Typhus Follow-up

Updated: Jul 24, 2017
  • Author: Jason F Okulicz, MD, FACP, FIDSA; Chief Editor: Michael Stuart Bronze, MD  more...
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Follow-up

Further Outpatient Care

No further outpatient care is usually necessary in uncomplicated cases of typhus.

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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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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

aUncomplicated 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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