Rickettsia is a genus of nonmotile, Gram-poor, nonspore-forming, enormously pleomorphic bacteria that can exist as cocci (zero.1 μm in diameter), rods (1–four μm long), or thread-like (10 μm long). Being obligate intracellular parasites, the Rickettsia survival relies upon on entry, growth, and replication inside the cytoplasm of eukaryotic host cells. Rickettsiae include a set of microorganisms that phylogenetically occupy a function between bacteria and viruses. The genus Rickettsia is blanketed inside the bacterial tribeRickettsiae, own family Rickettsiaceae, and order Rickettsiales. They may be obligate intracellular gram-bad coccobacillary bureaucracy that multiplies inside eukaryotic cells. Rickettsiae do now not stain well with Gram stain, however they tackle a feature red shade when stained by means of the Giemsa or Gimenez stain. They have usual gram-bad cellular walls and lack flagella. Their genome is very small, composed of 1-1.5 million bases.
Treatment of patients with feasible rickettsioses must be commenced early and ought to never watch for confirmatory testing, which may also take weeks while serology is used. Instantaneous empiric treatment with a tetracycline is recommended, maximum generally doxycycline. Extensive-spectrum antibiotics are not generally helpful. Chloramphenicol can be an opportunity in some cases, but its use is associated with greater deaths, specifically for R. rickettsii. Expert advice must be sought if opportunity agents are being considered.
Each of our three patients diagnosed with MSF presented with a different complicated course: one with meningoencephalitis, one with lung embolism and one with septic shock and multi organ failure. In published series, rate of complications (defined as severe organ involvement) ranged from 1% to 20%. However, study designs and settings were highly variable and did not allow for relevant comparisons. Meningoencephalitis and shock with multi organ failure were the most frequently observed complications. Mortality of severe course was up to 20% in some series.