scholarly journals Murine Typhus Presenting as Septic Acute Cholangitis in a Young Woman From South Texas

Cureus ◽  
2021 ◽  
Author(s):  
Jeffrey Xia ◽  
Sabi Shrestha ◽  
James C Saca
Keyword(s):  
Young Woman ◽  
Acute Cholangitis ◽  
South Texas ◽  
Murine Typhus

scholarly journals 669. Changing Epidemiology of Murine Typhus in Texas

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S242-S242 ◽  
Author(s):  
Jennifer Shuford ◽  
Patrick Hunt ◽  
Bonny Mayes
Keyword(s):  
Hot Spot ◽  
Severe Disease ◽  
Public Health Education ◽  
The United States ◽  
Spatial Cluster ◽  
Clinical Findings ◽  
South Texas ◽  
Murine Typhus ◽  
Increased Risk ◽  
Central Texas

Abstract Background Murine (also known as flea-borne) typhus is uncommon in the United States, but it is considered endemic in certain parts of Texas, especially the southernmost region. It is caused by Rickettsia typhi, which is transmitted to humans by rat and cat fleas. Murine typhus is often a mild illness with nonspecific clinical findings, though delayed treatment may result in severe disease and increased risk of complications. Diagnostic tests have low sensitivity in early disease. Therefore, correctly diagnosing patients with murine typhus is challenging unless clinical suspicion is high. In endemic regions, physicians are aware of the disease and diagnose it readily. However, in areas that have not historically been affected, physicians may be less familiar with the presentation of this rickettsial infection, impacting their ability to diagnose and treat it effectively. Methods Probable and confirmed murine typhus cases reported in Texas were collected for 1944–2017. Cases were mapped by county for each of the last 5 years. Cases reported over the last 5 years were also geocoded by residence for spatial cluster analysis by year. Results There has been an overall rise in the number of murine typhus cases reported per year over the last 13 years (Figure 1). The distribution of reported cases throughout Texas has changed over the last 5 years. There continues to be a high number of reported cases in South Texas and Central Texas, while reported cases are increasing in the Harris County/Houston area, Tarrant County/Ft. Worth area, and Dallas County/Dallas area. Spatial cluster (hot spot) analysis of typhus cases in Texas over the last 5 years shows areas of increased risk of murine typhus in South Texas that have persisted over time, while other areas of increased risk have appeared more recently in North Texas and Central Texas (Figures 2 and 3). Conclusion Murine typhus can be a difficult diagnosis to make based on clinical presentation, and physician awareness of its epidemiology is important. The gradual increase in case counts and the changing distribution of cases within Texas may put patients at risk of missed diagnoses. Recognizing the changing epidemiology of typhus in Texas may help inform public health education and control efforts. Disclosures All authors: No reported disclosures.

Murine typhus in South Texas children

2000 ◽  
Vol 19 (6) ◽  
pp. 535-538 ◽  
Author(s):  
JAIME E. FERGIE ◽  
KEVIN PURCELL ◽  
DIANE WANAT
Keyword(s):  
South Texas ◽  
Murine Typhus

scholarly journals Murine Typhus: a Common Cause of Acute Febrile Illness with Potential for Serious Complications

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S66-S66
Author(s):  
Zeeshan Afzal ◽  
Sunand Kallumadanda ◽  
Feng Wang ◽  
Vagish S Hemmige ◽  
Daniel Musher
Keyword(s):  
Febrile Illness ◽  
South Texas ◽  
Insufficient Information ◽  
Murine Typhus ◽  
Clinical Complications ◽  
Hepatic Transaminases ◽  
The Us ◽  
Mesenteric Adenitis ◽  
Hidalgo County ◽  
Typhus Fever

Abstract Background Individual cases and outbreaks of murine typhus have been documented in South Texas. We report 90 cases from Hidalgo County, Texas, enumerating complications and comparing results in children and adults. Methods We reviewed records of 101 patients in three hospitals in Hidalgo County, Texas, who had positive typhus serology (IgG or IgM titer ≥1:128) during 3 years, 2014–2016 and were categorized as suspected, probable or confirmed murine typhus cases in accord with CDC definitions. We excluded 11 cases because a concurrent infection may have confounded our tabulation of manifestations or there was insufficient information to make a clinical diagnosis. Results The majority presented with typical typhus: fever, headache, myalgias and fatigue. Rash, thrombocytopenia and elevated hepatic transaminases were frequent (Table). Clinical complications in 25 cases (28%) caused a less typical syndrome, including bronchiolitis, pneumonia, pancreatitis, cholecystitis, mesenteric adenitis, myositis, rhabdomyolysis, meningitis and septic shock. Procalcitonin was >0.5 in 10 of 14 (71%) cases. Once the diagnosis was suspected, patients were treated with doxycycline with a rapid response in every case. Generally fever disappeared within 24–36 hours of the first dose. Conclusion Murine typhus is a common endemic infection in South Texas. Although most patients had a typical syndrome, the disease is multisystem, and complications appeared in 28% of cases. Procalcitonin was usually elevated. Rats and opossums are common reservoirs for Rickettsia typhi, and a search for cases of murine typhus may be warranted in other parts of the US as well, so that treatment with doxycycline can be begun promptly. Disclosures All authors: No reported disclosures.

Murine Typhus in South Texas Children

2018 ◽  
Vol 37 (11) ◽  
pp. 1071-1076 ◽  
Author(s):  
Ashley Howard ◽  
Jaime Fergie
Keyword(s):  
South Texas ◽  
Murine Typhus

Transient Global Amnesia in a Young Woman on Prolonged Treatment with Oral Contraceptive Drugs

1996 ◽  
Vol 75 (06) ◽  
pp. 980-980
Author(s):  
G Orefice ◽  
L Soriente ◽  
A M Cerbone ◽  
M Coppola ◽  
R Lanzillo ◽  
...  
Keyword(s):  
Oral Contraceptive ◽  
Young Woman ◽  
Transient Global Amnesia ◽  
Prolonged Treatment ◽  
Global Amnesia
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