1921
Volume 99, Issue 2
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

Abstract.

Murine typhus (MT) is an important cause of febrile illness in endemic areas, and there is an epidemiologic resurgence of this infection currently transpiring in Texas and California. Fatal cases and severe neurological complications are rare. A fatal case of MT in a middle-aged man is reported with a course culminating in multi-organ failure and refractory status epilepticus. An autopsy revealed hemorrhagic pneumonia, acute tubular necrosis, and ischemic necrosis in the liver, adrenals, and brain. We have also reviewed the neurologic complications of MT.

Loading

Article metrics loading...

The graphs shown below represent data from March 2017
/content/journals/10.4269/ajtmh.18-0084
2018-06-25
2019-07-19
Loading full text...

Full text loading...

/deliver/fulltext/14761645/99/2/tpmd180084.html?itemId=/content/journals/10.4269/ajtmh.18-0084&mimeType=html&fmt=ahah

References

  1. Civen R, Ngo V, , 2008. Murine typhus: an unrecognized suburban vectorborne disease. Clin Infect Dis 46: 913918. [Google Scholar]
  2. Afzal Z, Kallumadanda S, Wang F, Hemmige V, Musher D, , 2013. Acute febrile illness and complications due to murine typhus, Texas, USA. Emerg Infect Dis 23: 12681273. [Google Scholar]
  3. Tsioutis C, Zafeiri M, Avramopoulos A, Prousali E, Miligkos M, Karageorgos SA, , 2017. Clinical and laboratory characteristics, epidemiology, and outcomes of murine typhus: a systematic review. Acta Trop 166: 1624. [Google Scholar]
  4. Pieracci EG, Evert N, Drexler NA, Mayes B, Vilcins I, Huang P, Campbell J, Behravesh CB, Paddock CD, , 2017. Fatal flea-borne typhus in Texas: a retrospective case series, 1985–2015. Am J Trop Med Hyg 96: 10881093. [Google Scholar]
  5. Baker JN, McAlpine JG, Gill DG, , 1939. Endemic typhus. Am J Public Health 24: 10681073. [Google Scholar]
  6. Murray KO, Evert N, Mayes B, Fonken E, Erickson T, Garcia MN, Sidwa T, , 2017. Typhus group rickettsiosis, Texas, USA, 2003–2013. Emerg Infect Dis 23: 645. [Google Scholar]
  7. California Department of Health, 2018. Human Flea-Borne Typhus Cases in California. Available at: www.cdph.ca.gov/Programs/CID/DCDC/CDPH%20Document%20Library/Flea-borneTyphusCaseCounts.pdf. Accessed January 24, 2018.
  8. Binford CH, Ecker HD, , 1947. Endemic (murine) typhus: report of autopsy findings in three cases. Am J Clin Pathol 17: 797806. [Google Scholar]
  9. Walker DH, Parks FM, Betz TG, Taylor JP, Muehlberger JW, , 1989. Histopathology and immunohistologic demonstration of the distribution of Rickettsia typhi in fatal murine typhus. Am J Clin Pathol 91: 720724. [Google Scholar]
  10. Angelakis E, Botelho E, Socolovschi C, Sobas CR, Piketty C, Parola P, Raoult D, , 2010. Murine typhus as a cause of fever in travelers from Tunisia and Mediterranean areas. J Travel Med 17: 310315. [Google Scholar]
  11. Regan JJ, 2015. Risk factors for fatal outcome from rocky mountain spotted fever in a highly endemic area—Arizona, 2002–2011. Clin Infect Dis 60: 16591666. [Google Scholar]
  12. de Sousa R, 2008. Host- and microbe-related risk factors for and pathophysiology of fatal Rickettsia conorii infection in Portuguese patients. J Infect Dis 198: 576585. [Google Scholar]
  13. Walker DH, Hawkins HK, Hudson P, , 1983. Fulminant Rocky Mountain spotted fever. Its pathologic characteristics associated with glucose-6-phosphate dehydrogenase deficiency. Arch Pathol Lab Med 107: 121125. [Google Scholar]
  14. Kim IH, Lee HB, Hwang JH, Kwon KS, Lee CS, , 2010. Scrub typhus in patients with liver cirrhosis: a preliminary study. Clin Microbiol Infect 16: 419424. [Google Scholar]
  15. Molina DK, DiMaio VJ, , 2012. Normal organ weights in men: part II-the brain, lungs, liver, spleen, and kidneys. Am J Forensic Med Pathol 33: 368372. [Google Scholar]
  16. Ascione T, Di Flumeri G, Boccia G, De Caro F, , 2017. Infections in patients affected by liver cirrhosis: an update. Infez Med 25: 9197. [Google Scholar]
  17. Kirkland KB, Marcom PK, Sexton DJ, Dumler JS, Walker DH, , 1993. Rocky Mountain spotted fever complicated by gangrene: report of six cases and review. Clin Infect Dis 16: 629634. [Google Scholar]
  18. Cowan G, , 2000. Rickettsial diseases: the typhus group of fevers—a review. Postgrad Med J 76: 269272. [Google Scholar]
  19. Krishna MR, Vasuki B, Nagaraju K, , 2015. Scrub typhus: audit of an outbreak. Indian J Pediatr 82: 537540. [Google Scholar]
  20. Carr SB, Bergamo DF, Emmanuel PJ, Ferreira JA, , 2014. Murine typhus as a cause of cognitive impairment: case report and a review of the literature. Pediatr Neurol 50: 265268. [Google Scholar]
  21. Drevets DA, Leenen PJ, Greenfield RA, , 2004. Invasion of the central nervous system by intracellular bacteria. Clin Microbiol Rev 17: 323347. [Google Scholar]
  22. Dittrich S, 2015. Orientia, rickettsia, and leptospira pathogens as causes of CNS infections in Laos: a prospective study. Lancet Glob Health 3: e104e112. [Google Scholar]
  23. Tsioutis C, Chaliotis G, Kokkini S, Doukakis S, Tselentis Y, Psaroulaki A, Gikas A, , 2014. Murine typhus in elderly patients: a prospective study of 49 patients. Scand J Infect Dis 46: 779782. [Google Scholar]
  24. Woo ML, Leung JW, French GL, , 1988. Rickettsial infection presenting as culture-negative meningitis. Postgrad Med J 64: 614616. [Google Scholar]
  25. Masalha R, Merkin-Zaborsky H, Matar M, Zirkin HJ, Wirguin I, Herishanu YO, , 1998. Murine typhus presenting as subacute meningoencephalitis. J Neurol 245: 665668. [Google Scholar]
  26. Simon NG, Cremer PD, Graves SR, , 2011. Murine typhus returns to New South Wales: a case of isolated meningoencephalitis with raised intracranial pressure. Med J Aust 194: 652654. [Google Scholar]
  27. Galanakis E, Gikas A, Bitsori M, Sbyrakis S, , 2002. Rickettsia typhi infection presenting as subacute meningitis. J Child Neurol 17: 156157. [Google Scholar]
  28. Silpapojakul K, Ukkachoke C, Krisanapan S, Silpapojakul K, , 1991. Rickettsial meningitis and encephalitis. Arch Intern Med 151: 17531757. [Google Scholar]
  29. Silpapojakul K, Chayakul P, Krisanapan S, Silpapojakul K, , 1993. Murine typhus in Thailand: clinical features, diagnosis and treatment. Q J Med 86: 4347. [Google Scholar]
  30. Chaliotis G, Kritsotakis EI, Psaroulaki A, Tselenti Y, Gikas A, , 2012. Murine typhus in central Greece: epidemiological, clinical, laboratory, and therapeutic-response features of 90 cases. Int J Infect Dis 16: e591e596. [Google Scholar]
  31. Lew HL, Lane B, Zeiner H, , 2005. Neuroimaging and clinical manifestations of bilateral temporal encephalopathy secondary to murine typhus infection. Am J Phys Med Rehabil 84: 310311. [Google Scholar]
  32. Aouam A, Toumi A, Brahim HB, Loussaief C, Jelliti B, Romdhane FB, Yahia SB, Khairallah M, Chakroun M, , 2015. Epidemiological, clinical and laboratory features of murine typhus in central Tunisia. Med Mal Infect 45: 124127. [Google Scholar]
  33. Fergie JE, Purcell K, Wanat D, , 2000. Murine typhus in south Texas children. Pediatr Infect Dis J 19: 535538. [Google Scholar]
  34. Chang K, 2012. Murine typhus in southern Taiwan during 1992–2009. Am J Trop Med Hyg 87: 141147. [Google Scholar]
  35. Hernández-Cabrera M, Angel-Moreno A, Santana E, Bolaños M, Francès A, Martín-Sánchez AM, Pérez-Arellano JL, , 2004. Murine typhus with renal involvement in Canary Islands, Spain. Emerg Infect Dis 10: 740. [Google Scholar]
  36. Vallejo‐Maroto I, García‐Morillo S, Wittel MB, Stiefel P, Miranda M, Pamies E, Aparicio R, Carneado J, , 2002. Aseptic meningitis as a delayed neurologic complication of murine typhus. Clin Microbiol Infect 8: 826827. [Google Scholar]
  37. Walker DH, Dumler JS, , 1997. Rickettsial infections. Connor DH, Chandler FW, Schwartz DA, Manz HJ, Lack EE, eds. Pathology of Infectious Diseases. Stamford, CT: Appleton & Lange, 789–800.
  38. Dumler JS, Taylor JP, Walker DH, , 1991. Clinical and laboratory features of murine typhus in south Texas, 1980 through 1987. JAMA 266: 13651370. [Google Scholar]
  39. Mas Bernard A, , 1960. Focal epilepsy, sole revealing clinical manifestation of murine rickettsiosis. Apropos of 2 cases developing in parallel. Presse Med 68: 1656. [Google Scholar]
  40. Tsiachris D, Deutsch M, Vassilopoulos D, Zafiropoulou R, Archimandritis AJ, , 2008. Sensorineural hearing loss complicating severe rickettsial diseases: report of two cases. J Infect 56: 7476. [Google Scholar]
  41. Lin SY, Wang YL, Lin HF, Chen TC, Chen YH, Lu PL, , 2010. Reversible hearing impairment: delayed complication of murine typhus or adverse reaction to azithromycin? J Med Microbiol 59: 602606. [Google Scholar]
  42. Xu Z, Zhu X, Lu Q, Li X, Hu Y, , 2015. Misdiagnosed murine typhus in a patient with multiple cerebral infarctions and hemorrhage: a case report. BMC Neurol 15: 121. [Google Scholar]
  43. Bernabeu-Wittel M, Pachón J, Alarcón A, López-Cortés LF, Viciana P, Jiménez-Mejías ME, Villanueva JL, Torronteras R, Caballero-Granado FJ, , 1999. Murine typhus as a common cause of fever of intermediate duration: a 17-year study in the south of Spain. Arch Intern Med 159: 872876. [Google Scholar]
  44. Vander T, Medvedovsky M, Valdman S, Herishanu Y, , 2003. Facial paralysis and meningitis caused by Rickettsia typhi infection. Scand J Infect Dis 35: 887888. [Google Scholar]
  45. Moy WL, Ooi ST, , 2015. Abducens nerve palsy and meningitis by Rickettsia typhi. Am J Trop Med Hyg 92: 620624. [Google Scholar]
  46. Hsu CH, Hsieh LP, , 2014. Murine typhus with presentation of unilateral abducens nerve palsy: a case report. J Intern Med Taiwan 25: 3640. [Google Scholar]
  47. Whiteford SF, Taylor JP, Dumler JS, , 2001. Clinical, laboratory, and epidemiologic features of murine typhus in 97 Texas children. Arch Pediatr Adolesc Med 155: 396400. [Google Scholar]
  48. Samra Y, Shaked Y, Maier MK, , 1989. Delayed neurologic display in murine typhus: report of two cases. Arch Intern Med 149: 949951. [Google Scholar]
  49. Stuart BM, Pullen RL, , 1945. Endemic (murine) typhus fever: clinical observations of 180 cases. Ann Intern Med 23: 520536. [Google Scholar]
  50. Rosenblum MJ, Masland RL, Harrell GT, , 1952. Residual effects of rickettsial disease on the central nervous system: results of neurologic examinations and electroencephalograms following Rocky Mountain spotted fever. AMA Arch Intern Med 90: 444455. [Google Scholar]
http://instance.metastore.ingenta.com/content/journals/10.4269/ajtmh.18-0084
Loading
/content/journals/10.4269/ajtmh.18-0084
Loading

Data & Media loading...

  • Received : 30 Jan 2018
  • Accepted : 09 May 2018
  • Published online : 25 Jun 2018

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error