EPIDEMIC TYPHUS

 (LOUSE-BORNE)

Etiology and Epidemiology:-

Epidemic typhus is caused by R. prowazekii and is transmitted by the human body louse. Eastern flying squirrels and their lice and fleas maintain R. prowazekii in a zoonotic cycle.

• The louse lives in clothing under poor hygienic conditions, particularly in colder climates and classically at times of war or natural disaster.
• Lice feed on pts with epidemic typhus and then defecate the organism into the bite at their next meal. The pt autoinoculates the organism while scratching.
• Brill-Zinsser disease is a recrudescent and mild form of epidemic typhus whose occurrence years after acute illness suggests that R. prowazekiiremains dormant in the host.

CLINICAL MANIFESTATIONS: -

Epidemic typhus presents abruptly  the onset of high fevers, prostration, severe headache, cough, and severe myalgias. Photophobia with conjunctival injection and eye pain is also common.

• A rash appears on the upper trunk around the fifth day of illness and spreads to involve all body-surface areas except the face, palms, and soles.
• Confusion and coma, skin necrosis, and gangrene of the digits are noted in severe cases.
• Untreated, the disease is fatal in 7–40% of cases. Pts develop renal failure, multiorgan involvement, and prominent neurologic manifestations.

DIAGNOSIS:-

Epidemic typhus is sometimes misdiagnosed as typhoid fever. The diagnosis can be based on serology, immunohistochemistry, or detection of the organism in a louse found on a pt. Cross-adsorption IFA can distinguish  R. prowazekii from R. typhi.

HOMEOPATHIC MANAGEMENT:-

The medicines that can be thought of use are:-

• Arsenicum
• Belladonna
• Carbo veg
• Eucalyptus
• Terebinthina.