Typhus Fevers

Douglas W. MacPherson, MD, MSc–CTM, FRCPC Reviewed 06/2019

BASICS

An infectious disease syndrome caused by several rickettsial bacterial organisms resulting in acute, chronic, and recurrent disease (1)[C]

DESCRIPTION

Acute infection caused by three species of ...

DIAGNOSIS

Typhus syndromes are rare in the United States. A high level of clinical suspicion is necessary.

HISTORY

Travel or other risk exposure

Fever, chills
Intractable headache
Myalgias, malaise
Cough,...

TREATMENT

Initiate treatment based on epidemiologic risk and clinical presentation.

GENERAL MEASURES

Skin and mouth care
Supportive care—directed at complications

MEDICATION

First Line

Begin treatment when...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

Admit severely ill patients.
If treated as an outpatient, ensure regular follow-up to assess clinical improvement and resolution.

DIET

As tolerated...

REFERENCES

Centers for Disease Control and Prevention. Rickettsial (spotted & typhus fevers) & related infections, including anaplasmosis & ehrlichiosis. http://wwwnc.cdc.gov/travel/yello...

ADDITIONAL READING

Botelho-Nevers E, Raoult D. Host, pathogen and treatment-related prognostic factors in rickettsioses. Eur J Clin Microbiol Infect Dis. 2011;30(10):1139–1150. [View Abstract on...

CODES

ICD10

A75.9 Typhus fever, unspecified
A75.0 Epidemic louse-borne typhus fever d/t Rickettsia prowazekii
A75.2 Typhus fever due to Rickettsia typhi
A75.3 Typhus fever due to Rickettsia tsutsugamushi
A...

CLINICAL PEARLS

Consider typhus (along with malaria and dengue) in febrile travelers returning from endemic areas.
Rickettsial infections typically present within 2 to 14 days. Febrile illnesses presen...

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