Epidemic Typhus

  • Etimologia
    • The term "epidemic" in epidemic typhus refers to the fact that this disease has historically occurred in large, explosive outbreaks or epidemics, particularly in times of war, famine, or other conditions that result in overcrowding, poor hygiene, and unsanitary living conditions.
    • Epidemic typhus has been responsible for many devastating outbreaks throughout history, including during World War I and World War II, when it was responsible for the deaths of millions of people, primarily soldiers and civilians in war-torn regions of Europe and Asia.
    • The term "typhus" refers to a group of infectious diseases that are characterized by high fever, headache, muscle aches, and rash. Typhus is caused by a number of different bacteria, including Rickettsia prowazekii, which causes epidemic typhus, as well as other species of Rickettsia that cause other forms of typhus, such as murine typhus and scrub typhus.
  • Etiologia: Rickettsia prowazekii
  • Vetor: pediculus humanus var corporis (piolho do corpo humano) através das fezes
  • Reservatório: esquilo
  • Localização geográfica: américa do sul, eurasia, américa do norte
  • Período de incubação: 3-4 dias depois do contacto
  • Apresentação clínica
    • Máculas, pápulas e petéquias
 
DDx: syphilis, drug rash
Diagnóstico: clínico (= todas as ricketsias)
  • Iniciar tratamento sem confirmação laboratorial
  • Reação de Weil-Felix (reação cruzada com proteus mirabilis) - já não usada
  • Conversão serológica
  • Pode se pedir Rickettsia 23s rDNA por biologia molecular
 
Tratamento (= todas as ricketsias)
  • Suporte: paracetamol, AINEs
  • AB:
    • Doxycycline 100mg 2id 7 dias; 2,2mg/kg 2id em criançcas >8 anos
    • se <8 anos
      • azitromicina 10mg/kg single dose
      • claritromicina 7,5mg/kg/dia 2id 3 dias
  • Alternativas: quinolonas, cloranfenicol