Typhus

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Murine typhus; Epidemic typhus; Endemic typhus; Brill-Zinsser disease; Jail fever

Symptoms of murine typhus may include:

• Abdominal pain
• Backache
• Dull red rash that begins on the middle of the body and spreads
• Extremely high fever (105 - 106 degrees Fahrenheit), which may last up to 2 weeks
• Hacking, dry cough
• Headache
• Joint pain (arthralgia)
• Nausea
• Vomiting

Symptoms of endemic typhus may include:

• Chills
• Cough
• Delirium
• High fever (104 degrees Fahrenheit)
• Joint pain (arthralgia)
• Lights that appear very bright; light may hurt the eyes
• Low blood pressure
• Rash that begins on the chest and spreads to the rest of the body (except the palms of the hands and soles of the feet)
• Severe headache
• Severe muscle pain (myalgia)
• Stupor

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The early rash is a light rose color and fades when you press on it. Later, the rash becomes dull and red and does not fade. People with severe typhus may also develop small areas of bleeding into the skin (petechiae).

A complete blood count (CBC) may show anemia and low platelets. Other blood tests for typhus may show:

• High level of typhus antibodies
• Low level of albumin
• Low sodium level
• Mild kidney failure
• Mildly high liver enzymes

Review Date: 09/15/2010
Reviewed By: Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School; Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org).