Boutonneuse fever: Difference between revisions
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==Overview== | ==Overview== | ||
Boutonneuse fever is a [[fever]] as a result of a [[Rickettsia]]l infection caused by the bacterium ''Rickettsia conorii'' and transmitted by the dog tick ''Riphicephalus sanguineus''. Boutonneuse fever is endemic in many countries surrounding the Mediterranean Sea. It has an incubation period of 7 days. | Boutonneuse fever is a [[fever]] as a result of a [[Rickettsia]]l infection caused by the bacterium ''Rickettsia conorii'' and transmitted by the dog tick ''Riphicephalus sanguineus''. Boutonneuse fever is endemic in many countries surrounding the Mediterranean Sea. It has an incubation period of 7 days. Symptoms include fever, joint pain, [[chills]], [[headache]], and [[photophobia]]. On physical examination a black crust (tache noire) in the place of the tick bite may be seen. Diagnosis is made with serologic methods, either the classic [[Weil Felix test]] (agglutination of Proteus OX strains ), either [[ELISA]] or immunofluorescence assays. The mainstay of therapy for Boutonneuse fever is [[antimicrobial]] therapy. | ||
==Diagnosis== | ==Diagnosis== | ||
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==Treatment== | ==Treatment== | ||
===Antimicrobial Regimen=== | |||
:* Boutonneuese fever<ref name="pmid23253320">{{cite journal| author=Botelho-Nevers E, Socolovschi C, Raoult D, Parola P| title=Treatment of Rickettsia spp. infections: a review. | journal=Expert Rev Anti Infect Ther | year= 2012 | volume= 10 | issue= 12 | pages= 1425-37 | pmid=23253320 | doi=10.1586/eri.12.139 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23253320 }} </ref> | |||
::* 1. '''Adult''' | |||
:::* Preferred regimen (1): [[Doxycycline]] 200 mg PO bid for 1 day | |||
:::* Preferred regimen (2): [[Doxycycline]] 200 mg or 100 mg PO bid for 2-5 days | |||
:::* Alternative regimen (1): [[Josamycin]] 1g q8h for 7 days | |||
:::* Alternative regimen (2):[[Ciprofloxacin]] | |||
::* 2. '''Children''' | |||
:::* Preferred regimen (Children <100 lbs): [[Doxycycline]] 2.2 mg/kg PO bid | |||
:::* Preferred regimen (Children >100lbs): [[Doxycycline]] 200 mg PO bid in one day and 200 mg bid/qid or 100 mg bid for 2-5 days | |||
:::* Alternative regimen (Children <8 years) (1): [[Josamycin]] 2.2mg/kg q12h for 5 days | |||
:::* Alternative regimen (Children <8 years) (2): [[Clarithromycin]] 15 mg/ kg in bid for 7 days {{and}} [[Azithromycin]] 10 mg/kg/day qd for 3 days | |||
==Related Chapters== | ==Related Chapters== | ||
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[[nl:Fièvre boutonneuse]] | [[nl:Fièvre boutonneuse]] | ||
[[Category:Disease]] | [[Category:Disease]] | ||
[[Category:Rickettsiales]] | [[Category:Rickettsiales]] |
Latest revision as of 17:13, 18 September 2017
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Raviteja Guddeti, M.B.B.S. [2]
Synonyms and keywords: Kenya tick typhus; Marseilles fever; Mediterranean spotted fever; Rickettsia conorii; fièvre boutonneuse; Boutonneuese fever
Overview
Boutonneuse fever is a fever as a result of a Rickettsial infection caused by the bacterium Rickettsia conorii and transmitted by the dog tick Riphicephalus sanguineus. Boutonneuse fever is endemic in many countries surrounding the Mediterranean Sea. It has an incubation period of 7 days. Symptoms include fever, joint pain, chills, headache, and photophobia. On physical examination a black crust (tache noire) in the place of the tick bite may be seen. Diagnosis is made with serologic methods, either the classic Weil Felix test (agglutination of Proteus OX strains ), either ELISA or immunofluorescence assays. The mainstay of therapy for Boutonneuse fever is antimicrobial therapy.
Diagnosis
Symptoms
Physical Examination
Skin
- A black crust (tache noire) forms in the place of the tick bite.
- Around the 4th day of the illness an exanthem appears, first macular and then maculopapular and sometimes petechial.
Laboratory Findings
The diagnosis is made with serologic methods, either the classic Weil Felix test (agglutination of Proteus OX strains ), either ELISA or immunofluorescence assays.
Treatment
Antimicrobial Regimen
- Boutonneuese fever[1]
- 1. Adult
- Preferred regimen (1): Doxycycline 200 mg PO bid for 1 day
- Preferred regimen (2): Doxycycline 200 mg or 100 mg PO bid for 2-5 days
- Alternative regimen (1): Josamycin 1g q8h for 7 days
- Alternative regimen (2):Ciprofloxacin
- 2. Children
- Preferred regimen (Children <100 lbs): Doxycycline 2.2 mg/kg PO bid
- Preferred regimen (Children >100lbs): Doxycycline 200 mg PO bid in one day and 200 mg bid/qid or 100 mg bid for 2-5 days
- Alternative regimen (Children <8 years) (1): Josamycin 2.2mg/kg q12h for 5 days
- Alternative regimen (Children <8 years) (2): Clarithromycin 15 mg/ kg in bid for 7 days AND Azithromycin 10 mg/kg/day qd for 3 days
Related Chapters
References
- ↑ Botelho-Nevers E, Socolovschi C, Raoult D, Parola P (2012). "Treatment of Rickettsia spp. infections: a review". Expert Rev Anti Infect Ther. 10 (12): 1425–37. doi:10.1586/eri.12.139. PMID 23253320.