Typhus (cont.)

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How is typhus diagnosed?

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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.

What is the treatment for typhus?

Antibiotic therapy is recommended for both endemic and epidemic typhus infections because early treatment with antibiotics (for example, azithromycin, doxycycline, tetracycline, or chloramphenicol) can cure most people infected with the bacteria. Consultation with an infectious-disease expert is advised especially if epidemic typhus or typhus in pregnant females is diagnosed. Delays in treatment may allow renal, lung, or nervous system problems to develop. Some patients, especially the elderly, may die.

What is the prognosis of typhus?

Early diagnosis and appropriate treatment yield an excellent prognosis for almost all patients with any of the types of typhus. Delayed or undiagnosed or untreated typhus has a less promising prognosis, but the prognosis is related to the type. For example, untreated endemic typhus has a death rate under 2% of patients, but untreated epidemic typhus has a death rate that ranges from about 10%-60% of infected patients, with those over 60 years of age having the highest death rates. Even if the patient does not die, complications that may reduce the prognosis in endemic and epidemic typhus to fair or poor are renal insufficiency, pneumonia, and central nervous system problems.

Medically Reviewed by a Doctor on 4/24/2014

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