Symptoms of recurrent typhoid fever
Last reviewed: 23.04.2024
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Recurrent typhus vshny has an incubation period, which lasts from 3 to 14 (an average of 7-8) days.
Symptoms of recurrent typhoid fever are the basis for clinical classification, which provides for the isolation of aborted, mild, moderate, severe forms of vesicular recurrent typhus. The height and duration of fever, the severity of intoxication, and the intensity of hemodynamic disorders are considered criteria of severity.
For the vast majority of cases, a violent, sudden onset with a tremendous chill is characteristic, which after a few hours is replaced by heat and a rapid increase in body temperature to 39-40 ° C and higher. Occasionally recurrent typhoid fever begins with a prodromal period, during which non-specific symptoms of recurrent typhoid fever appear: general weakness, weakness, headache and joint pain.
On the first day, typical symptoms of recurrent typhoid fever appear: severe headache, aches in muscles (especially the calf), lower back, joints, photophobia, insomnia. Appetite disappears, nausea, vomiting, thirst may occur. Patients become lethargic, apathetic, some have meningeal symptoms. There is an injection of sclera, hyperemia conjunctiva. Possible nasal bleeding, petechial rash, hemoptysis. From the second day of illness, the spleen increases, which causes a feeling of heaviness, pressure, or dull pain in the left hypochondrium. From the 3rd-4th day, yellowness of the skin and sclera appear, and the liver is enlarged. Typical shortness of breath, tachycardia up to 140-150 per minute, lowering blood pressure. The tongue is dry, densely coated with a white coating, acquires a "milky", "porcelain" appearance. Diuresis is reduced.
Hyperthermia persists for 5-7 days, after which the body temperature decreases critically to subnormal, which is accompanied by heavy sweating and often a sharp drop in blood pressure right up to the collapse. The duration of the first attack ranges from 3 to 13 days. During the "crisis", up to 3-4.5 liters of light urine is excreted.
After normalizing the temperature, the patients feel better, the pulse is weakened, but the weakness remains strong.
Recurrent typhus vshny can be limited to a febrile seizure (especially with early antibiotic treatment). In most patients, after 7-10 days of apyrexia, the body temperature suddenly rises again and a second febrile attack occurs, similar to the first, but less prolonged (3-4 days), although often more severe.
In more than half of cases, recurrent typhoid fever ends with a second attack. Sometimes after 9-12, extremely rarely - 20 days after the next period of normal temperature there comes a third attack, even shorter and easier. A total of 4-5 febrile seizures are possible, each subsequent shorter than the previous one, and periods of apyrexia are more prolonged. The early onset of etiotropic therapy reduces the number of seizures.
In typical cases, the temperature curve is so characteristic that it allows one to suspect recurrent typhus.
The period of convalescence is long, the patients feel well, slowly, within a few weeks after the final normalization of the temperature, general weakness, rapid fatigue, dizziness, insomnia remain.
[Complications of recurrent typhoid fever
Specific complications, as with other spirochaetas, are meningitis, encephalitis, iritis, iridocyclitis. The most serious, but rare complication, requiring urgent surgical intervention, is the rupture of the spleen. Nasal and uterine bleeding, hemorrhage to the brain and other organs are also possible. A critical drop in body temperature of 4-5 ° C may be complicated by collapse.
Mortality and causes of death
Mortality with a timely antibacterial treatment of about 1% (in the past reached 30%).