Scrub typhus

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scrub typus caused by o.tsutsugamushi

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Scrub typhus

  1. 1. ( CHIGGER BORNE TYPHUS) SCRUB TYPHUS 1CHIGGER
  2. 2. Scrub typhus-MICRO MGMC&H, Jaipur 2 RICKETTSIACEAE RICKETTSIA R.prowazekii R.typhi R.rickettsii R.conori R.australis R.siberica R.akari ORIENTIA O.tsutsugamushi FAMILY GENUS SPECIES DISEASE • True bacteria • Obligate intracellular parasite Mostly by ticks mites Epidemic typhus Brill-Zinsser disease Endemic typhus Rocky-mountain spotted fever Boutonneuse fever Australian tick typhus Siberian tick typhus Rickettsial pox Scrub typhus
  3. 3. INTRODUCTION-  Caused by O.tsutsugamushi “tsutsuga”-dangerous “mushi”-mite  Occurs in Japan, Sumatra, Australia and islands along the Western Pacific coast.  Disease transmitted by- larval form of Mite (Trombicula deliensis)  Incubation period-7-10 days  Case fatality-10-60% Scrub typhus-MICRO MGMC&H, Jaipur 3 O.tsutsugamushi
  4. 4. INFECTION-  Larval form is known as chiggers.  Found in areas of suitable climate, plenty of moisture and scrub vegetation.  Microbes are transmitted transovarianlly in all mites.  Various rodents and birds also act as reservoirs. Scrub typhus-MICRO MGMC&H, Jaipur 4 CHIGGER
  5. 5. Scrub typhus-MICRO MGMC&H, Jaipur 5 Four factors are essential for the establishment of infection, namely, co- existence and intimate relationship among-
  6. 6. CLINICAL FEATURES-  A necrotic lesion (eschar) occurs at the site of bite in the skin.  Severe headache  Chills  Fever  Conjunctivitis  Maculopapular rash  Enlarged spleen and lymph nodes  Severe cases –encephalitis and pneumonia Scrub typhus-MICRO MGMC&H, Jaipur 6 MACULOPAPULAR RASH ESCHAR
  7. 7. LABORATORY DIAGNOSIS • SPECIMENS • DIRECT MICROSCOPY • CULTURE (ISOLATION OF ORGANISM) • SEROLOGY • MOLECULAR METHODS Scrub typhus-MICRO MGMC&H, Jaipur 7
  8. 8. PRE REQUISITE - They are highly infectious, their isolation should be attempted only in labs equipped with appropriate safety measures. UNABLE TO GROW ON CELL FREE MEDIA. Scrub typhus-MICRO MGMC&H, Jaipur 8
  9. 9. SPECIMENS- For culture-  Blood  Tissue For serological test  serum Scrub typhus-MICRO MGMC&H, Jaipur 9
  10. 10. DIRECT MICROSCOPY GIEMSA STAIN  Purple colored basophilic inclusions MACHIAVELLO’S STAIN  Red colored inclusions Scrub typhus-MICRO MGMC&H, Jaipur 10
  11. 11. ISOLATION - Scrub typhus-MICRO MGMC&H, Jaipur 11 Blood clot in skimmed milk is inoculated intraperitoneally in male mice. Animals are to be observed for 3-4 weeks. Temperatures are recorded daily. RESULT- animal becomes ill and develop ASCITIS.
  12. 12. Demonstration-  Smears are taken from peritoneum, tunica and spleen of infected animals.  Stained by- GIEMSA STAIN  Culture used- 1. YOLK SAC OF CHICK EMBRYO 2. TISSUE CULTURE 3. Vero and MRC5 CELL CULTURES (not suitable for primary inoculation)  Identified by- IMMUNOFLUOESCENCE TEST Scrub typhus-MICRO MGMC&H, Jaipur 12 TISSUE CULTURE
  13. 13. SEROLOGY Weil felix test Scrub typhus-MICRO MGMC&H, Jaipur 13 Others- • Compliment fixation test • Latex agglutination test • Enzyme immune assay
  14. 14. Weil-Felix Test  Developed by Weil and Felix in 1916.  Some Proteus (OX19, OX2, OXK) strains are agglutinated by sera of patients with rickettsial infections.  This is due to the antigenic sharing between species of proteus and rickettsia.  It is an eg. of heterophile agglutination test. Scrub typhus-MICRO MGMC&H, Jaipur 14 DISEASE AGGLUTINATION WITH PROTEUS STRAIN OX19 OX2 OXK Scrub typhus - - +++
  15. 15. Scrub typhus-MICRO MGMC&H, Jaipur 15Treatment- Tetracyclines and chloramphenicol General measures- Control of vectors and animal reservoir. Vaccination- There is no safe and effective vaccine.
  16. 16. THANK YOU BY- UMANG JUNEJA 16

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