Tick ​​bite fever caused by Rickettsia rickettsii

The Tick ​​bite fever caused by Rickettsia rickettsii occurs mainly in North and South America, but there in all countries of the double continent. That is why the names are also found American tick bite fever, Rocky Mountain spotted fever, Colombian Tobia fever, Sao Paulo fever or New world fever.

What is tick bite fever caused by Rickettsia rickettsii?

Ticks are a type of mite that, as blood-sucking parasites, can transmit dangerous germs to all vertebrates. Rickettsiae are tick-borne bacteria named after Howard Taylor Ricketts, an American pathologist who identified the type of bacteria in 1907.

The Tick ​​bite fever caused by Rickettsia rickettsii belongs to the group of rickettsioses, which includes all diseases that are caused by rickettsia bacteria. Rickettsia are not only transmitted by ticks, but also by other types of mites, as well as by lice and fleas. Rickettsioses include tick bite fever caused by Rickettsia rickettsii and typhus diseases.

The diseases mostly occur in the spring and summer months. About 2 people are infected for every million people in the United States each year. Most of the sick live in rural areas. Tick-bite fever caused by Rickettsia rickettsii affects men over the age of 40 and children up to 10 years of age.

causes

The Tick ​​bite fever caused by Rickettsia rickettsii caused by an infection with a special type of rickettsial bacteria. The bacteria can only survive within a host cell. Mainly they are in the intestinal cells z. B. from ticks.

The bacteria perish quickly if it is dry or if disinfectants are used. Rickettsiae also do not survive in artificially produced nutrient solutions. However, rickettsiae can occur in excretions such B. lice survive a longer time and therefore still have an infectious effect after months.

As soon as the bacteria have been transferred to the human body by a tick bite, they multiply in the host cells through continuous transverse division. They then spread through the body via lymph vessels and blood vessels.

The symptoms of tick bite fever caused by Rickettsia rickettsii are triggered by the destruction of body cells caused by the bacteria.

Symptoms, ailments & signs

The tick bite fever caused by Rickettsia rickettsii is a very serious illness that can only be completely cured with the onset of rapid medical help. The disease, which only occurs in America, can be life-threatening, especially in children under ten years of age, in immunocompromised people or in the event of delayed treatment.

Initially, after an incubation period of two to fourteen days, unspecific flu-like symptoms appear. The sick person complains of headache, high fever, body aches, stomach pain, nausea, vomiting, loss of appetite, red eyes and muscle pain. After another two to five days, a widespread rash appears.

This exanthem is characterized by small red spots alternating with raised papules. Small bleeding is possible from the papules. Otherwise, the rash is not associated with discomfort. However, there can be a multitude of complications in the further course, which do not proceed the same for every person. For the individual, the combination of symptoms that will occur cannot be foreseen.

However, symptoms such as a sudden sharp drop in blood pressure, palpitations, blood clotting disorders, jaundice (jaundice), acute kidney failure, shock or neurological disorders are observed. Acute kidney failure, a sudden drop in blood pressure, or cardiac arrhythmias can quickly lead to death. In other cases, serious long-term damage occurs, which manifests itself, among other things, in the death of fingers and toes, symptoms of paralysis, numbness or blindness.

Diagnosis & course

An infection with the Tick ​​bite fever caused by Rickettsia rickettsii Hardly diagnose in the early phase of the disease, as suitable test methods are not available for this initial period.

Nevertheless, the disease must be treated as early as possible. The first indications of a possible tick bite can be found by asking the sick person about their living environment, their travel habits and the seasonal beginning of their symptoms. Only at a later point in time can a reliable diagnosis of the presence of a tick-bite fever due to Rickettsia rickettsii be made by examining the skin tissue or by blood tests, as well as the targeted reproduction of rickettsiae in blood cultures.

Tick ​​bite fever caused by Rickettsia rickettsii is a serious, albeit curable, disease. Without treatment, the disease is fatal in around 30% of cases. However, if the person survives the first few days of illness, a complete healing usually ensues.

The tick bite fever caused by Rickettsia rickettsii takes a more severe course in children up to 3 years of age and in men in general. In these cases, complications such as significant circulatory disorders or kidney failure can quickly lead to death. Possible long-term consequences of tick-bite fever caused by Rickettsia rickettsii are symptoms of paralysis or loss of hearing.

Complications

The tick bite fever caused by Rickettsia rickettsii is often a very difficult disease, which, however, has a good chance of recovery if treated in time. The infection then usually heals completely. The course of the infection and possible complications, however, depend on the time at which treatment is started and on the constitution of the person affected.

Children under ten years of age and immunocompromised people in particular often suffer serious complications that are fatal or can lead to long-term chronic damage. The start of treatment is also decisive for the chances of recovery. If therapy is started too late, about five days after the onset of infection, fatal complications can occur even in previously healthy people.

However, if treatment starts immediately, almost everyone will survive. In the acute phase, without timely therapy, circulatory shock, palpitations and kidney failure are possible. Then death often occurs within a very short time. In a few cases, long-term effects such as paralysis, numbness, blindness or tissue necrosis on the fingers and toes can occur.

However, this usually only affects people with a weakened immune system, children under ten years of age, alcohol addicts or people with a deficiency in the enzyme glucose-6-phosphate dehydrogenase. Patients who survive the severe complications in the acute phase of the infection can also suffer from chronic heart or kidney diseases as long-term consequences.

When should you go to the doctor?

A doctor is not always needed when a tick bites. If the person concerned feels able to completely remove the tick from the organism, he can heal himself with a few simple steps. If there is no complaint within the next few days, no further measures need to be taken. Tick ​​bite fever occurs on the American continent. If there are health problems immediately after the tick bite, action is required.

A doctor should be consulted if symptoms such as headache, vomiting, nausea, body aches or abdominal pain occur. If there is a loss of appetite or if there are irregularities in the muscular system, a doctor's visit is necessary. In the event of changes in the appearance of the skin, disorders of the heart rhythm, symptoms of paralysis or a high fever, medical care must be initiated immediately. In acute cases, an ambulance service should be alerted.

If there are disorders of sensitivity or if the physical performance drops, the person concerned needs medical help. Feelings of numbness in the fingers or toes are characteristic of the disease. A doctor should therefore be consulted at the first signs of the health discrepancies mentioned. Since the disease can lead to serious complications if left untreated, action should be taken as soon as possible in the event of a general deterioration in health.

Treatment & Therapy

The earliest possible treatment of the Tick ​​bite fever caused by Rickettsia rickettsii. If the therapy does not start by the fifth day after the onset of the disease, an unfavorable course of the disease is predicted.

If tick-bite fever caused by Rickettsia rickettsii is suspected, treatment should be carried out in a hospital if possible. The disease can be cured in most cases by giving antibiotics. Antibiotics suitable for treating tick-bite fever caused by Rickettsia rickettsii are the so-called tetracyclines, which inhibit protein production and the growth of the rickettsiae. However, tetracyclines should not be given to pregnant women or children, as the active ingredient is deposited in bones and teeth and can lead to an increased susceptibility to tooth decay and an increased frequency of bone fractures.

Another very effective antibiotic is chloramphenicol. This is a broad spectrum antibiotic, but due to possible side effects it should only be used if the tick bite fever caused by Rickettsia rickettsii cannot be controlled in any other way. Both preparations are administered intravenously to the body.

In addition to the pure antibiotic treatment, which is aimed directly against the rickettsia bacteria, accompanying therapies may be required in order to alleviate the symptoms of tick-bite fever caused by rickettsia rickettsii. It may be useful to administer pain medication. Some patients may need an infusion to give fluids to those suffering from tick bite fever caused by Rickettsia rickettsii.

prevention

Against that Tick ​​bite fever caused by Rickettsia rickettsii there are no generally available vaccines. The only possible prevention is to avoid tick bites.

Anyone who is in North and South American risk areas should regularly check their body for ticks. Outside, the body should be largely covered by clothing. This includes wearing long pants, long-sleeved upper body clothing and headgear. This at least makes it more difficult for ticks to implant and for infection with tick bite fever caused by Rickettsia rickettsii.

Aftercare

If a tick-bite fever caused by Rickettsia rickettsii was detected early and has completely healed, the tick-bite fever usually does not cause any complications. Nevertheless, in the first time after the illness, regular follow-up examinations should take place to be sure, during which the blood is checked for Rickettsia rickettsii. If pathogens are found again, antibiotic therapy must be repeated.

After successful treatment of tick-bite fever with rickettsia rickettsii, alcohol consumption should be avoided completely for two to four weeks, as this often causes complications and long-term consequences in people suffering from tick-bite fever. In addition, regular neurological follow-up examinations should take place, since tick-bite fever caused by Rickettsia rickettsii can in some cases cause nerve disorders as long-term consequences.

If symptoms of paralysis, numbness or tingling of the body or extremities occur in the course of life without a cause being identified, a doctor should be consulted immediately and informed accordingly. In this case, a neurological diagnosis and treatment must be carried out, as these can not only be late sequelae of tick-bite fever, but also symptoms of a stroke.

If paralysis or numbness occurs as a result of tick bite fever, these must be treated with medication (pain therapy) and physiotherapy. A corresponding therapy must be discussed intensively with the supervising neurologist and monitored by him.

You can do that yourself

When a tick bites, the person affected should be able to assess his own competencies well. If he does not have sufficient knowledge of how to remove a tick correctly, the help of people from the social environment or medical professionals should be sought.

Regardless of whether the tick bite occurs in domestic regions or while traveling in American areas, the procedure for removing the insect bite is the same. During the entire process, it is important to have a steady hand and not make any hectic movements. If, in spite of all efforts and a professional approach, complications have been encountered when removing the insect yourself, a doctor should be consulted immediately. If residues of the insect's body can be seen or felt in the organism, medical help is required.

The person concerned should not expose himself to physical overexertion and should carefully observe the further development of health and his own well-being. Sufficient fluid must be absorbed and the existing wound should be treated sterile. Rest and protection are particularly important for the regeneration process.

However, the possibilities for self-help reach their limits as soon as there is a deterioration in health. General functional disorders, pain or fever can no longer be adequately cared for on their own.