Murine (Endemic) Typhus

Presentation :

• After an incubation of 6 to 18 days (mean 10 days), a shaking chill accompanies headache and fever in patients with murine typhus. The fever lasts about 12 days; then temperature gradually returns to normal.
  • The rash and other manifestations are similar to those of Epidemic Typhus but are much less severe. The early rash is sparse and discrete.

Pathophysiology :

• Caused by Rickettsia typhi and Rickettsia felis which are transmitted to humans by bites from fleas (rat fleas and probably cat + opossum fleas too)

Diagnostic Testing:

• Diagnosis is clinical, due to unreliability of early diagnostic tests.
  • treatment decisions should be made based on clinical presentation and epidemiologic settings: Murine typhus should be considered in patients with persistent fever, a history of exposure to fleas or flea hosts (such as rats, cats or opossums), or if there is a history of travel to tropical or semitropical regions.
• When treated early, patients typically experience a less severe illness and shorter recovery time. Treatment should never be withheld pending diagnostic tests.

Treatment :

• Doxycycline 100mg BID for at least 3 days after the fever subsides and until there is evidence of clinical improvement (usually 7–10 days)

Prognosis:

References: