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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Furthermore, an acute whole blood sample was not available, and this may have served as a better tool for assessment. Vibrio cholerae Cholera Vibrio vulnificus Vibrio parahaemolyticus Vibrio alginolyticus Plesiomonas shigelloides. Rickettsia typhi Murine typhus Rickettsia prowazekii Epidemic typhusBrill—Zinsser diseaseFlying squirrel typhus. Pseudomonas aeruginosa Pseudomonas infection Moraxella catarrhalis Acinetobacter baumannii.

The patient was given empirical treatment with oral doxycycline at mg twice daily. This patient had been treated for a rib injury and underwent myringotomy in the 6 months prior to receiving a diagnosis of Brill-Zinsser disease, and it is possible that these stressful events may have influenced reactivation.

Brill-Zinsser disease

Brill-Zinsser disease is a form of recrudescent epidemic typhus that occurs years or decades after primary typhus infection [ 1—4 ]. Views Read Edit Idsease history. Oxford University Press is a department of the University of Oxford. Lutwick LI Brill-Zinsser disease. After a patient contracts epidemic typhus from the fecal matter of an infected louse Pediculus humanusthe rickettsia can remain latent and reactivate months or years later, with symptoms similar to or even identical to the original attack of typhus, including a maculopapular rash.

Email alerts New issue alert. He subsequently traveled every 3 years zinxser Morocco for 1-month summer holidays, always in urban areas. Thank you for submitting a comment on this article. Because the patient lived near a goat farm, Q fever and tularemia were zonsser plausible hypotheses, and oral doxycycline was introduced on March Although the classic louseborne cycle of Rickettsia prowazekii is not common in the United States, R.


The patient zinsseer been raised in Morocco. We report a case of Brill-Zinsser disease in a patient who was born in Morocco and had no history of epidemic typhus. 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. Klebsiella pneumoniae RhinoscleromaKlebsiella pneumonia Klebsiella granulomatis Granuloma inguinale Klebsiella oxytoca Escherichia coli: Infobox medical condition new All stub articles.

The patient’s primary infection was thus essentially untreated, and this may have in uenced the zinsxer later development of Brill-Zinsser disease. Am J Trop Med Hyg.

Brill-Zinsser Disease in Moroccan Man, France,

The patient’s prior R. The development of Brill-Zinsser disease in this patient during is supported by increasing IgG antibody titers to R. Serologic study of rickettsioses among acute febrile patients in central Tunisia.

It furthers the University’s objective of excellence in research, scholarship, and education by publishing worldwide. He had most recently traveled to Morocco in Citing articles via Web of Science 3. A recently explored reservoir for silent forms of R.

I agree to the terms and conditions. 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. In all cases, known risk factors were present overcrowding, poor hygiene, or contact with flying squirrels.

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. Adipose tissue serves as a reservoir for recrudescent Rickettsia prowazekii infection in a mouse model. You can help Wikipedia by expanding it. Footnotes Suggested citation for this article: Brill—Zinser disease is a delayed relapse of epidemic typhuscaused by Rickettsia prowazekii.

After consultation with the Centers for Disease Control and Prevention, serum samples were submitted for serological assessment. Brill-Zinsser disease, Rickettsia prowazekii, Morocco, France, typhus, bacteria. Close mobile search navigation Article navigation. Doxycycline is considered the drug of choice for treatment of all rickettsial infections, including R.


Reply to Peiffer-Smadja, et al. Although results of PCR of the patient’s acute serum sample were negative, this finding is not wholly unexpected. A microimmunofluorescence assay showed titers of for IgM and 6, for IgG.

On the basis of serologic analysis with Western blot, we confirmed R. For all other comments, please send your remarks via contact us. Subsequently, this region was thought to be free from epidemic typhus, but 2 cases have been zinsxer 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.

Tick-borne Rickettsia rickettsii Rocky Mountain zinssee fever Rickettsia conorii Boutonneuse fever Rickettsia japonica Diswase spotted fever Rickettsia sibirica North Asian tick typhus Rickettsia australis Queensland tick typhus Rickettsia honei Flinders Island spotted fever Rickettsia africae African tick bite fever Rickettsia parkeri American tick bite fever Rickettsia aeschlimannii Rickettsia aeschlimannii infection.

In addition to PCR or culture of whole blood or rash-site skin biopsy sample, paired acute and convalescent serum samples should be tested for presence of antibodies to R. Other antibiotics are generally considered less effective for treatment of rickettsial infection and have been associated with an increased risk of fatal outcome [14].

In addition, archived serum that had been collected from the patient in after his initial R. Bone adaptation compensates resorption when sciatic neurectomy ddisease followed by low magnitude induced loading. In this report, we describe the first known brilll case of Brill-Zinsser disease following a primary infection with sylvatic epidemic typhus acquired from flying squirrels.

Ecologic studies on the interepidemic survival of louse-borne epidemic typhus fever.