Article Research Differentiation Between Typhoid and Typhus Fever Infection and Coinfection with Limited Resources in Iraq

Enteric fever is caused by the Gram-negative bacilli Salmonella typhi and paratyphi, which have similar signs and symptoms to typhus and rickettsial illness. Both typhoid fever and rickettsia typhus, whether endemic or epidemic, have similar presentations, making it difficult to distinguish between the two diseases. As a result, co-infection of typhoid and typhus fever can be ignored if not recognized clinically. Serum was collected from 182 patients from the Suweib and fourth shurta areas who had a temperature of more than 38°C and two or more signs and symptoms of typhoid and typhus, such as headache lasting more than a week, rash, myalgia, arthralgia, and bleeding. Started with widal test slide method All result results confirmed by tube method Same samples investigated for typhus infection by weil-felix tests. Data entered to analyzed by SPSS program. the results were appeared of the 182 patients tested, 58 (18%) yielded results suggested that rickettsial infections or typhoid were the most likely because of their illnesses. patients’ age ranged from 8 to 75 years with mean age 29.10 years. The majority were female and mainly student (41.4%) and housewife (25.9%) by age and sex for the 58 patients for whom data were recorded. Age groups did not differ significantly (p > 0.5). The frequency of disease was 69% in female patients and 31% in male patients (p < 0.005). Finally, can Concluded Both widal and weil-felix test should done specially if no responses to typhoid treatment and depend on trial therapy by adding doxycycline in case that more sensitive and accurate tests are not available.

Scrub typhus associated acute kidney injury in a 33-year-old male

Scrub typhus or bush typhus is caused by Orientia tsutsugamushi. An eschar at the site of bite is evidentiary of scrub typhus. Increased mortality is seen in cases presenting with acute kidney injury (AKI), acute respiratory distress syndrome (ARDS), pneumonitis, meningitis, myocarditis and multi-organ dysfunction. Renal impairment in scrub typhus should be identified and management initiated early to prevent the progress of the damage. Scrub typhus if left undiagnosed and untreated results in high morbidity and mortality. Here we report a case of a 33-year-old male with AKI following scrub typhus fever. In our case early diagnosis and management led the patient to recovery.

The contributions of James Carmichael Smyth, Archibald Menzies and Robert Jackson to the treatment of typhus in royal naval vessels in the late 18th century

In late 18th century Britain, typhus fever plagued the mass mobilisation of soldiers and posed a significant challenge to physicians of the time. Epidemic typhus was spread through highly infectious faeces of infected lice and carried a high mortality in patients and healthcare staff alike. Physicians James Carmichael Smyth (1741–1821) and Archibald Menzies (1754–1842) theorized that typhus fever was caused by infection of human exhalation. They trialled the use of vapourised nitrous acid to fumigate patients, their clothes and their bedspace, with apparent success. Despite this, typhus fever continued to ravage deployments of soldiers into the early 19th century, stimulating the continuing evolution of the understanding of typhus and its treatment.

EVALUATING THE ETIOLOGY AND DISEASE SPECIFIC CLINICAL PROFILES OF ACUTE UNDIFFERENTIATED FEBRILE ILLNESS

Background: To evaluate the etiology and disease specific clinical profiles of acute undifferentiated febrile illness (AUFI) in Medicine Department of Govt. Medical College and Hospital, Bettiah, W. Champaran, Bihar. Methods: This 1 year prospective, observational study was conducted in Govt. Medical College and Hospital, Bettiah, Bihar from October 2019 to September 2020 in 150 patients. Clinical evaluation and relevant investigations like Blood culture; malarial parasites and febrile serology (acute and convalescent) were performed. Results and Observation: A total of 150 AUFI patients were evaluated: scrub typhus (19); malaria (3); enteric fever (2); dengue (11); leptospirosis (19); hantavirus (1), acute bacterial infections (14), HIV (1), hepatitis (1), and unclear diagnoses (79). Conclusion: This study reports discovery of dengue, typhus fever, leptospirosis, and rare disease like Hanta and more number undiagnosed cases ranging from 15% to 42% in local community. This shows that further research is required in identifying the etiology of undifferentiated fevers.

Posterior reversible encephalopathy syndrome in scrub typhus fever

The clinical course of a 40-year-old female patient, who presented with acute febrile illness due to scrub typhus fever became complicated by seizures and posterior reversible encephalopathy syndrome (PRES), leading to a fatal outcome. She had normal blood pressure at admission; however, she later developed hypotension and shock. PRES is a syndrome of vasogenic cerebral oedema and accompanying neurological deficits resulting from the breakdown of blood-brain barrier due to high blood pressure or radical blood pressure changes. PRES is a clinico-radiographic diagnosis of heterogeneous aetiologies and is rare in the context of infections. Although there are many neurological manifestations in scrub typhus, to the best of our knowledge, PRES has never been reported.

DISEASES THAT CHANGED THE WORLD

Different contagious diseases had huge impact on the society during the history. Their appearance destroyed and devastated whole teritories, caused number of victims which drastically surpassed the ones in wars, and after the appearance of such disease the whole path of the history changed. The most important contagious diseases are known and written in the earliest known records, from the beginning of the world they were humans` companion, their impact on the development, suffer and death is huge during hundreds of years. Smallpox belong to the most deadly and the scariest viral diseases faced by humanity. Pandemic of Spanish flu from 1918 is the biggest global demographic earthquake that the world has ever experienced. One of the most important transmisive (vector) mosquito-borne diseases, caused by protozoa, is malaria. Lice transmit the causer of typhus fever, trench fever and recurrent fever. Plague in natural habitats transmits rat flea and it is one of the most dangerous bacterial diseases. Typhus fever was a constant companion of the distress, accidents and suffering of the people during wars. Many faiths of people were connected with tuberculosis, it was always an unavoidable part of living community. Leprosy is one of the oldest and scariest diseases. It was a synonym for stigmatization and discrimination because of big deformations on the body. Styphilis is constant and unwanted companion of humanity for more than 400 years. Since its first occurance, styphilis was stigmatisized, disgraceful disease. Contemporary past of cholera began in 1817. Cholera causes difficult clinical diseases followed by humans pain and panic, and disrupts social and economic structure and develompent of the society wherever it occurs. It is visible that throughout the whole history, contagious diseases had huge impact on development and prosperity of the humanity. Throughtout the history, humans had many important wars and battles, but perhaps the biggest ones were fought, and many of them are still fighting, against the contagious diseases.

Cerebellitis as a rare manifestation of scrub typhus fever

Scrub typhus is a mite-borne rickettsial disease caused by Orientia tsutsugamushi, a gram-negative coccobacilli transmitted through the bite of chigger mite. Scrub typhus has diverse clinical manifestations, often presenting either as a simple febrile illness or as a complicated multi-organ dysfunction. Neurological complications in scrub typhus are diverse but their exact incidence is unknown. Cerebellitis is another rare neurological manifestation associated with scrub typhus. Here, we report the case of a 26-year-old woman with serologically confirmed scrub typhus presenting with fever and gross cerebellar dysfunction. MRI was normal. She was managed with antimicrobials and made an uneventful recovery.