Typhus

Dr. Richin Koshy

Basic details

• 46 yr old female came wih complaints of high fever, joint pain and truncal rashes for 2 week.

• Consulted Rural PHC

• Analgesics taken as and when needed

• Not responding to medications

Chief Complaints

• Headache

• Fever

• Rash

DIFFRENTIAL DIAGNOSIS – Fever with a rash

• Measles

• Rubella h/o - Immunisation

• Lyme disease

• Leptospirosis

• Typhoid Fever

• Acute Retroviral Syndrome

• Roseola – HHV 6

• Louse-borne Typhus

• Murine Typhus

• Secondary Syphilis

• Meningococcemia

INVESTIGATION ADVISED

• CBC

• WIDAL

• ESR

• CRP

• HIV antibody and viral load

• Antibody Orientia tsutsu gamushi

Diagnosis

• Typhus

TREATMENT GIVEN

Treatment for all rickettsial diseases and vector-borne illness is doxycycline.

REPORT

• R. typhi is carried usually in rats and transmitted to humans from feces of fleas.

• R. prowazekii is transmitted from the feces of lice.

• Symptoms of typhus include an incubation of 6-15 days. After 1-3 weeks post bite an infected individual presents with sudden chills, high fever, and headache. 5-9 days after onset a maculopapularrash appears on the trunk and spreads to extremities, usually sparing the face, palms, and soles.

• Diagnosis can be made via serology using the indirect fluorescent antibody (IFA) test.

• Rickettsia are Weil-Felix positive

• THANK YOU.