1. Fatal Flea-Borne Typhus in Texas: A Retrospective Case Series, 1985-2015.
- Author
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Pieracci EG, Evert N, Drexler NA, Mayes B, Vilcins I, Huang P, Campbell J, Behravesh CB, and Paddock CD
- Subjects
- Adult, Aged, Aged, 80 and over, Animals, Anti-Bacterial Agents administration & dosage, Exanthema diagnosis, Exanthema physiopathology, Fatal Outcome, Female, Fever diagnosis, Fever physiopathology, Humans, Male, Middle Aged, Nausea diagnosis, Nausea physiopathology, Rickettsia prowazekii isolation & purification, Rickettsia typhi isolation & purification, Texas, Thrombocytopenia diagnosis, Thrombocytopenia physiopathology, Time-to-Treatment, Transaminases metabolism, Treatment Failure, Typhus, Endemic Flea-Borne drug therapy, Typhus, Endemic Flea-Borne microbiology, Typhus, Endemic Flea-Borne pathology, Typhus, Epidemic Louse-Borne drug therapy, Typhus, Epidemic Louse-Borne microbiology, Typhus, Epidemic Louse-Borne pathology, Vomiting diagnosis, Vomiting physiopathology, Rickettsia prowazekii pathogenicity, Rickettsia typhi pathogenicity, Typhus, Endemic Flea-Borne diagnosis, Typhus, Epidemic Louse-Borne diagnosis
- Abstract
AbstractFlea-borne (murine) typhus is a global rickettsiosis caused by Rickettsia typhi . Although flea-borne typhus is no longer nationally notifiable, cases are reported for surveillance purposes in a few U.S. states. The infection is typically self-limiting, but may be severe or life-threatening in some patients. We performed a retrospective review of confirmed or probable cases of fatal flea-borne typhus reported to the Texas Department of State Health Services during 1985-2015. When available, medical charts were also examined. Eleven cases of fatal flea-borne typhus were identified. The median patient age was 62 years (range, 36-84 years) and 8 (73%) were male. Patients presented most commonly with fever (100%), nausea and vomiting (55%), and rash (55%). Respiratory (55%) and neurologic (45%) manifestations were also identified frequently. Laboratory abnormalities included thrombocytopenia (82%) and elevated hepatic transaminases (63%). Flea or animal contact before illness onset was frequently reported (55%). The median time from hospitalization to administration of a tetracycline-class drug was 4 days (range, 0-5 days). The median time from symptom onset to death was 14 days (range, 1-34 days). Flea-borne typhus can be a life-threatening disease if not treated in a timely manner with appropriate tetracycline-class antibiotics. Flea-borne typhus should be considered in febrile patients with animal or flea exposure and respiratory or neurologic symptoms of unknown etiology. more...
- Published
- 2017
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