Last reviewed: September 2018
Last updated: August  2018

Summary

Definition

History and exam

Key diagnostic factors

  • fever >38°C
  • rash
  • eschar
  • lymphadenopathy associated with eschar

Risk factors

  • exposure to human body lice
  • exposure to rodents (rats and mice) and their fleas
  • tick bites
  • mite bites (Southeast Asia, Oceania, northern Australia)
  • travel to the tropics
  • exposure to natural vegetation, forests, scrub, bush
  • exposure to cat or dog fleas

Diagnostic investigations

1st investigations to order

  • FBC
  • LFTs
  • serum electrolyte levels
  • C-reactive protein (CRP)
  • serology
  • polymerase chain reaction (PCR)
Full details

Investigations to consider

  • chest x-ray
  • trial of doxycycline therapy
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Professor of Medicine

Section on Infectious Diseases

Wake Forest University School of Medicine

Winston-Salem

NC

Disclosures

CAO declares that he has no competing interests.

Professor Christopher A. Ohl would like to gratefully acknowledge Dr Stephen R. Graves, a previous contributor to this topic. SRG is the author of a reference cited in this topic.

Peer reviewers VIEW ALL

Professor

Department of Medicine

University of Peradeniya

Peradeniya

Sri Lanka

Disclosures

SAMK declares that he has no competing interests.

Professor of Medicine and Pathology

Albert Einstein College of Medicine

New York City

NY

Disclosures

LW's laboratory research programme is supported by NIH (NIAID) grants. He performs infectious diseases consultation at Montefiore (Weiler Hospital).

Use of this content is subject to our disclaimer