Rickettsialpox is a febrile, infectious disease caused by Rickettsia akari, which is transmitted to humans by the painless bite of mouse mites (Liponyssoides sanguineus). The disease has been identified in urban areas of the United States as well as South Korea, South Africa, and parts of Russia.
An eschar develops at the site of the mite bite within 24-48 hours, and this typically precedes the fever and systemic illness by another 1 or 2 days. The clinical course consists of fever that ranges from 38.3-41.1°C (101-106°F), malaise, headache, stiff neck, photophobia, myalgias, sweats, and chills. Conjunctival inflammation, cough, generalized adenopathy, and pharyngitis have all been described. The disease lasts 2-3 weeks with a persistent headache and lassitude that can last for weeks following the acute illness.
Rickettsialpox in Child
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Synopsis
Codes
ICD10CM:
A79.1 – Rickettsialpox due to Rickettsia akari
SNOMEDCT:
75096007 – Rickettsialpox
A79.1 – Rickettsialpox due to Rickettsia akari
SNOMEDCT:
75096007 – Rickettsialpox
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Other rickettsioses with eschar that are typically acquired outside the United States (eg, tick typhus, Mediterranean spotted fever, and scrub typhus).
- Varicella lesions (primary or post-vaccination) evolve in different stages (ie, they do not appear uniform) and often scar, whereas rickettsialpox lesions do not.
- Eczema herpeticum
- Eczema vaccinatum
- Gonococcemia
- Mpox
- Enteroviral infections
- Infectious mononucleosis
- Cutaneous anthrax
- Spider bite
- Acute meningococcemia (early)
- Coxsackie A viruses
- The lesions of smallpox are deeper and larger and are prominent on the face (this has been eradicated but remains a bioterrorism threat).
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Therapy
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Last Updated:09/05/2023
Rickettsialpox in Child