Typhoid typhus endemic
endemic typhus– an acute infectious disease characterized by a cyclic course, fever, roseolous-papular rash on the skin. Etiology. The causative agent is the gram-negative bacterium Rickettsia typhi, morphologically similar to Provacek’s rickettsiae. Epidemiology. The reservoir of infection is rats and mice, the vectors are fleas, rat lice (Polyplax) and, probably, the rat tick (Bdelonyssus). Infection of people occurs when the feces of infected fleas are rubbed into the skin during scratching, after the infected feces of parasites enter the mucous membranes of the eyes, upper respiratory tract, and also through the alimentary route through products contaminated with the urine of diseased rodents. It is possible to transmit the pathogen from person to person with body lice. Endemic areas – North and South Africa, Southeast Asia, Australia, India, the coasts of the North, Baltic, Caspian, Black Seas. Pathogenesis. Rickettsia, having penetrated into the human body, intensively multiply in endothelial cells and, as a result of their destruction, enter the bloodstream, causing rickettsiemia and endotoxemia.
Clinical picture
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- Incubation period – 5-15 days
- The disease begins acutely, with chills, high body temperature, headache, joint and muscle pain, flushing of the face and conjunctiva.
- Fever reaches a maximum by the end of 1 week (38-40 ° C), has a permanent or laxative character. A little later, rashes and enanthema are found on the mucous membrane of the soft palate.
- For 5-7 days, an abundant roseolous-papular rash is observed on all parts of the body, incl. on the face, palms, feet, soles (unlike epidemic typhus). On 11-12 days the rash disappears
- Muffled heart sounds, bradycardia and arterial hypotension are noted
- 50%
diseased – enlargement of the liver and spleen
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- Sometimes blood shows leukopenia, aneosinophilia, or lymphocytes
- Complications are rare, most often thrombophlebitis, pneumonia, sinusitis and otitis media develop.
Research methods
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- Microscopy of the pathogen in stained smears, Romanovsky-Giemsa, Castaneda and Macchiavelo stains are used (Zdrodovsky’s modification of PF can be used)
- Serological reactions (RCC with Rickettsia typhi Ag, microagglutination reaction, hemagglutination, etc.). WHO recommends an indirect immunofluorescence test. In diagnostic titers, AT begin to appear in the blood serum on days 4-7 of the disease. Differential Diagnosis
- epidemic typhus
- Meningitis
- Measles
- Rubella
- Toxoplasmosis
- Leptospirosis
- Typhoid fever
- Secondary syphilis
- Infectious mononucleosis.
Treatment – see Epidemic typhus Synonyms
- Flea typhus
- Toulon typhus
- Bangalore
- Tabardillo ICD. A75 Typhus Literature. 129:250