Hepatitis in Association with Rickettsialpox

Abstract

Rickettsialpox is an acute, self-limited, febrile illness caused by Rickettsia akari and transmitted by Liponyssoides sanguineus, a mite that infests the common house mouse, Mus musculus. Liver involvement in rickettsialpox has received little attention, although hepatitis has been reported in several other rickettsial infections. In this report, we describe two patients with rickettsialpox who had acute hepatitis that resolved completely. In the appropriate clinical setting, rickettsialpox should be considered in the differential diagnosis of hepatitis.

Severe human infection with Rickettsia felis associated with hepatitis in Yucatan, Mexico

“…Recently, hepatitis has been associated with rickettsialpox and is a well-documented manifestation of some cases of Rocky Mountain spotted fever but seldom occurs in R. akari infection which manifests moderate self-limiting signs and symptoms (Madison et al, 2008). Such an atypical clinical manifestation could also take place in other rickettsial infections and mislead the physician to an incorrect diagnosis.…”

Syndromic classification of rickettsioses: an approach for clinical practice

“…111 In 2008, two cases of acute hepatitis were described in patients infected with R. akari. 112 Liponyssoides sanguineus (Allodermanyssus sanguineus) is the only vector and reservoir, and the domestic mouse (Mus musculus) is the primary host of L. sanguineus, 113 although this mite has been found infesting wild and synanthropic rodents. 114 The presence of R. akari has been described in some American countries, [115][116][117] Europe, 118,119 Asia, 120 and Africa.…”

Fever and a Solitary Papule on the Foot

“…Cases associated with hepatitis have rarely been reported. 8 Doxycycline is the treatment of choice and in some cases halts progression of disease within 48 to 72 hours. 9 Quinolones, tetracycline, and chloramphenicol are alternative therapies, although use of the latter is limited by a risk of adverse hematologic events.…”