Discuss the events that led to a diagnosis of typhus.
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How is typhus diagnosed?
The diagnosis is based on the patient's clinical history, physical exam, and tests based on identification of the bacterial genus and species by PCR testing of skin biopsy of skin rash, skin lesions, or blood samples or by immunohistological staining that identifies the bacteria within infected tissue (skin tissue, usually). It can also be diagnosed, usually late or after the disease has been treated with antibiotics, when significant titers of antirickettsial antibodies are detected by immunological techniques. Although some state labs may do these tests, the CDC should be contacted for testing questions and be given information if there is an outbreak of epidemic typhus. These tests help distinguish between epidemic and endemic typhus, anthrax, and other viral diseases.