Typhus physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Aditya Ganti M.B.B.S. [2]

Overview

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]

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.