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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Brill-Zinsser disease is a form of recrudescent epidemic typhus that occurs years or decades after primary typhus infection [ 1—4 ].

Brill-Zinsser disease

D Dsease – He subsequently traveled every 3 years to Morocco for 1-month summer holidays, always in urban areas. Please check for further notifications by email. The patient had been raised in Morocco. In addition, the availability of tetracycline-class antibiotics to effectively treat rickettsial infections has reduced the severity and duration of infections [ 14 ].

Epidemic typhus was endemic to North Africa until the s 4. Epidemic typhus is caused by Rickettsia prowazekii and transmitted by human body lice. Clinical features are similar to, but milder than, those of epidemic typhus 1. Past studies have described patients with Brill-Zinsser disease as those with a fever of unknown origin who had a history of living in an area where typhus is endemic and who presented with a headache and rash dixease 23 ].

Brill and Zinsser described that stress or waning immunity could reactivate R. Check this box if you wish to receive a copy of your message.


Brill–Zinsser disease – Wikipedia

Brill-Zinsser disease should be considered as a possible diagnosis for acute fever in any patient who has lived in an area where epidemic typhus is endemic.

Adipose tissue serves as a reservoir for recrudescent Rickettsia prowazekii infection in a mouse model. Disase response of patients suffering from primary and recrudescent typhus: Related articles in Web of Science Google Scholar.

Chloramphenicol and fluoroquinolones have been shown to have some variable degree of efficacy in treatment of infections with zinseer typhus group rickettsiae, R. An indirect immunofluorescence assay using a cell culture-derived antigen for the detection of antibodies to the agent of human granulocytic ehrlichiosis. Brjll LI Brill-Zinsser disease. Results of tests for IgG antibodies to E. Hospital-onset neonatal sepsis and mortality in low resource settings — will bundles save the day?

Approximately 13 days after that activity, the patient developed headache, rash, chills, fatigue, and arthralgias.

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.

Acute-phase and convalescent-phase serum samples were positive for typhus-group rickettsiae by the microimmunofluorescence assay at the World Health Organization Collaborative Center for Rickettsioses and Other Arthropod-Borne Bacterial Diseases Marseille, France. This article has been cited by other articles in PMC. The patient’s primary infection was thus essentially untreated, and this may have in uenced the patient’s later development of Brill-Zinsser disease.

An Orphanet summary for this disease is currently under development. Ecologic studies on the interepidemic survival of louse-borne epidemic typhus fever.

Brill-Zinsser disease, Rickettsia prowazekii, Morocco, France, typhus, bacteria. Vibrio cholerae Cholera Vibrio vulnificus Vibrio parahaemolyticus Vibrio alginolyticus Plesiomonas shigelloides. Enterotoxigenic Enteroinvasive Enterohemorrhagic O The low-level antibody titers to R. I agree to the terms and conditions. Recrudescent Rickettsia prowazekii infection, also known as Brill-Zinsser disease, can manifest decades after untreated primary infection but is rare in contemporary settings.


Author information Article notes Copyright and License information Disclaimer. Infectious diseases Bacterial disease: On the basis of serologic analysis with Western blot, we confirmed R. Retrieved from ” https: Suspected cases should be treated empirically with doxycycline, and appropriate diagnostic tests for rickettsial infections should be requested.

Reply to Peiffer-Smadja, et al. Infection with the tick-borne pathogens Ehrlichia chaffeensis or Anaplasma phagocytophilum was considered in the differential diagnosis on the basis of clinical presentation and the patient’s rural Massachusetts residence, although the patient denied recent exposure to ticks. The patient denied recent exposure to possible reservoirs or vectors of R. We report the first known case of Brill-Zinsser disease in a patient originally infected with a zoonotic strain of R.

Brill–Zinsser disease

Few published data exist about the seroprevalence of R. An additional reason why Brill-Zinsser disease may zinssfr infrequently identified following sylvatic typhus infection is treatment of properly diagnosed infections with the drug of choice, tetracyclines, during acute illness. Receive exclusive offers and updates from Oxford Academic. There have been at least 47 cases documented in humans since Centers for Disease Control and Prevention, unpublished data [ 56 ].

Nicholson, Joseph Singleton, Catherine M.