Symptoms:

Symptoms of murine or endemic typhus may include:

• Abdominal pain
• Backache
• Diarrhea
• Dull red rash that begins on the middle of the body and spreads
• Extremely high fever (105 - 106 degrees Fahrenheit), which may last up to 2 weeks
• Hacking, dry cough
• Headache
• Joint and muscle pain
• Nausea
• Vomiting

Symptoms of epidemic typhus may include:

• Chills
• Cough
• Delirium
• High fever (104 degrees Fahrenheit)
• Joint pain (arthralgia)
• Lights that appear very bright; light may hurt the eyes
• Low blood pressure
• Rash that begins on the chest and spreads to the rest of the body (except the palms of the hands and soles of the feet)
• Severe headache
• Severe muscle pain (myalgia)
• Stupor

The early rash is a light rose color and fades when you press on it. Later, the rash becomes dull and red and does not fade. People with severe typhus may also develop small areas of bleeding into the skin (petechiae).

Signs and tests:

A complete blood count (CBC) may show anemia and low platelets. Other blood tests for typhus may show:

• High level of typhus antibodies
• Low level of albumin
• Low sodium level
• Mild kidney failure
• Mildly high liver enzymes