2015). http://www.cdc.gov/otherspottedfever / Accessed on December 30, 2015</ref> <ref name="ATI”">Australian Tick Index http://www.karlmcmanusfoundation.org.au/ticks-in-oz Accessed on December 30, 2015</ref>
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| | style="background: #DCDCDC; padding: 5px;" | ''Rickettsia honei''
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| | style="background: #DCDCDC; padding: 5px;" | ''Tick''
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| | style="background: #DCDCDC; padding: 5px;" |''' Widespread in Independent Regions'''
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| *Australia
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| *Thailand
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| |-
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| | style="background: #F5F5F5; padding: 5px; text-align: center;" |'''Japanese spotted fever''' <ref name="Other Tick-borne Spotted Fever ”">Disease Index General Information, Rickettsia (2015). http://www.cdc.gov/otherspottedfever / Accessed on December 30, 2015</ref>
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| | style="background: #DCDCDC; padding: 5px;" | ''Rickettsia japonica''
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| | style="background: #DCDCDC; padding: 5px;" | ''Tick''
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| | style="background: #DCDCDC; padding: 5px;" |'''Japan'''
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| *Widespread yet isolated to portions of Japan
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| |-
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| | style="background: #F5F5F5; padding: 5px; text-align: center;" |'''Mediterranean spotted fever-like disease''' <ref name="Other Tick-borne Spotted Fever ”">Disease Index General Information, Rickettsia (2015). http://www.cdc.gov/otherspottedfever / Accessed on December 30, 2015</ref>
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| | style="background: #DCDCDC; padding: 5px;" | ''Rickettsia massiliae and R. monacensis''
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| | style="background: #DCDCDC; padding: 5px;" | ''Tick''
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| | style="background: #DCDCDC; padding: 5px;" |'''Widespread:'''
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| ''R.massiliae induced:''
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| *France
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| *Greece
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| *Spain
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| *Portugal
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| *Switzerland
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| *Sicily
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| *Central Africa
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| *Mali
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| ''R.monacensis induced:''
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| *Europe
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| *North Africa
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| |-
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| | style="background: #F5F5F5; padding: 5px; text-align: center;" |'''Maculatum infection'''
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| | style="background: #DCDCDC; padding: 5px;" | ''Rickettsia parkeri''
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| | style="background: #DCDCDC; padding: 5px;" | ''Tick''
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| | style="background: #DCDCDC; padding: 5px;" |'''Americas:'''
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| *United States
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| *Portions of Canada
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| *South America
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| |-
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| | style="background: #F5F5F5; padding: 5px; text-align: center;" |'''Tick-borne necrosis and lymphadenopathy''' <ref name="TNL”">Dermacentor-borne necrosis erythema and lymphadenopathy: clinical and epidemiological features of a new tick-borne disease. Oteo JA, Ibarra V, Blanco JR, et al. Dermacentor-borne necrosis erythema and lymphadenopathy: clinical and epidemiological features of a new tick-borne disease. Clin Microbiol Infect. 2004;10(4):327-31 http://www.ncbi.nlm.nih.gov/pubmed/15059122 Accessed on December 30, 2015</ref>
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| | style="background: #DCDCDC; padding: 5px;" | ''Rickettsia raoultii''
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| | style="background: #DCDCDC; padding: 5px;" | ''Dermacentor marginatus ''
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| | style="background: #DCDCDC; padding: 5px;" |'''Widespread:'''
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| *Europe
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| *Asia
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| | style="background: #F5F5F5; padding: 5px; text-align: center;" |'''North Asian Tick Typhus''' <ref name="Other Tick-borne Spotted Fever ”">Disease Index General Information, Rickettsia (2015). http://www.cdc.gov/otherspottedfever / Accessed on December 30, 2015</ref>
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| | style="background: #DCDCDC; padding: 5px;" | ''Rickettsia sibirica''
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| | style="background: #DCDCDC; padding: 5px;" | ''Tick''
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| | style="background: #DCDCDC; padding: 5px;" |'''Widespread:'''
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| *Russia
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| *China
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| *Mongolia
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| | style="background: #F5F5F5; padding: 5px; text-align: center;" |'''Lymphangitis''' <ref name="Other Tick-borne Spotted Fever ”">Disease Index General Information, Rickettsia (2015). http://www.cdc.gov/otherspottedfever / Accessed on December 30, 2015</ref>
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| | style="background: #DCDCDC; padding: 5px;" | ''Rickettsia sibirica mogolotimonae''
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| | style="background: #DCDCDC; padding: 5px;" | 'No specific species identified
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| | style="background: #DCDCDC; padding: 5px;" |'''Widespread:'''
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| *Southern France
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| *Portugal
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| *China
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| *Africa
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| | style="background: #F5F5F5; padding: 5px; text-align: center;" |'''TIBOLA''' <ref name="Other Tick-borne Spotted Fever ”">Disease Index General Information, Rickettsia (2015). http://www.cdc.gov/otherspottedfever / Accessed on December 30, 2015</ref> <ref name="TNL”">TIBOLA acquired in Southwest Germany. Rieg S, Schmoldt S, Theilacker C, et al. Tick borne lymphadenopathy (TIBOLA) acquired in Southwestern Germany. BMC Infect Dis. 2011;11:167. http://www.ncbi.nlm.nih.gov/pubmed/21663601 Accessed on December 30, 2015</ref>
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| | style="background: #DCDCDC; padding: 5px;" | ''Rickettsia slovaca''
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| | style="background: #DCDCDC; padding: 5px;" | ''Dermacentor species''
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| | style="background: #DCDCDC; padding: 5px;" |'''Widespread:'''
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| *Southern and Eastern Europe
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| *Asia
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| |}
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| ==Differentiation between medical therapies based on classification==
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| {| style="font-size: 85%;"
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| ! style="width: 80px; background: #4479BA; text-align: center;" |{{fontcolor|#FFF|Disease}}
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| ! style="width: 720px; background: #4479BA; text-align: center;" | {{fontcolor|#FFF|Treatment}}
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| |style="background: #F5F5F5; padding: 5px; text-align: center;" | ''Rocky Mountain Spotted Fever'' <ref name="RMSF CDC”> Rocky Mountain Spotted Fever Information. Centers for Disease Control and Prevention (2015). http://www.cdc.gov/rmsf/ Accessed on December 30, 2015</ref>
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| | style="background: #DCDCDC; padding: 5px;" | '''Antibiotics'''
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| *[[Doxycycline]]
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| *[[Tetracycline]]
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| | style="background: #F5F5F5; padding: 5px; text-align: center;" | ''Helvetica Spotted Fever''
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| | style="background: #DCDCDC; padding: 5px;" | '''Antibiotics'''
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| *Broad-spectrum antibiotic therapy
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| *[[Penicillin]]
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| | style="background: #F5F5F5; padding: 5px; text-align: center;" | ''Ehrlichiosis Anaplasmosis'' <ref name="Ehrlichiosis CDC”> Disease index General Information (2015). http://www.cdc.gov/parasites/babesiosis/health_professionals/index.html Accessed on December 30, 2015</ref>
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| | style="background: #DCDCDC; padding: 5px;" | '''Antibiotics'''
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| *[[Doxycycline]], dosages should begin prior to lab results if ehrlichiosis is suspected.
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| :*''Adults:'' 100 mg PO q12h for 7-14 days
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| :*''Children'' (under 100lbs/45kg): 2.2 mg/kg PO q12h for 7-14 days
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| | style="background: #F5F5F5; padding: 5px; text-align: center;" | ''Tularemia'' <ref name="Tulameria CDC”> Rocky Mountain Spotted Fever Information. Centers for Disease Control and Prevention (2015). \http://www.cdc.gov/tularemia/index.html Accessed on December 30, 2015</ref>
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| | style="background: #DCDCDC; padding: 5px;" | '''Antibiotics'''
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| *[[Streptomycin]]
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| *[[Gentamicin]]
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| *[[Doxycycline]]
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| *[[Ciprofloxacin]]
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| | style="background: #F5F5F5; padding: 5px; text-align: center;" | ''Other Spotted Fevers (Rickettsia bacterial infections)'' <ref name="Other Tick-borne Spotted Fever ”> Disease Index General Information, Rickettsia (2015). http://www.cdc.gov/otherspottedfever / Accessed on December 30, 2015</ref>
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| | style="background: #DCDCDC; padding: 5px;" | '''Antibiotics'''
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| *[[Doxycycline]]
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| :*''Adults:'' 100 mg PO q12h for 7-14 days
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| :*''Children'' (under 100lbs/45kg): 2.2 mg/kg PO q12h for 7-14 days
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| |}
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| ==References== | | ==References== |