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date: 26 November 2020

Typhus is an acute and widespread infectious disease in the world. It is a member of rickettsiosis which is caused by intracellular bacteria, including Rickettsia typhi (causes murine or endemic typhus), Rickettsia prowazekii (causes epidemic typhus), and Orientia tsutsugamushi (causes scrub typhus). Most children infected with the diseases may have similar clinical manifestations of fever of unknown origin or prolonged fever, chills, liver function impairment, severe headache, rash, jaundice, myalgia, and pulmonary symptoms. Multiple organ involvement may occur in critical conditions or fetal cases. Misdiagnosis can be easily made; physicians should be highly suspicious in children who have had a travel history and exposure in endemic areas. Early and appropriate empirical antibiotics should be used to reduce severe complications or mortality. However, doxycycline-resistant strain of scrub typhus has been reported. There is no vaccine available currently. This chapter on typhus has been extensively revised and updated; current and clinical approaches to evaluating and managing typhus in children are studied. In addition, useful pictures of typical eschars and chiggers bites on bodies are also shown.

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