Typhus physical examination

Typhus fever presents with high grade fever and a maculopapular rash. Generalized lymphadenopathy is present in majority of the patients. Physical examination usually reveal combination of several non-specific findings.^[1][2][3]

• Fever (as high as 104oF)
• Bradycardia
• Tachypnea and cough

• Conjunctival redness occurs in scrub typhus.

• A maculopapular, or petechial rash initially appears on the trunk and axilla and spreads to involve the rest of the body except for the face, palms, and soles.
• Rash is petechial in patients with epidemic or murine typhus.
• Eschar is found in the scrub form of typhus and is diagnostic. Eschar develops at the site of the arthropod bite as a painless papule. It then becomes indurated and enlarged. The center of the lesion becomes necrotic and develops into a black scab.

• Generalized lymphadenopathy
• Lymph nodes are often tender and enlarged.

• Hepatomegaly
• Splenomegaly

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