Body louse vector, person to person; alchoholic, homeless (Nejm 1999;340:184), and AIDS pts (Nejm 1995;332:419, 424); Europe, USSR, Mexico
Endocarditis; and bacillary angiomatosis (Nejm 1997;337:1876, 1888, 1916; 1995;332:419, 424) cutaneous and deep tissue infections as well as osteolytic bone lesions, esp in AIDS and other immunocompromised pts
Lab:
Bact: Small pleomorphic gram-neg
Serol: comp-fix antibody; Weil-Felix OXK positive ST, 50% never become OXK Weil-Felix positive; fluorescent antibody increased × 4 in 100%
Rx:Macrolide antibiotics, tetracyclines, chloramphenicol