(Caucasian, classic or lice related typhoid fever, “jail Fever”)
Epidemic typhus caused by Rickettsia prowazekii. The symptoms consist of prolongiertem high fever, persistent headache and a rash makulopapulären.
Epidemic typhus is a rickettsial disease.
Epidemic typhus caused by Rickettsia prowazekii. The symptoms consist of prolongiertem high fever, persistent headache and a rash makulopapulären. Epidemic typhus is a rickettsial disease. The natural reservoir for the world’s occurring pathogens R. prowazekii is man. The pathogen is transmitted by body lice when Läusekot is carved into bite or other wounds or rubbed (or occasionally on the conjunctival or oral mucosa). In the US, there are occasional human infections after contact with flying squirrel. In children <10 years it rarely comes to death, but mortality increases with age and if not treated patients> reach 60% for 50 years. Symptoms and complaints After an incubation period of 7-14 days, it suddenly comes to fever, headache and exhaustion. The temperature reached within days 40 ° C and remains elevated for about two weeks, with slight morning remissions. There appear generalized and intense headache. The body is covered quickly by small, pink macules that on 4th-6th are day appear and usually found in the axilla and upper torso, but not on the palms, soles and face. Later, the rash becomes dark and maculopapular. In severe cases, the rash is petechial and hemorrhagic. Sometimes there is a splenomegaly. For most severely ill patients experience a drop in blood pressure. Circulatory collapse, renal insufficiency, signs of encephalitis, ecchymosis with gangrene and pneumonia are unfavorable prognostic sign. Diagnosis Clinical symptoms biopsy of skin rash with fluorescent antibody staining, Acute to recognize the pathogen and current serological tests (serological tests are acutely not make sense) PCR lice infestation is usually obvious and is highly suggestive of typhoid back when the medical history (eg. B. are resident or visiting an endemic area) is an indication of exposure. Details for diagnosis, overview of Rickettsia infections: diagnosis. Doxycycline therapy The primary therapy is carried out with doxycycline 200 mg p.o. 1 times a day, followed by 100 mg 2 times daily until clinical improvement occurs, the patient is 24-48 h afebrile and has received a therapy for at least 7 days. Means of the second choice is Chloramphenicol 500 mg p.o. or iv 4 times daily for 7 days. Prevention Vaccination and lice control are highly effective prevention measures. However, vaccines are not available in the US. For lice elimination people can be dusted with malathion or lindane. Brill-Zinsser disease The Brill-Zinsser disease is a recurrence of the epidemic typhus that occurs years after a primary disease. Patients with Brill-Zinsser disease have previously purchased typhus or living in an endemic area. Apparently are activated in the body and cause rekurrierendes shipping fever with diminishing host defenses capable of reproduction pathogens; therefore the disease occurs sporadically in any seasons or geographic areas and in the absence of infected lice. Lice that suck blood to patients, but they can take up the pathogen and transmitted. The symptoms and signs are almost always easy and recall the symptoms of shipping fever with similar circulatory disorders and hepatic, renal and central nervous system changes. The remitting course of the fever will take about 7-10days. The rash is usually vanishingly small or absent. Increased mortality does not exist. For diagnosis and therapy, Epidemic typhus: diagnosis.