Diagnosis of recurrent typhoid fever

Diagnosis of recurrent typhoid fever is based to a large extent on the data of the epidemiological anamnesis - stay in the area where the typhus is recurrent typhoid. In the period of the first attack, the main symptoms are taken into account: acute onset of the disease, hyperthermia from the first hours, severe pain syndrome (headache, muscle pain), early increase and soreness of the spleen and liver, subicteric skin and sclera. In subsequent seizures, a typical type of temperature curve helps in the diagnosis.

The most informative method of specific laboratory diagnosis is the detection of Obermeyer's Borrelia in peripheral blood during fever (rarely during apyrexia). Explore the smear and a thick drop of blood, colored by Romanovsky-Giemsa (as in malaria).

In clinical blood analysis, moderate anemia, thrombocytopenia, increased ESR, normal or slightly elevated white blood cell count are noted. In urine, a small number of red blood cells, protein, hyaline cylinders are found.

[1], [2], [3], [4], [5], [6], [7]

Indications for consultation of other specialists

Consultations of other specialists are indicated in the event of complications: if suspicion of rupture of the spleen is suspected, urgent consultation of the surgeon is necessary: when signs of an infectious-toxic shock-resuscitator appear.

Example of the formulation of the diagnosis

A68.0. Epidemic recurrent typhus, severe form (in the blood smear of Spirochete Obermeyer). Complication: rupture of spleen.

[8], [9], [10], [11], [12], [13], [14]

Differential diagnosis of recurrent typhoid fever

Differential diagnostics of recurrent typhus is performed with malaria, tick-borne recurrent typhoid, leptospirosis, influenza, typhus, meningitis, pneumonia, hemorrhagic fever. Errors can be avoided by taking into account the details of the epidemiological history (staying within the terms corresponding to the duration of the incubation period in the area where the typhoid is found), repeated attacks of fever and the results of careful examination of blood smears in patients who suddenly developed with high fever, marked signs intoxication, rapid and significant increase in spleen and its soreness.

[15], [16], [17], [18], [19], [20], [21],