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Section 3. Summaries of Infectious Diseases
Epidemic Typhus
(Louseborne Typhus)
Clinical Manifestations
Etiology
Epidemiology
Diagnostic Tests
Treatment
Isolation of the Hospitalized Patient
Control Measures
CLINICAL MANIFESTATIONS: Epidemic louseborne typhus is characterized
by the abrupt onset of high fever, chills, and myalgias accompanied
by severe headache and malaise. Influenza illness commonly is
suspected. A rash appears 4 to 7 days after illness onset, beginning
on the trunk and spreading to the limbs. A concentrated eruption
can be present in the axillae. The rash typically is maculopapular,
becomes petechial or hemorrhagic, then develops into brownish
pigmented areas. The face, palms, and soles usually are not
affected. Changes in mental status are common, and delirium
or coma can occur. Myocardial and renal failure can occur when
the disease is severe. The fatality rate in untreated people
is as high as 30%. Mortality is less common in children, and
the rate increases with advancing age. Untreated patients who
recover typically have an illness lasting 2 weeks. Brill-Zinsser
disease is a relapse of epidemic louseborne typhus that occurs
years after the initial episode. Factors that reactivate the
rickettsiae are unknown. The recrudescent illness is similar
to the primary
. . . [Go to Full Text]
Related text in Red Book:
- Introduction
Red Book
2006: 735.
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