epidemic typhus

Etiology: Rickettsia prowazekii Epidemiology: 1) exposure to body lice 2) occurrence of recrudescent typhus as relapse after 30-50 years (Brill-Zinsser disease) Clinical manifestations: 1) maculopapular skin eruption a) generally spares the face, palms & soles b) evolves from blanchable macules to confluent eruption with petechiae c) rash of short duration in recrudescent typhus 2) headaches 3) myalgias 4) milder clinical presentation in recrudescent form Complications: -> 40% mortality if untreated Management: see Rocky Mountain spotted fever

General

typhus louse (Anoplura)-borne infection

References

Harrison's Principles of Internal Medicine, 14th ed. Fauci et al (eds), McGraw-Hill Inc. NY, 1998, pg 91