1. Rickettsia prowazekii
Domina Petric, MD

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Introduction
Rickettsia prowazekii causes classic typhus (typhus exanthematicus, epidemic typhus).
This bacteria is obligate intracellular bacteria, coccobacill, gram negative.
11/23/2018
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3. Pathogen Profile Dictionary
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Patogenesis
Target place for this bacteria are endotel cells of all small blood vessels.
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Transmission
From louse (Pediculus humanus corporis): there is NO primary lesion or tache noire, eschara.
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6. Clinical presentation
Incubation period: 1 to 2 weeks (usually 12 days).
Abrupt onset: fever, severe headache, shivering, malaise, myalgias, arthralgias.
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7. Clinical presentation
After 5 to 7 days from the first symptoms, purple macular rash develops (initially pale on pressure) in axillary pits and upper part of the thorax.
After some time rash centrifugally spreads to all body parts.
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Purzuit
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9. Clinical presentation
There is usually NO rash on hands, feet and face.
There can be symptoms of toxemia if the patient is not treated.
Mortality of untreated patients can be from 10% to even 40%.
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10. Clinical presentation
Rare manifestations of the disease:
dry cough (with pneumonic infiltration on chest X ray)
coma and delirium (CNS affection)
myocarditis
acute renal insufficiency with full recovery
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Treatment
Doxycycline 100 mg twice a day 24 to 48 hours after temperature drops.
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12. Brill-Zinsser´s disease
It is late relapse after many years (10 or more years) after the primary infection.
Symptoms are similar to those of classic typhus, but milder and shorter in duration.
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Literature
Purzuit.com
Begovac J. Božinović D. Lisić M. Baršić B. Schönwald S. Infectology, Profil.
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