Typhus natural history, complications and prognosis

Jump to navigation Jump to search

Typhus Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Typhus from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Chest X Ray

Other Diagnostic Studies

Treatment

Medical Therapy

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Typhus natural history, complications and prognosis On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Typhus natural history, complications and prognosis

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Typhus natural history, complications and prognosis

CDC on Typhus natural history, complications and prognosis

Typhus natural history, complications and prognosis in the news

Blogs on Typhus natural history, complications and prognosis

Directions to Hospitals Treating Typhus

Risk calculators and risk factors for Typhus natural history, complications and prognosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Aditya Ganti M.B.B.S. [2]

Overview

Rickettsioses range in severity from diseases that are usually relatively mild (rickettsialpox, cat scratch disease, and African tick-bite fever) to those that can be life-threatening (epidemic and murine typhus, Rocky Mountain spotted fever, scrub typhus and Oroya fever), and they vary in duration from those that can be self-limiting to chronic (Q fever and bartonelloses) or recrudescent (Brill-Zinsser disease). Without treatment, fever may last 2 weeks, followed by a prolonged recovery time and a significantly greater chance of developing complications. Possible complications include renal insufficiency, pneumonia, meningitis. Without treatment, death may occur in 10 - 60% of patients with epidemic typhus. Patients over age 60 have the highest risk of death.[1][2][3][4][5][6]

Natural History, Complications and Prognosis

Natural History

  • The clinical severity and duration of illnesses associated with different rickettsial infections vary considerably, even within a given antigenic group.
  • Rickettsioses range in severity from diseases that are usually relatively mild (rickettsialpox, cat scratch disease, and African tick-bite fever) to those that can be life-threatening (epidemic and murine typhus, Rocky Mountain spotted fever, scrub typhus and Oroya fever), and they vary in duration from those that can be self-limiting to chronic (Q fever and bartonelloses) or recrudescent (Brill-Zinsser disease).
  • Without treatment, fever may last 2 weeks, followed by a prolonged recovery time and a significantly greater chance of developing complications.
  • Delay in treatment may result in advanced disease, including neurologic manifestations such as confusion, seizures, or coma, and widespread vasculitis (damage to the endothelial cells that line blood vessels).

Complications

Possible complications include:

Prognosis

Without treatment, death may occur in 10 - 60% of patients with epidemic typhus. Patients over age 60 have the highest risk of death. Patients who receive treatment quickly should completely recover. Less than 2% of untreated patients with murine typhus may die. Most patients with rickettsial infections recover with timely use of appropriate antibiotic therapy.[3]

References

  1. Tsioutis C, Zafeiri M, Avramopoulos A, Prousali E, Miligkos M, Karageorgos SA (2017). "Clinical and laboratory characteristics, epidemiology, and outcomes of murine typhus: A systematic review". Acta Trop. 166: 16–24. doi:10.1016/j.actatropica.2016.10.018. PMID 27983969.
  2. Zhou YH, Xia FQ, Van Poucke S, Zheng MH (2016). "Successful Treatment of Scrub Typhus-Associated Hemophagocytic Lymphohistiocytosis With Chloramphenicol: Report of 3 Pediatric Cases and Literature Review". Medicine (Baltimore). 95 (8): e2928. doi:10.1097/MD.0000000000002928. PMC 4779037. PMID 26937940.
  3. 3.0 3.1 Taylor AJ, Paris DH, Newton PN (2015). "A Systematic Review of Mortality from Untreated Scrub Typhus (Orientia tsutsugamushi)". PLoS Negl Trop Dis. 9 (8): e0003971. doi:10.1371/journal.pntd.0003971. PMC 4537241. PMID 26274584.
  4. Delord M, Socolovschi C, Parola P (2014). "Rickettsioses and Q fever in travelers (2004-2013)". Travel Med Infect Dis. 12 (5): 443–58. doi:10.1016/j.tmaid.2014.08.006. PMID 25262433.
  5. van der Vaart TW, van Thiel PP, Juffermans NP, van Vugt M, Geerlings SE, Grobusch MP, Goorhuis A (2014). "Severe murine typhus with pulmonary system involvement". Emerging Infect. Dis. 20 (8): 1375–7. doi:10.3201/eid2008.131421. PMC 4111165. PMID 25062435.
  6. Dotters-Katz SK, Kuller J, Heine RP (2013). "Arthropod-borne bacterial diseases in pregnancy". Obstet Gynecol Surv. 68 (9): 635–49. doi:10.1097/OGX.0b013e3182a5ed46. PMID 25102120.

Template:WH

Template:WS