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Rickettsialpox ri-ˌket-sē-əl-ˈpäks

(Vesicular Rickettsiosis)

By William A. Petri, Jr, MD, PhD, Wade Hampton Frost Professor of Medicine and Chief, Division of Infectious Diseases and International Health, University of Virginia School of Medicine

Rickettsialpox is a rickettsial disease that is caused by Rickettsia akari.

Rickettsiae are a type of bacteria that can live only inside the cells of other organisms (see also Overview of Rickettsial Infections). The rickettsiae that cause rickettsiosis usually live in mice (the host).

Rickettsialpox occurs in many areas of the United States and in Russia, Korea, and Africa. The rickettsiae are transmitted to people when they are bitten by a chigger (mite larva) or an adult mite. The mites may also transmit the bacteria to house mice.

Symptoms of rickettsialpox are mild. A small buttonlike sore covered by a black scab (eschar) appears at the site of the bite. About a week later, other symptoms develop: a fever with chills and sweating, a headache, sensitivity to light, muscle pains, and a widespread rash. Nearby lymph glands may swollen.

The diagnosis of rickettsialpox is suggested by symptoms. Doctors may do blood tests that detect antibodies to the bacteria. However, these test cannot detect the antibodies until at least several days after the illness begins. Thus, these tests do not help doctors diagnose the infection immediately after someone becomes ill but can help confirm the diagnosis. To confirm the diagnosis, doctors may do an immunofluorescence assay or use the polymerase chain reaction (PCR) technique.

Treatment of rickettsialpox consists of antibiotics, usually doxycycline taken by mouth for 5 days.

Prevention of rickettsialpox involves controlling the mice population and using pesticides to kill the mites.

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