4. • Travellers/ inhabitants of endemic areas likely have
septicemia but (-)cultures ?Typhus
• Incubation period: 2 -23 days
5. Signs
Mild/ asymptomatic
Severe/ systemic: sudden fever, frontal
headache, confusion & jaundice
Eschar: dark crusty ulcer at the site of a bite
Rickettsial rash: macular, papular, petechial or
hemorrhagic
12. Murine Endemic Typhus
• R. typhi
• Spread: fleas from rats to humans
• Prevalent in warm coastal ports
13. Diagnosis
• clinical history
• physical exam
• tests based on identification of the bacterial genus
and species by PCR testing of skin biopsy of skin
rash, skin lesions/blood samples
• immunohistological staining that identifies the
bacteria within infected tissue (skin tissue, usually)
• Dx late or after the disease has been treated with
antibiotics, when significant titers of antirickettsial
antibodies are detected by immunological
techniques.
14. Diagnosis
• CBC: show anemia and low platelets
• High level of typhus antibodies
• Low level of albumin
• Low sodium level
• Mild kidney failure
• Mildly high liver enzymes
15.
16. Treatment
• Doxycycline 100mg/ 12hrs PO/IV for 7 days or
48 hours after temp is normal
• Chloramphenicol 500mg/ 6 hours PO for 10-14 days
• Azithromycin 500 mg 1 dose for tick & Scrub typhus
