title: Syndromic classification of rickettsioses: an approach for clinical practice.
abstract: Rickettsioses share common clinical manifestations, such as fever, malaise, exanthema, the presence or absence of an inoculation eschar, and lymphadenopathy. Some of these manifestations can be suggestive of certain species of Rickettsia infection. Nevertheless none of these manifestations are pathognomonic, and direct diagnostic methods to confirm the involved species are always required. A syndrome is a set of signs and symptoms that characterizes a disease with many etiologies or causes. This situation is applicable to rickettsioses, where different species can cause similar clinical presentations. We propose a syndromic classification for these diseases: exanthematic rickettsiosis syndrome with a low probability of inoculation eschar and rickettsiosis syndrome with a probability of inoculation eschar and their variants. In doing so, we take into account the clinical manifestations, the geographic origin, and the possible vector involved, in order to provide a guide for physicians of the most probable etiological agent.
authors.affiliation: Microbiology Department, Faculty of Sciences, Pontificia Universidad Javeriana, Bogotá, Colombia.
authors.forename: Álvaro A
authors.initials: ÁA
authors.lastname: Faccini-Martínez
authors.affiliation: Infectious Diseases Department, Center of Rickettsioses and Vector-borne Diseases, Hospital San Pedro-CIBIR, Logroño, Spain.
authors.forename: Lara
authors.initials: L
authors.lastname: García-Álvarez
authors.affiliation: Microbiology Department, Faculty of Sciences, Pontificia Universidad Javeriana, Bogotá, Colombia.
authors.forename: Marylin
authors.initials: M
authors.lastname: Hidalgo
authors.affiliation: Infectious Diseases Department, Center of Rickettsioses and Vector-borne Diseases, Hospital San Pedro-CIBIR, Logroño, Spain. Electronic address: jaoteo@riojasalud.es.
authors.forename: José A
authors.initials: JA
authors.lastname: Oteo
mesh_terms: D005076:Exanthema / Q000473:pathology; D006801:Humans; D011336:Probability; D012282:Rickettsia Infections / Q000145:classification / Q000175:diagnosis* / Q000382:microbiology / Q000473:pathology; D013577:Syndrome
keywords: Arthropod-borne diseases; Eschar; Rash; Rickettsia spp.; Rickettsioses; Syndrome