Typhus

Notifiable, potentially fatal infection with Salmonella typhi.

Ca. 500,000 dead year.

• Pathogen
  • Salmonella typhi.
• Transmission
  • Contamination of food by faeces.
• The reservoir of the pathogen is humans. Asymptomtic excretion is also possible.

• Fever, reduced general condition, constipation and cephalgia.
• Erythematous macules (roseolae) may form abdominally and transform to papules as they progress.
• Healing may occur with postinflammatory hyperpigmentation.

• Clinical
• Stool sample for pathogen detection.
• Serological antibody detection.
• If necessary, dermatopathological backup.

Dilated capillaries correlate with roseolae.

• Ciprofloxacin p.o. 500 mg 2x tgl. for 14 days.
• The pathogen detection is notifiable.

1. Chapman AS, Swerdlow DL, Dato VM, Anderson AD, Moodie CE, Marriott C et al. Cluster of Sylvatic Epidemic Typhus Cases Associated with Flying Squirrels, 2004–2006. Emerg Infect Dis 2009;15:1005-11.
2. Dumler JS. Clinical and Laboratory Features of Murine Typhus in South Texas, 1980 Through 1987. JAMA 1991;266:1365.
3. Kim I-S , Walker DH. Scrub Typhus. Tropical Infectious Diseases: Principles, Pathogens and Practice: Elsevier BV; 2011. p. 334-8.
4. Raoult D, Ndihokubwayo JB, Tissot-Dupont H, Roux V, Faugere B, Abegbinni R et al. Outbreak of epidemic typhus associated with trench fever in Burundi. The Lancet 1998;352:353-8.
5. Watt G, Chouriyagune C, Ruangweerayud R, Watcharapichat P, Phulsuksombati D, Jongsakul K et al. Scrub typhus infections poorly responsive to antibiotics in northern Thailand. The Lancet 1996;348:86-9.
6. Watt G , Parola P. Scrub typhus and tropical rickettsioses. Current Opinion in Infectious Diseases 2003;16:429-36.