Acute Febrile Illness and Complications Due to Murine Typhus, Texas, USA1,2

Details

• Alternative Title:
  Emerg Infect Dis
• Personal Author:
  Afzal, Zeeshan ; Kallumadanda, Sunand ; Wang, Feng ; Hemmige, Vagish ; Musher, Daniel
• Description:
  Murine typhus occurs relatively commonly in southern Texas, as well as in California. We reviewed records of 90 adults and children in whom murine typhus was diagnosed during a 3-year period in 2 hospitals in southern Texas, USA. Most patients lacked notable comorbidities; all were immunocompetent. Initial signs and symptoms included fever (99%), malaise (82%), headache (77%), fatigue (70%), myalgias (68%), and rash (39%). Complications, often severe, in 28% of patients included bronchiolitis, pneumonia, meningitis, septic shock, cholecystitis, pancreatitis, myositis, and rhabdomyolysis; the last 3 are previously unreported in murine typhus. Low serum albumin and elevated procalcitonin, consistent with bacterial sepsis, were observed in >70% of cases. Rash was more common in children; thrombocytopenia, hyponatremia, elevated hepatic transaminases, and complications were more frequent in adults. Murine typhus should be considered as a diagnostic possibility in cases of acute febrile illness in southern and even in more northern US states.
• Subjects:
  Adolescent Adult Animals Antibodies, Bacterial Child Female Fever Humans Immunoglobulin G Immunoglobulin M Male Mice Rickettsia Typhi Typhus, Endemic Flea-Borne Young Adult Zoonoses

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• Source:
  Emerg Infect Dis. 23(8):1268-1273.
• Pubmed ID:
  28726607
• Pubmed Central ID:
  PMC5547806
• Document Type:
  Journal Article
• Place as Subject:
  Texas
• Volume:
  23
• Issue:
  8
• Collection(s):
  Emerging Infectious Diseases
• Main Document Checksum:
  urn:sha256:f3bd3cdbfc61716e5887e1c083f474d8f2fdfdacf2460b8c753f53c02abc62eb
• Download URL:
  https://stacks.cdc.gov/view/cdc/47390/cdc_47390_DS1.pdf
• File Type:
  [PDF - 910.80 KB ]