Definition

Rickettsialpox is a relatively mild disease caused by a member of the bacterial family called Rickettsia. Rickettsialpox causes rash, fever, chills, heavy sweating, headache, eye pain (especially when exposed to light), weakness, and achy muscles.

  Description

Like other members of the family of Rickettsia, the bacteria causing rickettsialpox live in mice. Tiny mites feed on these infected mice, thus acquiring the organism. When these mites feed on humans, the bacteria can be transmitted.

Rickettsialpox occurs mostly within cities. In the United States, the disease has cropped up in such places as New York City, Boston, Philadelphia, Pittsburgh, and Cleveland. It has also been identified in Russia, Korea, and Africa.

  Causes and symptoms

The specific bacteria responsible for rickettsialpox is called Rickettsia akari. A person contracts this bacteria through the bite of an infected mite. After a person has been bitten by an infected mite, there is a delay of about 10 days to three weeks prior to the onset of symptoms.

The first symptom is a bump which appears at the site of the original bite. The bump (papule) develops a tiny, fluid-filled head (vesicle). The vesicle sloughs away, leaving a crusty black scab in its place (eschar). In about a week, the patient develops a fever, chills, heavy sweating, headache, eye pain (especially when exposed to light), weakness, and achy muscles. The fever rises and falls over the course of about a weak. A bumpy rash spreads across the body. Each individual papule follows the same progression: papule, then vesicle, then eschar. The rash does not affect the palms of the hands or the soles of the feet.

  Diagnosis

Most practitioners are able to diagnose rickettsialpox simply on the basis of its rising and falling fever, and its characteristic rash. Occasionally, blood will be drawn and tests performed to demonstrate the presence of antibodies (immune cells directed against specific bacterial agents) which would confirm a diagnosis of rickettsialpox.

  Treatment

Because rickettsialpox is such a mild illness, some practitioners choose to simply treat the symptoms (giving acetaminophen for fever and achiness, pushing fluids to avoid dehydration). Others will give their patients a course of the antibiotic tetracycline, which will shorten the course of the illness to about one to two days.

  Prognosis

Prognosis for full recovery from rickettsialpox is excellent. No deaths have ever been reported from this illness, and even the skin rash heals without scarring.

  Prevention

As with all mite- or tick-borne illnesses, prevention includes avoidance of areas known to harbor the insects, and/or careful application of insect repellents. Furthermore, because mice pass the bacteria on to the mites, it is important to keep mice from nesting in or around residences.

   Key Terms:

Eschar A crusty, blackish scab. Papule A bump on the skin. Vesicle A fluid-filled head on a papule.

   Resources:

Books

• Corey, Lawrence. "Rickettsia and Coxiella." In Sherris Medical Microbiology: An Introduction to Infectious Diseases. 3rd ed. Ed. Kenneth J. Ryan. Norwalk, CT: Appleton & Lange, 1994.
• Walker, David, et al. "Rickettsial Diseases." In Harrison's Principles of Internal Medicine, ed. Anthony S. Fauci, et al. New York: McGraw-Hill, 1997.

Organizations

• Centers for Disease Control and Prevention. 1600 Clifton Rd., NE, Atlanta, GA 30333. (800) 311-3435, (404) 639-3311. http://www.cdc.gov