Typhus

Typhus (typhus exanthematicus; synonym of epidemic typhus) - an acute infectious disease proceeding with toxemia, the defeat of the cardiovascular and Central nervous system, exanthema-rash, characteristic of the temperature curve.
Etiology. The disease are rickettsiae of Prowazeki that breed in vascular endothelium person and in the epithelium of intestinal lice; deteriorating rapidly in a wet environment and are persistent in the dried state (see Rickettsiae).
Epidemiology. The source of infection is a sick person, and a carrier - louse, mostly clothing. Louse catches at sucking the blood of the patient; rickettsiae of Prowazeki with the blood penetrate epithelial cells of the intestinal wall of insects to breed and are in the intestinal lumen. During the next sucking the blood of the lice is defecation and together with faeces, a large amount of rickettsiae. On the site of the bite occurs itching; man brushing her skin and rubbing her feces containing rickettsiae. Nasosavshis ' the blood of the patient, louse becomes contagious on 5-6-th day. A sick person is contagious from the end of the incubation period (the last two days), the whole febrile period and the first 7-8 days after the normalization of temperature. The disease most often occurs in temperate latitudes in winter-spring period. Spread of infection contributes to congestion, overcrowding; is set and movement of large population groups.
Pathogenesis and pathological anatomy. RUB when scratching the skin rickettsiae of Prowazeki penetrate into blood and are carried to the various organs and systems. In the cells of the endothelium of blood vessels, they are hard to breed, last swell, resulting inflammation may occur with formation of thrombovascular and development in subsequent destruction of the vessels. However, the leading role in the pathogenesis of the disease is played not by themselves rickettsiae, how much they secrete the toxin. Specific riccadonna intoxication and thrombovascular lead to infringement activities primarily cardiovascular system and Central nervous system.
The immune system. After typhus remains strong immunity; however, sometimes there are recurring disease with easier clinical course.

  • The clinical picture
  • Diagnosis of typhus is based on the set of the most important symptoms: growing high fever, severe headache, redness and puffiness of the face, red rabbit ' eyes, spots Chiari - Auzina, anathema, enlarged liver and spleen, positive phenomenon "harness" (identifying a point hemorrhages in the skin if a tourniquet), exanthema on 4-6th day of illness, with the characteristic of its localization and others; it is also necessary to take into account epidemiological anamnesis.
    Of laboratory diagnostic methods use a specific reaction: agglutination (RA) with ricketsiosis antigen (see Weil - Felix reaction), passive haemagglutination (TPHA) and of complement fixation (RAC). RA becomes positive on the 4th day of illness, most patients typhus. Minimum diagnostic titre is 1 : 160 provided its growth. TPHA becomes positive with 3-5-day fever and reaches up to 2-week high titers of 1 : 64 000). Minimum diagnostic titre is 1 : 1000, provided it is grown. RAC also specific and becomes positive in the majority of patients typhus with the 5th day of illness followed rise titles. Diagnostic titre is a dilution of 1 : 160.
    To differentiate typhus should with severe flu, bronchial pneumonia, infectious mononucleosis, typhoid fever, epidemic meningitis and other


    Fig. 2. Cyproterone granulomas and endovascular in the brain. Fig. 3. Ciproterona exanthema. Vasculitis in the skin. Fig. 4. Subnational conjunctivitis with vasculitis. Fig. 5. Oleogranulomas with typhus.

    The forecast. In recent years, the prognosis is favorable.