Akamushi disease


Akamushi Disease

Description, Causes and Risk Factors:

Also called as tsutsugamushi disease.

An acute infectious disease caused by Rickettsia tsutsugamushi and transmitted by Trombicula akamushi and T. deliensis that occurs in harvesters of hemp in some parts of Japan; characterized by fever, painful swelling of the lymphatic glands, a small blackish scab on the genitals, neck, or axilla, and an eruption of large dark red papules.

Alternative Names: Island disease, shimamushi disease, flood fever, inundation fever, island fever, Japanese river fever, kedani fever, tsutsugamushi fever, mite typhus, scrub typhus, and tropical typhus.

ICD-9-CM: 081.2.

akamushi disease

An infection caused by Orientia tsutsugamushi - a small intracellular bacterium related to the family of Rickettsiaceae - the organism is classified on its own and not with other rickettsiaceae as it has differences in genes and cell wall structure. The name scrub typhus was applied after discovery of increased frequency of the disease in scrub or wasteland areas.

Orientia tsutsugamushi is transmitted by the ovaries of trombiculid mites. The offspring mites or larvae are then infected and these are known as "chiggers". These mites then pass the infection to humans by feeding on the fluid in skin cells.

Infection with scrub typhus is most often self-limiting but can occasionally be severe and even fatal.

Symptoms:

The early clinical course of Akamushi disease is marked by a gradual rise of the body temperature and swelling of the adjacent lymph nodes. The incubation period is about eight days. The fever, which is usually 38-39 C in the early stage, may rise to 40 C or ever higher, and usually last three or four weeks. In bad cases a fatal results follows about tend days after the onset. The mortality of the disease is approximately forty percent.

Diagnosis:

Investigations:

  • PCR: Some studies have used PCR (polymerase chain reaction) on specimens obtained from eschars. This involves obtaining a small piece of the eschar and then amplifying the DNA to look for the genetic sequence of scrub typhus.

  • Indirect immunofluorescence.

Treatment Options:

Antibiotics: Doxycycline orally or chloramphenicol in more severe cases. Azithromycin has been used in resistant cases and may be better than doxycycline - especially in children and pregnant women

DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.

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