Cause:Rickettsia prowazekiiand mooseri
Pathophys:Arteritis by intracellular invasion causing vascular occlusion. Nodules in cortical gray matter
Endemic: man to man via human body louse or lab technique; worldwide; especially winter/spring in cold climates
Brill-Zinsser disease: recurrent disease in carriers, perhaps via fleas
Murine type: man to rat to man
Sx:Headache; rash
Si:Fever; rash, centrifugal (central body spreading to extremities); pneumonia, atypical; CNS sx; necrotic skin over pressure points
May precipitate G6PD deficiency in blacks, leading to hemolysis and subsequent ATN
Rx:
Prevent by killing lice with DDT; kill rats
of disease: tetracycline or chloramphenicol; loading dose 2-2.5 × daily dose, then rx × 10 d