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

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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]

## Physical examination

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### Vitals

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

### HEENT

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* Conjunctival redness occurs in scrub typhus.

### Skin

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* 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.

### Lymph nodes

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

### Abdomnen

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* Hepatomegaly
* Splenomegaly

## References

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1. ↑ "Epidemic Typhus".
2. ↑ "Murine Typhus".
3. ↑ "Scrub Typhus".

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