Abstract:
Rickettsial diseases, caused by a variety of obligate intracellular, gram-negative bacteria from the genera Rickettsia, Orientia, Ehrlichia, Neorickettsia, Neoehrlichia, and Anaplasma, belonging to the Alphaproteobacteria, are considered some of the most covert emerging and re-emerging diseases and are being increasingly recognized. Among the major groups of rickettsioses, commonly reported diseases in India are scrub typhus, murine flea-borne typhus, Indian tick typhus and Q fever. Rickettsial infections are generally incapacitating and difficult to diagnose; untreated cases have case fatality rates as high as 30-45 per cent with multiple organ dysfunction, if not promptly diagnosed and appropriately treated. The vast variability and non-specific presentation of this infection have often made it difficult to diagnose clinically. Prompt antibiotic therapy shortens the course of the disease, lowers the risk of complications and in turn reduces morbidity and mortality due to rickettsial diseases. There is a distinct need for physicians and health care workers at all levels of care in India to be aware of the clinical features, available diagnostic tests and their interpretation, and the therapy of these infections. Therefore, a Task Force was constituted by the Indian Council of Medical Research (ICMR) to formulate guidelines for diagnosis and management of rickettsial diseases. These guidelines include presenting manifestations, case definition, laboratory criteria (specific and supportive investigations) and treatment.
摘要:
立克次体病,由多种细胞内专性引起,来自立克次体属的革兰氏阴性细菌,东方,埃里希亚,Neorickettsia,Neoehrlichia,和无性体,属于阿尔法变形杆菌,被认为是一些最隐蔽的新兴和重新出现的疾病,并且越来越受到认可。在立克次体病的主要群体中,印度常见的疾病是斑疹伤寒,鼠跳蚤传播的斑疹伤寒,印度斑疹伤寒和Q热。立克次体感染一般无行为能力,难以诊断;未经治疗的病例多器官功能障碍的病死率高达30-45%,如果不及时诊断和适当治疗。这种感染的巨大变异性和非特异性表现通常使临床诊断变得困难。及时的抗生素治疗缩短了病程,降低并发症的风险,进而降低立克次体疾病的发病率和死亡率。印度各级护理的医生和卫生保健工作者都需要了解临床特征,可用的诊断测试及其解释,以及这些感染的治疗。因此,印度医学研究理事会(ICMR)成立了一个工作组,负责制定立克次体疾病诊断和治疗指南.这些准则包括提出各种表现形式,案例定义,实验室标准(具体和支持性研究)和治疗。