‫بسم اهلل الرحمن الرحيم‬

RICKETTSIA
AND
COXIELLA
Prof. Khalifa Sifaw Ghenghesh
 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
 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 intra-
cellularly >> destroy host cell
 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
 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)
 Scrub typhus
• Orientia tsutsugamushi (previously
R. tsutsugamushi )
• Larval stages (chiggers) of mites
(Leptotrombidium)
• Hosts: Rats or other small mammals
 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
 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
 Treatment
 Rickettsiostatic antibiotics
• Tetracyclines
• Chloramphenicol
 Intensive nursing care and
management of fluids and
electrolytes
 Child's right hand and wrist displaying the
characteristic spotted rash of Rocky Mountain
spotted fever caused by Rickettsia rickettsii
 Rickettsia tsutsugamushi free within the
cytoplasm of a mouse brain capillary
endothelial cell. Capillary wall appears in cross
section
 Dorsal view of an American Dog Tick,
Dermacentor variabilis, a known carrier of
Rocky Mountain Spotted Fever caused by the
bacterium Rickettsia rickettsii.
IFA reaction of a positive human serum
on Rickettsia rickettsii grown in chicken
yolk sacs, 400X
 Red structures indicate immunohistological
staining of Rickettsia rickettsii in endothelial
cells of a blood vessel from a patient with fatal
RMSF
Removing attached ticks
 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
Coxiella burnetii
Coxiella burnetii
 Laboratory Diagnosis
• Demonstration of specific Abs
 Complement fixation test
 Indirect immunofluorescence

assay
• Isolation of organism
 Not recommended
 Treatment
• Doxycycline

 Control