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Reliable, easy-to-read patient information on common medical conditions — written in plain language, free of jargon, and grounded in current evidence. Browse the most frequent diagnoses, understand what they mean for everyday life, and learn which steps and questions help you have a focused conversation with your doctor.

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Typhus differential diagnosis

Introduction

Overview

Overview

Typhus must be differentiated from other diseases that cause fever, rash, diarrhea and vomiting, such as Ebola, Typhoid fever, Malaria and Lassa fever.[1][2][3][4][5]

Differentiating Typhus from other Diseases

Differentiating Typhus from other Diseases

The table below summarizes the findings that differentiate Typhus from other conditions that cause fever, diarrhea and abdominal pain.[1][2][3][4][5]

Disease Findings
Ebola Presents with fever, chills vomiting, diarrhea, generalized pain or malaise, and sometimes internal and external bleeding, that follow an incubation period of 2-21 days.
Typhoid fever Presents with fever, headache, rash, gastrointestinal symptoms, with lymphadenopathy, relative bradycardia, cough and leucopenia and sometimes sore throat. Blood and stool culture can confirm the presence of the causative bacteria.
Malaria Presents with acute fever, headache and sometimes diarrhea (children). A blood smears must be examined for malaria parasites. The presence of parasites does not exclude a concurrent viral infection. An antimalarial should be prescribed as an empiric therapy.
Lassa fever Disease onset is usually gradual, with fever, sore throat, cough, pharyngitis, and facial edema in the later stages. Inflammation and exudation of the pharynx and conjunctiva are common.
Yellow fever and other Flaviviridae Present with hemorrhagic complications. Epidemiological investigation may reveal a pattern of disease transmission by an insect vector. Virus isolation and serological investigation serves to distinguish these viruses. Confirmed history of previous yellow fever vaccination will rule out yellow fever.
Shigellosis & other bacterial enteric infections Presents with diarrhea, possibly bloody, accompanied by fever, nausea, and sometimes toxemia, vomiting, cramps, and tenesmus. Stools contain blood and mucous in a typical case. A search for possible sites of bacterial infection, together with cultures and blood smears, should be made. Presence of leucocytosis distinguishes bacterial infections from viral infections.
Others Leptospirosis, viral hepatitis, rheumatic fever, and mononucleosis can produce signs and symptoms that may be confused with Ebola in the early stages of infection.
References

References

  1. ↑ 1.0 1.1 Brown CS, Mepham S, Shorten RJ (2017). “Ebola Virus Disease: An Update on Epidemiology, Symptoms, Laboratory Findings, Diagnostic Issues, and Infection Prevention and Control Issues for Laboratory Professionals”. Clin. Lab. Med. 37 (2): 269–284. doi:10.1016/j.cll.2017.01.003. PMID 28457350.
  2. ↑ 2.0 2.1 Bebell LM, Oduyebo T, Riley LE (2017). “Ebola virus disease and pregnancy: A review of the current knowledge of Ebola virus pathogenesis, maternal, and neonatal outcomes”. Birth Defects Res. 109 (5): 353–362. doi:10.1002/bdra.23558. PMID 28398679.
  3. ↑ 3.0 3.1 Spanò S (2016). “Mechanisms of Salmonella Typhi Host Restriction”. Adv. Exp. Med. Biol. 915: 283–94. doi:10.1007/978-3-319-32189-9_17. PMID 27193549.
  4. ↑ 4.0 4.1 Basu S, Sahi PK (2017). “Malaria: An Update”. Indian J Pediatr. doi:10.1007/s12098-017-2332-2. PMID 28357581.
  5. ↑ 5.0 5.1 Brosh-Nissimov T (2016). “Lassa fever: another threat from West Africa”. Disaster Mil Med. 2: 8. doi:10.1186/s40696-016-0018-3. PMC 5330145. PMID 28265442.

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2]