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Typhus


The disease is caused by Provachek's rickettsiae, characterized by a cyclical course with fever, typhoid state, a peculiar 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, sucking blood containing rickettsia, transmit them to a healthy person. A person becomes infected by combing bites, rubbing the excrement of lice into the skin. At the very bite of lice infection does not occur, as in their salivary glands causative agent of typhus is absent. The susceptibility of people to typhus is high enough.
Symptoms and course:
The incubation period lasts 12-14 days. Sometimes at the end of incubation, there is a slight headache, body aches, and position.
The body temperature rises with a slight chill and by 2-3 days is set at high numbers (38-39 ± C), sometimes it reaches the maximum value by the end of 1 day. Further, the fever has a permanent character with a slight decrease on 4, 8, 12 day of illness. Early there is a sharp headache, insomnia, a breakdown occurs quickly, the patient is excited (talkative, mobile). The face is red, puffy. Minor hemorrhages are sometimes visible on the conjunctiva of the eye. In zeperadiffusion hyperemia, point hemorrhages may appear on the soft palate. The tongue is dry, not thickened, lined with a grayish-brown patina, sometimes it hardly protrudes. The skin is dry, hot to the touch, in the first days of sweating almost does not happen. There is a weakening of heart tones, rapid breathing, enlarged liver and spleen (from 3-4 days of illness). One of the characteristic signs is a typhoid rash. The rash appears on the 4-5 day of illness. It is multiple, abundant, located mainly on the skin of the side surfaces of the chest and abdomen, on the crook of the arms, it captures the palms and the feet, it never happens on the face. The rash occurs within 2-3 days, then gradually disappears (after 78 days), leaving pigmentation for some time. With the onset of rash, the patient's condition worsens. Sharply increased intoxication. Excitement 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 at 8–12 days of illness, a gradual decrease in headache, improvement in sleep, appetite, and restoration of the activity of internal organs.
Treatment:
The most effective antibiotics of the tetracycline group, which is prescribed by 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 injected 5% glucose solution. Apply oxygen therapy. With a sharp arousal barbiturates, chloral hydrate are shown. Nutrition and vitamin therapy are of great importance. Proper patient care plays an important role (complete rest, fresh air, comfortable bedding and underwear, daily toilet of the skin and mouth).
Prevention:
Early hospitalization of patients. Sanitary treatment of the hearth. Monitoring of persons who have been in contact with the patient is carried out for 25 days with daily thermometry.