A 55-year-old man who lived in a louse-infested refugee camp 20 years ago presents with mild fever, headache, and a sparse macular rash. Serology shows high titres of IgG against Rickettsia prowazekii. Recrudescence of this infection years after the primary episode is called:
- A Trench fever recrudescence
- B Brill-Zinsser disease ✓
- C Scrub typhus reinfection
- D Murine typhus reactivation
Correct answer: B. Brill-Zinsser disease
Explanation
Brill-Zinsser disease is the reactivation of latent Rickettsia prowazekii in lymphoid and adipose tissue years after recovery from epidemic typhus, producing a milder, shorter illness without an eschar. Because rickettsiae circulate in the blood during the episode, a louse feeding on such a patient can acquire the organism and spread epidemic typhus again, making the patient a potential reservoir. Murine typhus is caused by R. typhi, and trench fever is caused by Bartonella quintana.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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