1. Sunil Kumar Daha
Typhus Fever

2. • A group of diseases caused by Rickettsiae species
• Rickettsiae :small intracellular bacteria that inhabit the alimentary
tract of arthropods, including body lice, fleas, hard ticks and larval
mites
• Spread by inoculation of their faeces throgh broken human skin
• Multisystem involvement is usual.
Typhus

3. Rickettsial fever
• Most common tick-borne infections
• Occur in warm climates
• Rickettsial fever
• Spotted Fever
• Typhus
• Epidemic Typhus (1-2 weeks)
• Endemic Typhus (8-16 days)
• Scrub typhus (6-21 days)

4. Features

5. • Fever
• Fever rises to (39-41)ºC and is persistent
• Patients with typhus have relative bradycardia with the fever
•Malaise
• Tachypnea and cough (scrub typhus)
• Rash
• The macular, maculopapular, or petechial rash
• initially on the trunk and axilla and spreads to involve the rest of the body
including face, palms, and soles
• Rash may be petechial in patients with epidemic or murine typhus.
Clinical Features

6. • Regional lymphadenopathy (scrub typhus)
• Generalized lymphadenopathy
• Lymph nodes are often tender and enlarged.
• Eschar (scrub typhus)
• Headache
• Arthalgia
• Pain in back and limbs
• Facial flushing (Epidemic)
Clinical Features

7. Brill Zinsser disease (Recrudescent typhus)
• Recurrent form of epidemic typhus.
• Signs and symptoms: similar to those of epidemic typhus but are
1. less severe
2. shorter duration
3. and rarely fatal
4. Does not cause skin rash

8. • Frequently misdiagnosed as typhoid
• Diagnosis
• made on clinical grounds
• response to treatment
• Confirmatory
• PCR
• Antibody detection
Investigation

9. • All typhus respond to
• Tetracycline x 500 mg x PO x QID x 7 days
• Doxycycline x 200 mg x PO x OD x 7days
• Chloramphenicol x 500 mg x PO x QID x 7 days
• Epidemic and Scrub typhus
• Doxycycline x 200 mg –single dose, repeated for 2-3 days to prevent relapse.
• If Doxycycline and Chloramphenicol resistant
• Rifampicin
Treatment

10. • Nursing care essential for epidemic typhus
• If delirium-Sedation
• If hemorrhage-Blood transfusion
• Prevention
• Control of ticks, lice, fleas and mites with insecticides
Cont…

11. • Dockrell DH, Sundar S, Angus BJ, Hobson RP. Infectious disease,In: Walker BR,
Colledge NR, Ralston SH, Penman I. Davidson's principles and practice of
medicine. 22nd ed. Edinburgh : Churchill Livingstone/Elsevier; 2014.p.350-
352.
• Fauci AS, Braunwald E, Kasper DL, Hauser SL, Longo DL, Jameson JL, et al.,
editors. Harrison’s principles of internal medicine. Hematology and
Oncology.19th ed. New York: McGraw Hill; 2014
References

12. Thank you!