Gefährliches Souvenier - Rocky Mountain Spotted Fever

Zusammenfassung

Rickettsiosen gehören zu einer weltweit vorkommenden Gruppe von Anthropozoonosen. Rickettsien sind Verursacher des Rocky Mountain Spotted Fever und der Rickettsienpocken. Aufgrund der Unspezifität und Variabilität ihrer Symptome sowie der relativen Unbekanntheit in Deutschland können sie die Diagnosestellung und Therapie bei Reisenden aus Endemiegebieten verzögern. Dies führt im Falle des Rocky Mountain Spotted Fever zu einer deutlichen Prognoseverschlechterung und birgt die Gefahr von multiplen Organschäden wie Enzephalopathien, Lungenödem und Störungen von Elektrolythaushalt und Blutgerinnung. Aufgrund des zunehmenden Reiseverkehrs in Endemiegebiete und des Nachweises neuer Rickettsiosen in Europa muss der deutsche Arzt für diese Erkrankungen sensibilisiert werden, um adäquat und frühzeitig (be)handeln zu können. Die vorliegende Kasuistik beschreibt den siebentägigen Krankheitsverlauf einer letztlich ungeklärten Rickettsiose bei zwei deutschen Touristen in Toronto, Ontario, Kanada.

Abstract

Rickettsioses belong to a group of world wide occurring anthropozoonoses causing both rocky mountain spotted fever and rickettsialpox. Unspecifity and variety of symptoms as well as unawareness of the disease in German medical practice may lead to underdiagnose in repatriates and tourists from endemic areas. Prolonged incertitude in diagnosis and delayed therapy in the case of Rocky Mountain Spotted Fever may contribute to a worse outcome and holds risk of multiple organ dysfunction, such as encephalopathy, pulmonary edema, electrolyte disturbances and impairments within the coagulation system. In view of increased tourist travel in endemic areas and detection of new rickettsioses in Europe, German physicians have to be sensitized for rickettsial infections to react early and adequately. The here reported case demonstrates a seven-day course of disease of two German tourists traveling to Toronto, Ontario, Canada.

Schlüsselwörter

Rickettsiose - Rocky Mountain Spotted Fever - Anthropozoonose - Rickettsienpocken - RMSF

Key words

Rickettsiosis - Rocky Mountain Spotted Fever - Anthropozoonose - Rickettsialpox - RMSF

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