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Case Report: Fulminant Murine Typhus Presenting with Status Epilepticus and Multi-Organ Failure: an Autopsy Case and a Review of the Neurologic Presentations of Murine Typhus

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  • 1 Department of Medicine, Long School of Medicine at University of Texas Health, San Antonio, Texas;
  • | 2 Division of Pulmonary and Critical Care Medicine, Department of Medicine, Long School of Medicine at University of Texas Health, San Antonio, Texas;
  • | 3 Department of Pathology and Laboratory Medicine, Long School of Medicine at University of Texas Health, San Antonio, Texas;
  • | 4 Division of Infectious Diseases, Department of Medicine, Long School of Medicine at University of Texas Health, San Antonio, Texas;
  • | 5 Medicine Service, Division of Infectious Diseases, South Texas Veterans Healthcare System, San Antonio, Texas
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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.

Author Notes

Address correspondence to Christopher Dayton, Division of Pulmonary and Critical Care Medicine, Department of Medicine, Long School of Medicine at University of Texas Health, 7703 Floyd Dr. MC: 7885, San Antonio, TX 78229. E-mail: dayton@uthscsa.edu

Authors’ addresses: Benjamin E Stephens, Department of Medicine, Long School of Medicine at University of Texas Health, San Antonio, TX, E-mail: stephensbe@uthscsa.edu. Meilinh Thi and Christopher Dayton, Division of Pulmonary and Critical Care Medicine, Department of Medicine, Long School of Medicine at University of Texas Health, San Antonio, TX, E-mails: thi@uthscsa.edu and dayton@uthscsa.edu. Rahaf Alkhateb, Apeksha Agarwal, and Francis E Sharkey, Department of Pathology and Laboratory Medicine, Long School of Medicine at University of Texas Health, San Antonio, TX, E-mails: alkhateb@uthscsa.edu, agarwala@uthscsa.edu, and sharkyf@uthscsa.edu. Gregory M. Anstead, Division of Infectious Diseases, Department of Medicine, Long School of Medicine at University of Texas Health, San Antonio, TX, and Medicine Service, Division of Infectious Diseases, South Texas Veterans Healthcare System, San Antonio, TX, E-mail: anstead@uthscsa.edu.

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