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Typhus


The disease is caused by Rickettsia Provacheka, characterized by a cyclical course with fever, typhoid state, a kind of rash, as well as damage to the nervous and cardiovascular systems.
The source of infection is only a sick person, from whom body and head lice, having pumped blood containing rickettsia, transmit them to a healthy person. A person becomes infected by combing bites, rubbing the excrement of lice into the skin. With the lice bite itself, infection does not occur, since the causative agent of typhus is absent in their salivary glands. The susceptibility of people to typhus is quite high.
Symptoms and course:
The incubation period lasts 12-14 days. Sometimes at the end of the incubation, a slight headache, body aches, and stabilization are noted.
The body temperature rises with a slight chill and by the 2-3 day is set at high numbers (38-39 ± C), sometimes it reaches its maximum value by the end of 1 day. In the future, the fever has a constant character with a slight decrease on the 4th, 8th, 12th day of illness. A sharp headache, insomnia appear early, a breakdown quickly occurs, the patient is excited (talkative, mobile). The face is red, puffy. Small hemorrhages are sometimes visible on the conjunctiva of the eyes. In zoediffuse hyperemia, point hemorrhages may appear in the soft palate. The tongue is dry, not thickened, covered with a grayish-brown coating, sometimes with difficulty sticking out. The skin is dry, hot to the touch, in the first days of sweating almost never happens. Weakening of heart sounds, rapid breathing, an increase in the liver and spleen (from 3-4 days of illness) are observed. One of the characteristic signs is typhoid exanthema. The rash appears on day 4-5 of the disease. It is multiple, plentiful, located mainly on the skin of the lateral surfaces of the chest and abdomen, on the bend of the hands, grabs the palms and feet, never on the face. Rash occurs within 2-3 days, then gradually disappears (after 78 days), leaving pigmentation for a while. With the beginning of the rash, the patient's condition worsens. Intoxication sharply amplifies. Excitation is replaced by oppression, inhibition. At this time, a collapse may develop: the patient is in prostration, the skin is covered with cold sweat, the pulse is frequent, heart sounds are deaf.
Recovery is characterized by a decrease in body temperature, accelerated lysis on the 8-12th day of illness, a gradual decrease in headache, improved sleep, appetite, and restoration of the activity of internal organs.
Treatment:
The most effective antibiotics of the tetracycline group, which are prescribed at 0.3-0.4 g 4 times a day. You can use chloramphenicol. Antibiotics give up to 2 days of normal temperature, the duration of the course is usually 4-5 days. For detoxification, a 5% glucose solution is administered. Applied oxygen therapy. With sharp excitement, barbiturates and chloral hydrate are indicated. Of great importance are good nutrition and vitamin therapy. An important role is played by proper patient care (complete rest, fresh air, comfortable bedding and linen, daily toilet of the skin and oral cavity).
Prevention:
Early hospitalization of patients. Sanitary treatment of the outbreak. Observation of persons who were in contact with the patient is carried out 25 days with daily thermometry.