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Infectious Diseases > Typhus > Flashcards

Typhus Flashcards

1
Q

Typhus

Two types of Typhus in Sri Lanka

A
  • Scrub typhus ( Orientia tsutsugamashi)
  • Endemic typhus ( Rickettsia typhus)
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2
Q

Typhus

Scrub typhus Vector

A

Trombiculid mite

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3
Q

Typhus

Endemic typhus vector

A

Rat flea

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4
Q

Typhus

Epidemic typhus MO

A

Rickettsia prowazeki

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5
Q

Typhus

Epidemic typhus vector

A

human body louse ( rare)

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6
Q

Typhus

Ix

A

Clinical. Rx on suspicion. Hard to Dx

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7
Q

Typhus

Pathogenesis

A
  • Enter into body by tick bite or scratch ( innoculation of tick feces through skin)
  • Local lesions - Inflammatory response ( eschar at the bite site, regional lymphadenopathy)
  • Becomes generalized ( vasculitis, endovasculitis)
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8
Q

Typhus

Eschar

A

brown crusted necrotic painless papule - like a cigarette burn mark

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9
Q

Typhus

Endovasculitis causes

A

rash and bleeding diasthesis

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10
Q

Typhus

Incubation period

A

2 weeks

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11
Q

Typhus

Sx during acute phase

A
  • swinging fever
  • frontal headache
  • myalgia
  • conjunctival infection
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12
Q

Typhus

Sx progression

A
  • Acute phase - abrupt onset fever, myalgia, frontal headache, conjunctival infection
  • Towards the end of the first week- generalized lymphadenopathy, meningism, hepatosplenomegaly, rash
  • ESCHAR!!!!!!
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13
Q

Typhus

Fever +Rash&raquo_space;»

A

Consider typhus and look for an eschar!!!

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14
Q

Typhus

Fever + Rash + deafness/ tinnitus»>

A

Typhus?

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15
Q

Typhus

Complications

A
  • Pulmonary involvement - pneumonia, pleural effusion
  • Neuro - various degrees of meningitis, encephalopathy, deafness, tinnitus
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16
Q

Typhus

Similiarities/ differences to lepto

A
  • liver involvement is rare
  • No renal failure in typhus!
17
Q

Typhus

Rash

A

Begins as macules on hands and feet and then spreads over the body as petechial hemorrhage

18
Q

Typhus

Lab Ix

A
  • Weil Felix reaction
  • Anti rickettsial Ab test
  • FBC
19
Q

Typhus

Weil Felix reaction test

A

Not done now. Lack specificity and sensitivity

20
Q

Typhus

Main confirmatory test

A

Indirect immune peroxidase test and immune fluorescent test

21
Q

Typhus

Indirect immune peroxidase test and immune fluorescent test

A

Anti rickettsial Ab in patient serums, cross reacts and agglutinates with certain somatic Ag of proteus species. DONE NOW

22
Q

Typhus

FBC

A
  • Leukopenia ( can be normal too)
  • Slight neutrophilia
  • Thrombocytopenia
23
Q

Typhus

FBC smiliarity in lepto

A

Thrombocytopenia

24
Q

Typhus

Rx

A
  • Dramatic response to tetracyclines
  • Also respond to chloramphenicol, fluoroquinolones
25
Q

Typhus

Therapeutic trial

A

Doxycycline

26
Q

Typhus

How long does it take for the treatment

27
Q

Typhus

Does typhus respond to Beta lactams, aminoglycosides

Infectious Diseases (7 decks)

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