From Big Medical Encyclopedia

RICKETTSIOSES (rickettsiosis, the singular) — group of the transmissible infectious diseases caused by rickettsiae.

Rubles of the person subdivide into 5 groups: group of a sapropyra — sapropyra epidemic (see), flea typhus local (see); group of tick-borne spotty fevers — spotty fever of the Rocky Mountains (see), Marseilles fever (see), North Asian tick-borne rickettsiosis (see), vesicular rickettsiosis (see), the Brazilian sapropyra, the East African tick-borne typhus, the South African tick-borne typhus, the Australian tick-borne rickettsiosis (see. Tick-borne rickettsioses ); group of a tsutsugamusha with the only nosological form — tsutsugamush (see); group of the Q fever also with the only nosological form — Q fever (see); group of paroxysmal rickettsioses — trench fever (see) and a tick-borne paroxysmal rickettsiosis (see. Tick-borne rickettsioses ).

Rubles meet worldwide. An epidemic sapropyra and trench fever — antroponoza; a source of an infection at these R. is the sick person or the long carrier (at trench fever), and a carrier of an infection — a clothes and head louse. Other R. — zoonoza with a natural ochagovost, at to-rykh a source of the activator — nek-ry small mammals, and a carrier — blood-sicking arthropods. Only the activator of the Q fever can be transferred also in the contact, alimentary, and also airborne way.

Patol. process at R. of the person is caused by reproduction of rickettsiae of hl. obr. in the endothelial cells covering walls of blood vessels especially small. As a result of it infectious develops vasculitis (see). On walls of vessels, most often capillaries, precapillaries and arterioles, small knots (granulomas) revealed microscopically are formed specific to this group of diseases (except the Q fever). Intensive rickettsial intoxication and a diffusion specific vascular granulomatosis cause considerable disturbances from c. N page and circulatory disturbance, especially microcirculation. Data on a possibility of long parasitizing of rickettsiae in an organism had and about a possibility of development in this regard in them different cardiovascular pathology in many years after the postponed disease, napr, thromboangites are published (see. Thromboangitis obliterating ) and even myocardial infarction (see). This pathology can be caused by parasitizing of rickettsiae of Provachek, R. typhi (Muzer's rickettsiae), Conor's rickettsiae, rickettsiae of a tsutsugamusha and koksiyell Burnett (see. Rickettsiae ). These data are proved by the fact that in blood serum of patients with cardiovascular diseases antibodies to rickettsiae sometimes come to light. Latent infection, on representation of a number of researchers, can also cause slowly progressing patol. process in cardiovascular system with development coronaritisis (see) and ischemia of a myocardium (see. Ischemia ).

After the postponed disease usually resistant is created ikhmmunitt: anti-infectious and anti-toxic. Participation in development is established immunity (see) at R. not only humoral, but also cellular factors, in particular macrophages and T - and V-lymphocytes.

River — sharply proceeding diseases with a cyclic current, lasting from 2 to 3 weeks, followed by the expressed intoxication, a characteristic symptom complex from the central nervous and vascular systems, and also existence of a dieback (except the Q fever). At the same time, however, each R. has typical a wedge, a picture.

For R.'s diagnosis along with data of clinic and epidemiol. the anamnesis use the next laboratory researches: an agglutination test with the corresponding rickettsiae (see. Agglutination ); reaction of indirect hemagglutination (see. Hemagglutination ); reaction of binding complement (see), enzyme - marked antibodies reaction (see. Enzyme-immunological method ). Besides, apply skin allergy tests (see. Skin tests ).

For studying of action of rickettsiae on an organism, features of immunity and patol. process at R. reproduce a rickettsial infection on animals. Most often for this purpose use Guinea pigs, at infection to-rykh comes to light a feverish and scrotal phenomenon and the peritoneal phenomena, and also white mice, white rats, cotton rats, rabbits, at to-rykh specific pneumonia is reproduced. Cause a panophthalmia at introduction in rabbits of a rickettsia them in an anterior chamber of an eye. At intradermal infection at rabbits and Guinea pigs in an injection site of rickettsiae infiltration and a necrosis is noted; at introduction of rickettsiae to a small egg the orchitis with accumulation of rickettsiae develops; intraperitoneal and especially intravenous administration of rickettsiae in high doses leads to rpkketsiozny intoxication with death of animals during the 24th hour.

R.'s treatment is carried out by antibiotics of group of tetracycline. To resistance of rickettsiae to antibiotics it is not established.

The most effective action for R.'s prevention is destruction of arthropods — carriers of an infection (louses, mites, fleas) and protection of the person against attack of arthropods (see. Protecting screens , Clothes special , Repellents ). Specific prevention is developed for nek-ry R. (a sapropyra, the Q fever, spotty fever of the Rocky Mountains), edges it is used according to epidemic indications.

Bibliography: Giroud P. and Sarro-n of i M. The cardiovascular changes caused by rickettsiae and a neorickettsia-mi, Shurn. gigabyte., epid., mikr. and immun., t. 12, No. 2, page 119, 1968; 3 d r about d about in - with to and y P. F. both about l and N e in and the p E. M. The doctrine about rickettsiae and rickettsioses, M., 1972, bibliogr.; K. M mullet. The most important rickettsioses of the person, JI., 1980, bibliogr.; Diagnostic procedures for viral and rickettsial infections, ed. by E. H. Len-nette a. N. J. Schmidt, N. Y., 1969, bibliogr.; Hollingdale M. R., Herrmann J. E. and. At i n s o n J. W. Enzyme immunoassay of antibody to Ro-chalimae quintana, diagnosis of trench fever and serologic cross-reactions among other rickettsiae, J. infect. Dis., v. 137, p. 578, 1978; Nicolau St. S. §i Constantinescu N. Rickettsii §i rickettsioze, Bucure§ti, 1965; R u s-s about P. K. a. o. Epidemic typhus (Rickettsia prowazekii) of in Massachusetts evidence of infection, New Engl. J. Med., v. 304, p. 1166, 1981; Tropical medicine, ed. by G. W. Hunter a. o., p. 95, Philadelphia a. o., 1976.

K. M. Loban.