Lecture 30 Rickettsia and Coxiella
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This document discusses Rickettsia and Coxiella bacteria. Rickettsia species are gram-negative, obligate intracellular parasites transmitted by arthropod vectors like ticks and mites. They cause diseases like epidemic typhus, murine typhus, and Rocky Mountain spotted fever by infecting endothelial cells. Coxiella burnetii causes Q fever, a typhoid-like illness transmitted through inhalation of aerosols from infected animals. Both are diagnosed serologically and treated with doxycycline.
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Rickettsiae are small, obligate intracellular bacteria that can cause diseases in humans. They are transmitted through arthropod vectors like ticks and lice. Rickettsiae are divided into three groups based on the diseases they cause: spotted fever, typhus, and scrub typhus. Upon entering the body through a bite or broken skin, they infect endothelial cells. Some escape the phagosome and enter the cell cytoplasm, while others are released when the cell lyses. Doxycycline is the treatment of choice and preventing exposure to ticks can reduce risk of infection. Laboratory diagnosis involves serologic testing to detect antibodies in paired serum samples.
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Coxiella burnetii is an obligate intracellular bacterium that causes Q fever in humans and animals. It is distributed worldwide and the primary reservoirs are cattle, sheep and goats. Transmission to humans occurs mainly through inhalation of aerosols from infected animal birth products. Infection in humans ranges from asymptomatic to an acute flu-like illness or chronic conditions like endocarditis. Diagnosis involves serologic tests or PCR. Tetracycline is used to treat acute Q fever in humans. Vaccination of animals and pasteurization of dairy products can help control spread.
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Lecture 30 Rickettsia and Coxiella
- 1. بسم ا الرحمن الرحيم RICKETTSIA AND COXIELLA Prof. Khalifa Sifaw Ghenghesh
- 2. Rickettsia species Gram-negative bacilli Obligate intracellular parasites All associated with an arthropod vector Pathogenic species parasitize endothelial cells almost exclusively 2 antigenically distinct groups • Typhus group • Spotted fever group
- 3. Pathogenesis The organisms enter the body through the bite or faeces of an infected arthropod vector Disseminate through bloodstream >> endothelial cells by induced phagocytosis >> escape from phagosome >> multiply intracellularly >> destroy host cell
- 4. Rickettsial Diseases Epidemic typhus • Transmitted from human to human by R. prowazekii • Vector: body louse (Pediculus humanus) • Incubation period: 5-15 days • Macular rash: 4-7 days after illness and begin to fade after 1-2 days • In severe: rash may last longer and become haemorrhagic
- 5. Flea-borne fevers (Murine typhus) • R. typhi • Rats and their infected fleas • Tropical and subtropical coastal regions • Ports with large number of rats • Disease: similar to epidemic typhus but milder Tick-borne spotted fever (group) • Example: R. rickettsii • Can be life-threatening • Maintained in enzootic cycle (ticks and their wild animal hosts)
- 6. Scrub typhus • Orientia tsutsugamushi (previously R. tsutsugamushi ) • Larval stages (chiggers) of mites (Leptotrombidium) • Hosts: Rats or other small mammals
- 7. Laboratory Diagnosis Serological Methods • Weil-Felix test (Agglutination test) Somatic Ags of non-motile Proteus species Not reliable >> low levels of sensitivity and specificity • Detection of Abs to Rickettsia species by: Immunofluorescence Latex agglutination Enzyme immuno-assay • Death may occur before detectable levels of Ab are present
- 8. Isolation of the Organism • In cell culture • In susceptible laboratory animal • Not practicle Detection of the organism in tissue • Specimen: Skin biopsies from petechial lesions • Examined by: Immuno-fluorescence or immuno-enzyme methods
- 9. Treatment Rickettsiostatic antibiotics • Tetracyclines • Chloramphenicol Intensive nursing care and management of fluids and electrolytes
- 10. Child's right hand and wrist displaying the characteristic spotted rash of Rocky Mountain spotted fever caused by Rickettsia rickettsii
- 11. Rickettsia tsutsugamushi free within the cytoplasm of a mouse brain capillary endothelial cell. Capillary wall appears in cross section
- 12. Dorsal view of an American Dog Tick, Dermacentor variabilis, a known carrier of Rocky Mountain Spotted Fever caused by the bacterium Rickettsia rickettsii.
- 13. IFA reaction of a positive human serum on Rickettsia rickettsii grown in chicken yolk sacs, 400X
- 14. Red structures indicate immunohistological staining of Rickettsia rickettsii in endothelial cells of a blood vessel from a patient with fatal RMSF
- 17. Coxeilla burnetii Gram-negative, Pleomorphic, coccobacillary bacteria Obligatory intracellular Q fever • • • • Typhoid-like illness Almost worldwide distribution Reservoirs: wild and domestic animals Infection results from inhalation of aerosols containing the organism
- 20. Laboratory Diagnosis • Demonstration of specific Abs Complement fixation test Indirect immunofluorescence assay • Isolation of organism Not recommended Treatment • Doxycycline Control