Endemic typhus fever
Last Updated: 2019-08-27
lea spotted fever, murine spotted fever, rat spotted fever.
Notifiable rickettsiosis, which is similar to epidemic spotted fever but less severe.
- Causative organism
- Rickettsia typhi.
- Transmission is through the rat flea.
- Same as epidemic spotted fever, but much milder.
- Unspecific early stage (cephalgy, fatigue).
- In history: Fever, somnolence.
- 3rd - 6th days after onset of fever, occurrence of roseoles with partial punctiform haemorrhages on the trunk, which spread centrifugally. Palmoplantar involvement.
- Muscle twitching, peripheral nerve tenderness, motor restlessness.
- Bronchitis, conjunctivitis, splenomegaly.
- Mostly lice can be detected (Pediculosis corporis)
- Facies typhosa: Livid-red face.
- Medical history.
- Lice infestation.
- Blood count (mild leukocytosis or leukopenia, eosinophilia, thrombocytopenia), liver and kidney values (in up to 90% increased transaminases), electrolytes (hyponatremia)
- Lumbar puncture for suspected meningitis.
- From the 2nd week of disease Weil-Felix reaction (agglutination test).
- Complement fixation reaction from the 3rd week of the disease.
- Indirect immunofluorescence test after the 3rd week of the disease.
- De Sousa, R., et al., Molecular detection of Rickettsia felis, Rickettsia typhi and two genotypes closely related to Bartonella elizabethae. Am J Trop Med Hyg, 2006. 75(4): p. 727-31.
- McLeod, M.P., et al., Complete genome sequence of Rickettsia typhi and comparison with sequences of other rickettsiae. J Bacteriol, 2004. 186(17): p. 5842-55.
- Nogueras, M.M., et al., Serological evidence of infection with Rickettsia typhi and Rickettsia felis among the human population of Catalonia, in the northeast of Spain. Am J Trop Med Hyg, 2006. 74(1): p. 123-6.