Brill-Zinsser disease describes a recrudescence of typhus many years after apparent recovery.
Features of Brill-Zinnser disease:
(1) past history of epidemic typhus
(2) clinical recovery
(3) recurrence of illness many years later (20, 40 or more)
(4) exclusion of re-exposure
(5) exclusion of an alternative diagnosis
Clinical findings may include:
(1) fever of unknown origin
(2) intense, persistent headache
(3) macular or maculopapular rash on day 4-6 of fever
The diagnosis is supported if Rickettsia prowazekii can be demonstrated.
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Specialty: Infectious Diseases
