Typhus Follow-up

  • Author: Jason F Okulicz, MD; Chief Editor: Michael Stuart Bronze, MD   more...
 
Updated: Nov 22, 2011
 

Further Inpatient Care

  • Inpatient care may be required for ill patients with typhus who cannot maintain adequate oral hydration/intake or enteral antibiotic therapy.
  • Patients with complications from typhus may need inpatient care for further diagnosis, evaluation, and management for these disorders (see Complications).
  • Decisions regarding the need for inpatient care should be assessed on a case-by-case basis.
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Further Outpatient Care

  • No further outpatient care is usually necessary in uncomplicated cases of typhus.
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Inpatient & Outpatient Medications

  • See Medications.
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Deterrence/Prevention

  • Avoid exposure to areas known to be endemic for typhus.
  • Avoid overcrowding.
  • Insecticides may be helpful in controlling the arthropod vectors that spread typhus.
  • Reduce the rodent host population.
  • Wear protective clothing (eg, long-sleeved shirts, long pants) in endemic areas.
  • Practice good personal hygiene, including frequent bathing and frequent changing of clothes.
  • Vaccination for typhus is not recommended, and manufacturing of the vaccine has been discontinued in the United States.
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Complications

  • Signs, symptoms, and potential complications of typhus are due to hematogenous spread of organisms with resultant endothelial proliferation and vasculitis.
  • The central nervous, musculoskeletal, and cardiovascular systems may be involved, as well as the skin, lungs, and kidneys. Multiorgan system involvement is possible.
  • Vasculitis may result in hypovolemia, electrolyte disturbances, and digital gangrene.
  • Hemodynamic status and fluid/electrolyte replacement should be diligently monitored.
  • Secondary infections, such as bacterial pneumonia, should be treated appropriately.
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Prognosis

  • Uncomplicated cases of typhus that are diagnosed promptly and antibiotic therapy initiated early generally carry an excellent prognosis. Mortality rates are greatly reduced when appropriate antibiotics are initiated promptly (see Mortality/Morbidity).
  • Complicated cases of typhus generally carry a good prognosis, but this varies depending on the severity of the specific complications and the health status of the patient at the time of disease onset.
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Patient Education

  • Education concerning typhus should be focused on the preventive measures (see Deterrence/Prevention).
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Contributor Information and Disclosures
Author

Jason F Okulicz, MD  Assistant Professor of Medicine, Uniformed Services University of the Health Sciences; Staff, Infectious Disease Service, Brooke Army Medical Center

Jason F Okulicz, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians-American Society of Internal Medicine, and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Coauthor(s)

Mark S Rasnake, MD, FACP  Assistant Professor of Medicine, Program Director, Internal Medicine Residency, University of Tennessee Graduate School of Medicine; Consulting Staff, Department of Infectious Diseases, University of Tennessee Medical Center at Knoxville

Mark S Rasnake, MD, FACP is a member of the following medical societies: American Association for the Advancement of Science, American College of Physicians, and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Eric A Hansen, DO  Fellow, Clinical Instructor, Department of Internal Medicine, Division of Infectious Diseases, Winthrop-University Hospital, State University of New York at Stony Brook

Eric A Hansen, DO is a member of the following medical societies: American Medical Association, American Osteopathic Association, Infectious Diseases Society of America, and Undersea and Hyperbaric Medical Society

Disclosure: Nothing to disclose.

Burke A Cunha, MD  Professor of Medicine, State University of New York School of Medicine at Stony Brook; Chief, Infectious Disease Division, Winthrop-University Hospital

Burke A Cunha, MD is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Specialty Editor Board

John M Leedom, MD  Professor Emeritus of Medicine, Keck School of Medicine of the University of Southern California

John M Leedom, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians-American Society of Internal Medicine, American Society for Microbiology, Infectious Diseases Society of America, International AIDS Society, and Phi Beta Kappa

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Thomas M Kerkering, MD  Chief of Infectious Diseases, Virginia Tech Carilion School of Medicine

Thomas M Kerkering, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians, American Public Health Association, American Society for Microbiology, American Society of Tropical Medicine and Hygiene, Infectious Diseases Society of America, Medical Society of Virginia, and Wilderness Medical Society

Disclosure: Nothing to disclose.

Eleftherios Mylonakis, MD  Clinical and Research Fellow, Department of Internal Medicine, Division of Infectious Diseases, Massachusetts General Hospital

Eleftherios Mylonakis, MD is a member of the following medical societies: American Association for the Advancement of Science, American College of Physicians, American Society for Microbiology, and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Chief Editor

Michael Stuart Bronze, MD  Professor, Stewart G Wolf Chair in Internal Medicine, Department of Medicine, University of Oklahoma Health Science Center

Michael Stuart Bronze, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians, American Medical Association, Association of Professors of Medicine, Infectious Diseases Society of America, Oklahoma State Medical Association, and Southern Society for Clinical Investigation

Disclosure: Nothing to disclose.

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