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Epidemic typhus is caused by infection with Rickettsia prowazekii and is transmitted by the human body louse. Clinical features include, after an incubation period of 1-2 weeks, fever, headache and malaise.

Furthermore, an eruption consisting of pink, red, or purpuric, discrete or confluent macules starting on the lateral trunk and spreading to involve most of the body including the face while sparing the palms and soles. Skin ulceration may occur.

Conjunctivae may be involved. The eruption may become red and purpuric and can become confluent.

Death can occur from myocardial or central nervous system involvement.

Brill-Zinsser disease or sporadic typhus is the recurrence of epidemic typhus in individuals who have previously recovered from an attack. Skin lesions are the same but more mild.

Murine typhus is caused by Rickettsia mooseri, and is spread from rodent to man by the rat flea. Skin lesions are similar to those of epidemic typhus but are more mild.

Other rickettsial diseases include Rocky Mountain spotted fever, tick typhus, scrub typhus and rickettsial pox.

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