What are the signs and symptoms of louse-borne typhus in pediculosis and pthiriasis (lice infestation)?

Updated: Aug 16, 2019
  • Author: Lyn C C Guenther, MD, FRCPC, FAAD; Chief Editor: Michael Stuart Bronze, MD  more...
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The intracellular pathogen R prowazekii causes typhus. Typhus fever epidemics have consistently been related to times when overcrowded conditions and body louse infestations were prevalent. For example, mass migration, refugee camps, and times of war have been linked to body louse infestations and secondary epidemics of typhus. Human reservoirs of typhus also exist. Following natural disasters, body lice have the potential to spread rapidly throughout the population, causing great epidemics similar to those seen during World War I.

The illness begins with a high fever and progresses over hours to days to malaise, backache, headache, and myalgia. A petechial rash appears approximately on day 4, beginning in the flank and axillary regions and quickly spreading to the trunk and extremities. By the second week, the fever begins to wane, profuse sweating occurs, and convalescence ensues. CNS involvement during this period places the patient at high risk of mortality.

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