Tsutsugamushi fever

The Tsutsugamushi fever is an infectious disease, also called Japanese spotted fever is known. The disease caused by bacteria is particularly widespread in Asia, Oceania and parts of Australia. The Tsutsugamushi fever or its pathogen is caused by animals such. B. Ticks, mites and fleas are transmitted.

What is tsutsugamushi fever?

The Tsutsugamushi fever is also colloquially known as Bush fever or Mite spotted fever because so-called arthropods (mites, lice, fleas, etc.) are the carriers of the disease. Tsutsugamushi fever is an infectious disease and belongs to the group of rickettsioses. Diseases that are caused by bacteria of the genus Rickettsia are referred to as rickettsioses.

The first symptoms appear after about 7 to 30 days. The bite site is usually red in color and feels hot. At the beginning, flu-like symptoms such as fever, headache and body aches appear. Only as the disease progresses does a rash develop and spread over the entire body. Without proper treatment, the infection spreads throughout the body, causing Tsutsugamushi fever and the like. U. can be fatal.

Studies show that after suffering from Tsutsugamushi fever, one has immunity for about 1 to 2 years, so that the disease does not break out even if the pathogen is infected again.

causes

The cause of the Tsutsugamushi fever are bacteria of the genus Rickettsia tsutsugamushi, also known as Rickettsia orientalis. The preferred hosts for the bacteria are u. a. Mites, ticks, lice and fleas. There are currently four Rickettsia genera, each genus having several subgroups.

The bacteria are transmitted through a bite. The arthropods (ticks, etc.) secrete saliva before and during the bite in order to numb the bite site. The bacteria are transferred into the wound and can infect humans (as well as animals) with Tsutsugamushi fever.

The incubation period for Tsutsugamushi fever is between 7 and 30 days. The incubation period is the time that passes between infection and the onset of the disease.

Symptoms, ailments & signs

One of the first symptoms of tsutsugamushi fever is a skin nodule (papule) that forms in about half of patients and appears where the mite has bitten. The nodule can subsequently develop into a painful ulcer and form black scabs. In addition, headache and body aches, swollen lymph nodes, high fever and an enlarged spleen occur with the disease.

People feel very sick and may be confused. Within a few days, a rash develops with pale reddish spots that then turn dark in color, with the rash spreading all over the body. If the fever is severe, it can also lead to encephalitis or myocarditis.

The patients then suffer from hallucinations, severe nausea and seizures, and some also lose consciousness. The inflammation of the heart muscle can lead to severe circulatory problems, palpitations and a drop in blood pressure. If the tstusugamushi fever occurs in children, the symptoms are usually milder. Without treatment, the fever can lead to severe mental and physical disabilities and, in the worst case, even death.

Diagnosis & course

That is diagnosed Tsutsugamushi fever from the general practitioner. With the help of a detailed anamnesis (collection of the medical history) it is determined whether the person concerned has been in risk areas, whether there are insect bites and which symptoms have appeared.

Blood tests will determine if there is an infection. Furthermore, if necessary, a tropical medicine specialist can be called in if the diagnosis cannot be clearly assigned.

With early diagnosis and treatment, Tsutsugamushi fever usually heals without consequences. If there is no treatment, the infection will spread further and further. As a result, pneumonia and myocarditis can occur, which, if left untreated, lead to death. In addition, brain inflammation often occurs in the course of the disease, which, if left untreated or treated too late, can lead to physical and psychological disabilities.

After an infection with Tsutsugamushi fever, the sick person i. d. Usually an immunity of about 1 to 2 years. This means that even with repeated infection with the Reckettsiae, the disease does not break out. With the help of a so-called titer determination (blood analysis) it can be determined whether antibodies have been formed by the immune system and whether they are still present in sufficient quantities.

Complications

Tsutsugamushi fever is associated with various complaints and complications. As a rule, those affected suffer from a very high fever. The patient is also very tired and exhausted, so that most of those affected can no longer easily take part in everyday life. Papules or ulcers develop on the skin.

Patients also often suffer from a rash on the skin. This also leads to inferiority complexes or a significantly reduced self-esteem, as the aesthetics are reduced by the symptoms of Tsutsugamushi fever. Furthermore, the disease can lead to aching limbs or severe headaches. The patient's lymph nodes are severely swollen and impaired consciousness and adeptness appear.

If tsutsugamushi fever is not treated, it can also lead to inflammation in the lungs or heart muscle. In the worst case, the affected person dies from the symptoms of the fever. Treatment is relatively simple with the help of antibiotics. There are no particular complications. With an early diagnosis, a positive course of the disease is usually achieved. The patient's life expectancy remains unchanged if this disease is successfully treated.

When should you go to the doctor?

If you have tsutsugamushi fever, you should see a doctor immediately. This disease cannot heal itself, so that without treatment it can lead to severe complications and a further worsening of the symptoms. For this reason, a doctor should be contacted at the first symptoms and signs of this disease. In most cases, a high fever and swelling and enlargement of the spleen suggest the disease. There will also be severe pain in the limbs and a severe rash on the skin.

The rash often spreads over the entire body of the person affected and significantly reduces the aesthetics. Furthermore, if left untreated, inflammation in the brain can occur. In some cases, hallucinations or severe nausea can also indicate tsutsugamushi fever and should also be examined by a doctor. In severe cases, depression also occurs. Tsutsugamushi fever can be recognized and treated by a general practitioner. The further course depends heavily on the time of diagnosis, so that no general prediction can be made.

Treatment & Therapy

The Tsutsugamushi fever is usually treated with antibiotics. Tetracyclines and choramphenicol are preferably used here. The treatment should be carried out as an inpatient in the hospital, as Tsutsugamushi fever is sometimes difficult to treat. As with all infectious diseases, the earlier Tsutsugamushi fever is diagnosed and treated, the better the chances of recovery.

Further treatment for tsutsugamushi fever includes treating the accompanying symptoms. As the rash can be very itchy, mild creams or gels containing cortisone can be used. Antipyretic drugs can be prescribed for the fever and analgesics for the pain. Because the infection spreads quickly and can cause further inflammation in the body, anti-inflammatory drugs are also given.

When treating with antibiotics, it is important that a sufficient dose is taken over an adequately long period of time. If the duration of treatment is too short, there is a risk that bacteria will survive and develop resistance to the antibiotic.

prevention

Primary preventive measures against that Tsutsugamushi fever is the avoidance of mite, tick and flea bites. Before you travel to a risk area, you should find out in detail whether the Tsutsugamushi fever is spread there.

It is advisable to always wear long-sleeved clothing and a hat. After being outdoors, the entire body should be searched for arthropods and bite wounds. In particular, the hairy parts of the body (head, armpits and genital area) must be searched particularly carefully.

Insect repellants do not provide adequate protection. There is currently no vaccine that could prevent infection with Tsutsugamushi fever. If you find lice, fleas, etc. on the body or clothing or if you have a bite wound, you should see a doctor immediately, even if no symptoms appear. Because Tsutsugamushi fever can only be treated successfully and without consequences if treated early.

Aftercare

Follow-up care for Tsutsugamushi fever depends on the course of the disease. If the outcome is positive, the fever should subside quickly. The doctor usually prescribes the drug doxycycline, which is tapered off as part of the aftercare. In addition, typical side effects of the preparation must be clarified, such as inflammation of the mouth and throat mucosa and other gastrointestinal complaints.

If the treatment results in a hypersensitivity reaction in the patient, the drug must wane immediately. The physical exam during follow-up includes several tests, such as checking your body temperature and blood pressure. Any accompanying symptoms of Tsutsugamushi fever, such as nausea and malaise, should be clarified as part of the anamnesis.

Lymph node swelling, which occurs mainly in severe cases, can be determined by the doctor using visible signs of inflammation. Depending on how the aftercare goes, the patient will be discharged or undergo further treatment. Aftercare for tsutsugamushi fever is carried out by the internist or general practitioner, for example.

A hospital stay is usually necessary, especially if the disease is severe with necrosis or coma. If the course is severe, other specialists will be involved in the treatment. Care for relatives and the patient himself may also be necessary.

You can do that yourself

Tsutsugamushi fever is an extremely rare disease that occurs mainly in Asia, India, Australia and Oceania. The self-help measures are limited to taking care of the body and taking prescribed drugs such as the antibiotic doxycycline according to the instructions. Since it is an extremely rare infectious disease with few scientific studies, close medical monitoring is all the more important. Patients should be hospitalized or see a doctor regularly.

If the typical symptoms of scrub typhoid occur during a trip to Asian, Australian, oceanic or Indian regions, the trip must be interrupted immediately and a doctor should be consulted. If possible, Tsutsugamushi fever in Germany is treated by a specialist in internal medicine. If the first treatment takes place abroad, it is important to consult a doctor without delay after returning to Germany.

In addition to medical treatment, general measures such as rest breaks, light food and regular fluid intake apply. Bed rest is most important as Tsutsugamushi fever puts a lot of strain on the body and especially the immune system. Those affected are best advised to consult a specialist who can advise them on suitable self-help measures.