Acute febrile illness and complications due to murine typhus, Texas, USA

Zeeshan Afzal, Sunand Kallumadanda, Feng Wang, Vagish S. Hemmige, Daniel Musher

Research output: Contribution to journalArticle

13 Scopus citations

Abstract

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 immunocom-petent. 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; thrombocyto-penia, 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.

Original languageEnglish (US)
Pages (from-to)1268-1273
Number of pages6
JournalEmerging Infectious Diseases
Volume23
Issue number8
DOIs
StatePublished - Aug 1 2017
Externally publishedYes

ASJC Scopus subject areas

  • Epidemiology
  • Microbiology (medical)
  • Infectious Diseases

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