Indian tick typhus

Etiology

• Rickettsia conorii

Epidemiology

• reported throughout the Indian subcontinent

Clinical manifestations

• maculopapular rash occurs early
  • rash involves palms & soles
• anterior uveitis
  • blurred vision, photophobia, floaters
  • subconjunctival hemorrhage
• dry cough

Laboratory

• basic metabolic panel: hyponatremia
• Rickettsia spotted fever group antibody in serum
  • Rickettsia spotted fever group IgG in serum
  • Rickettsia spotted fever group IgM in serum
• Rickettsia spotted fever group DNA
• Rickettsia spotted fever group RNA
• exclusion testing
  • Rickettsia typhus group antibody in serum
  • Orientia tsutsugamushi antibody

Diagnostic procedures

• skin biopsy of rash

Management

• doxycycline for 2 weeks
  • shorter course may be associated with relapse
  • symptoms typically diminish markedly within 24 hours of appropriate therapy
• prednisolone ophthalmic for uveitis

More general terms

• rickettsial spotted fever; tick typhus