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[立克次体病]

[Rickettsioses].

作者信息

Bernabeu-Wittel Máximo, Segura-Porta Ferran

机构信息

Servicio de Medicina Interna, Hospitales Universitarios Virgen del Rocío, Sevilla, Spain.

出版信息

Enferm Infecc Microbiol Clin. 2005 Mar;23(3):163-72. doi: 10.1157/13072167.

Abstract

Species of the genus Rickettsia are small, obligate intracelular, gramnegative bacteria, many of which are considered nowadays a paradigm of emergent pathogens. With the exception of R. prowazekii, they are maintained in the natural environment through a cycle involving different hosts (mainly mammals), and arthropod vectors (in general ticks, and fleas); humans are affected only by incidental transmission due to arthropod bites. The common pathogenesis of these diseases lie on the predominantly infection of endotelial cells, that determines the development of multisistemic small vessel vasculitis, which may affect lungs (interstitial pneumonitis), heart (miopericarditis), skin (rash), central nervous system (meningoencephalitis), as well as liver, and kidneys. They are classified in two groups: spotted-fever group, and typhus group rickettsia. In Spain the most prevalent rickettsioses of both groups are mediterranean spotted fever (caused by R. conorii), and murine typhus (caused by R. typhi), respectively. This review focuses mainly in these two diseases, and also in other rickettsioses of interest due to their recently emergence or reemergence (R. slovaca, R. africae, R. prowazekii, R. felis), or to their high incidence in other areas (R. rickettsii, Orientia tsutsugamushi).

摘要

立克次氏体属的细菌体积微小,是专性细胞内寄生的革兰氏阴性菌,如今其中许多被视为新出现病原体的典范。除普氏立克次氏体之外,它们在自然环境中通过一个涉及不同宿主(主要是哺乳动物)和节肢动物媒介(通常为蜱和跳蚤)的循环得以维持;人类仅因节肢动物叮咬导致的偶然传播而受到感染。这些疾病的常见发病机制主要在于内皮细胞的感染,这会引发多系统小血管血管炎,可能影响肺部(间质性肺炎)、心脏(心肌心包炎)、皮肤(皮疹)、中枢神经系统(脑膜脑炎)以及肝脏和肾脏。它们分为两组:斑点热群立克次氏体和斑疹伤寒群立克次氏体。在西班牙,这两组中最常见的立克次体病分别是地中海斑点热(由康氏立克次氏体引起)和鼠型斑疹伤寒(由伤寒立克次氏体引起)。本综述主要聚焦于这两种疾病,以及其他因近期出现或再次出现(斯洛伐克立克次氏体、非洲立克次氏体、普氏立克次氏体、猫立克次氏体)或在其他地区发病率高(立氏立克次氏体、恙虫病东方体)而备受关注的立克次体病。

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