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No rapid laboratory tests are available to diagnose rickettsial diseases early in the course of illness, and serologic assays usually take 10–12 days to become positive. Research is indicating that swabs of eschars may be used for molecular detection of rickettsial infections. [6] [7]
Symptoms can take 1–2 days to 2 weeks to present themselves within the host. [10] The diagnosis of RMSF is easier when there is a known history of a tick bite or if the rash is already apparent in the affected individual. [39] If not treated properly, the illness may become serious, leading to hospitalization and possible fatality. [40]
The Weil–Felix test is an agglutination test for the diagnosis of rickettsial infections. It was first described in 1916. By virtue of its long history and of its simplicity, it has been one of the most widely employed tests for rickettsia on a global scale, despite being superseded in many settings by more sensitive and specific diagnostic tests.
Diagnosis in the early stages is difficult. [5] A number of laboratory tests can confirm the diagnosis but treatment should be begun based on symptoms. [5] It is within a group known as spotted fever rickettsiosis, together with Rickettsia parkeri rickettsiosis, Pacific Coast tick fever, and rickettsialpox. [6]
Spotted fever rickettsiosis, also known as spotted fever group rickettsia (SFGR), is a group of infections that include Rocky Mountain spotted fever, Rickettsia parkeri rickettsiosis, Pacific Coast tick fever, and rickettsialpox. [2] The group of infections was created in 2010 as they are difficult to tell apart. [2]
Rickettsia is a genus of nonmotile, gram-negative, nonspore-forming, highly pleomorphic bacteria that may occur in the forms of cocci (0.1 μm in diameter), bacilli (1–4 μm long), or threads (up to about 10 μm long).
Suspected infections are confirmed with serological tests. O. tsutsugamushi is most often detected from blood serum using the Weil–Felix test. Weil–Felix is the simplest and most rapid test, but it is not sensitive or specific, as it detects any kind of rickettsial infection.
Diagnosis is through finding the fluke eggs microscopically in a stool sample. A needle aspiration biopsy of an enlarged lymph node will reveal rickettsial organisms within macrophages in many cases. [6] The rickettsial infection can be successfully treated with tetracycline, and the fluke infection can be treated with fenbendazole.