Until the beginning of the 19th century, no clear clinical differentiation could be made between typhus and typhoid–two of the major pestilence. Brill-Zinsser disease: Recrudescence of epidemic typhus years after the initial attack. The agent that causes epidemic typhus (Rickettsia prowazekii) remains. Brill-Zinsser disease occurs as a late recrudescence of epidemic typhus. The clinical effect of a newly developed azalide, called azithromycin, against Rickettsia.

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Infobox medical condition new All stub articles.

Journal List Emerg Infect Dis v. For centuries, it has been associated with overcrowding, cold weather, and poor hygiene.

Brill-Zinsser disease

Subsequently, this region was thought to be free from epidemic typhus, but 2 cases have been reported since in Algeria, where 1 case of Brill-Zinsser disease was observed in a man who had had epidemic typhus in during the Algerian civil war 5 — 7.

In the case presented here, we found no stress factor, no immunosuppression, and no medical history of epidemic typhus.

The patient had been treated for a subacute rib fracture in March and underwent a myringotomy procedure in April but had been otherwise healthy. A recently explored reservoir for silent forms of R.

Hospital-onset neonatal sepsis and mortality in low resource settings — will bundles save the day? In Tunisia, no epidemic typhus was found in among 47 febrile patients 8. Blood test results were as follows: Abstract Recrudescent Rickettsia prowazekii infection, also known as Brill-Zinsser disease, can manifest decades after untreated primary infection but is rare in contemporary settings. Reply to Wasko et al. The patient’s typhus infection was confirmed by a significant increase in R.


In all cases, known risk factors were present overcrowding, poor hygiene, or contact with flying squirrels. In this report, we describe the first known reported case of Brill-Zinsser disease following a primary infection with sylvatic epidemic typhus acquired from flying squirrels.

Brill-Zinsser Disease in Moroccan Man, France,

Only comments seeking to improve the quality and accuracy of information on the Orphanet website are accepted. The material is in no way intended to replace professional medical care by a qualified specialist and should not be used as a basis for diagnosis or treatment. Brill-Zinsser disease is a recurrent form of epidemic typhus that is unrelated to louse infestation and develops sporadically years after the primary illness. Chest radiograph results were normal.

Orphanet: Brill Zinsser disease

Ann N Y Brkll Sci. Enterotoxigenic Enteroinvasive Enterohemorrhagic O He was admitted to hospital on March 9 for persistent fever. The patient denied recent exposure to possible reservoirs or vectors of R.

Suspected cases should be treated empirically with doxycycline, and appropriate diagnostic tests for rickettsial zinsse should be requested. Corticosteroids can trigger recurrence of R. Western blot analyses and cross-adsorption studies strongly suggested R. The patient was given empirical treatment with oral doxycycline at mg twice daily.

However, in the United States, improved sanitation and hygiene measures have largely eliminated the human body louse vector and epidemic typhus as public health concerns [1].


On the basis of serologic results, the following diagnoses could be ruled out: Views Read Edit View history. An additional reason why Brill-Zinsser disease may be infrequently identified following sylvatic typhus infection is treatment of properly diagnosed infections with the drug of choice, tetracyclines, during acute illness.

From Wikipedia, the free encyclopedia. Briol report a case of Brill-Zinsser disease in a patient who was born in Morocco and had no history of epidemic typhus. Analysis of risk factors for fatal Rocky Mountain spotted fever: Chloramphenicol and fluoroquinolones have been shown to have some variable degree of efficacy in treatment of infections with another typhus group rickettsiae, R.

This finding suggests that R. Brill-Zinsser disease may be linked to waning immunity, stress, or other factors that facilitate recrudescence, although the precise mechanism is unknown and may vary among individuals. The patient’s prior R. Recrudescent Rickettsia prowazekii infection, also known as Brill-Zinsser disease, can manifest decades after untreated primary infection but is rare in contemporary settings.

Salmonella enterica Typhoid feverDiwease feverSalmonellosis. Sylvatic typhus was not initially considered, and the patient was prescribed ciprofloxacin at mg twice daily for 10 days; recovery occurred over a span of 21 days.

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