Doctor's Notes on Typhus
The term typhus (or typhus fevers) is the name of a group of bacterial infectious diseases that spread to humans by lice, chiggers, and fleas (vectors). The three main types are scrub typhus, endemic typhus (also termed murine typhus), and epidemic typhus. In general, all forms of typhus produce symptoms of fever, headache, body aches, and rash. However, each type may produce additional signs and symptoms. Scrub typhus may produce a scab-like lesion at the site of a chigger bite and enlarged lymph nodes. Severe infections can result in mental changes like confusion, coma, or death. Endemic typhus symptoms and signs include malaise, high fever, cough, joint pain, abdominal pain, and back pain. Epidemic typhus has similar symptoms to endemic typhus but more severe. The rash may cover the entire body except the palms of the hands and the soles of the feet; delirium, stupor, bleeding into the skin, low blood pressure, shock, and death may occur.
The cause of scrub typhus is from a chigger bite infected with the bacteria Orientia tsutsugamushi. The cause of endemic typhus is when flea feces, infected with Rickettsia typhi, are rubbed into cuts or skin scrapes. Body lice, infected with Rickettsia prowazekii, cause epidemic typhus when they obtain a blood meal from a human and transmit the bacteria. Early treatment with doxycycline is an effective treatment for all bacterial causes.
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Fever (in Adults)
A fever is a body temperature of 100.4 F or greater. A fever may be caused by a virus, bacteria, fungus, blood clot, tumor, drug, or the environment. Treatment of fever in adults usually involves ibuprofen, acetaminophen, or aspirin. -
Fever in Children
Fever is defined as a rectal temperature over 100.4 F or 38 C. Fever isn't life-threatening unless it is persistently high - greater than a 107 F rectal temperature. Fever is usually caused by an infection. Treatment focuses on controlling the temperature, preventing dehydration, and monitoring for serious illness. -
Headache (Mild)
Mild headaches and tension headaches are common but usually do not represent a serious illness. They result from irritation or injury to pain-sensing structures of the head. Symptoms of mild headache pain include aching, squeezing, or bandlike pain, on both sides of the head, generally above the level of the eyebrows. Treatment includes a variety of self-care measures and over-the-counter medications. -
Lice (Head Lice, Body Lice, Pubic Lice)
Lice infestation (pediculosis) is common. Itch is the main symptom of a lice infestation. Lice treatment involves using anti-lice agents, removing nits with a fine-tooth comb, washing and drying all clothes and linens on the hot cycle, and vacuuming floors and furniture. -
Louse-Borne Typhus (Epidemic Typhus)
A bacteria called Rickettsia prowazekii causes epidemic typhus. Lice infected with this bacteria can transmit epidemic typhus to humans. Louse-borne typhus is another name for epidemic typhus. Signs and symptoms include nausea, vomiting, fever, chills, confusion, cough, rash, rapid breathing, and headache. The antibiotic doxycycline effectively treats louse-borne typhus. -
Murine Typhus (Flea-Borne Typhus)
A bacteria called Rickettsia typhi causes murine typhus. Endemic typhus and flea-borne typhus are other names for murine typhus. Signs and symptoms of murine typhus include fever, nausea, vomiting, stomach pain, rash, and body aches. The antibiotic doxycycline is an effective treatment for murine typhus. -
Rash (Causes, Types, and Cures)
A rash is a visible skin outbreak. Examples of noninfectious rashes include eczema, psoriasis, contact dermatitis, seborrheic dermatitis, rosacea, hives, and allergic dermatitis. Types of infectious rashes include ringworm, impetigo, scabies, herpes, chickenpox, and shingles. Rashes may be caused by fungi, viruses, bacteria, and parasites. Treatment depends upon the type of rash. -
Scrub Typhus (Bush Typhus)
Orientia tsutsugamushi is a bacteria that causes bush typhus. Scrub typhus is another name for bush typhus. Infected chiggers transmit this bacterial infection to humans through their bites. Symptoms and signs include fever, headache, confusion, enlarged lymph nodes, rash, coma, eschar, and body aches. The antibiotic doxycycline effectively treats scrub typhus. -
Skin Rashes in Children
Skin rashes in children may be categorized as bacterial, viral, life-threatening, fungal, and parasitic rashes. Oftentimes, the associated symptoms help establish the diagnosis. Treatment depends upon the type of rash and the severity of the signs and symptoms. -
Swollen Lymph Nodes
Lymph nodes (part of the lymphatic system) may signal infection if they are swollen. Types of conditions that involve swollen lymph nodes include: infection, virus, inflammation, or cancers. Symptoms of swollen lymph nodes depend upon the location. Treatment of swollen lymph nodes also depends upon the location and reason for the enlargement.
REFERENCE:
Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.