Murine typhus - Revision history

Rossdonaldson1 at 20:57, 16 April 2025

2025-04-16T20:57:28Z

← Revisión anterior		Revisión del 20:57 16 abr 2025
Línea 1:		Línea 1:
	''Not to be confused with [[typhoid fever]], a distinct disease caused by a different genera of bacteria''		''Not to be confused with [[typhoid fever]], a distinct disease caused by a different genera of bacteria''
	==Background==		==Background==
	[[File:NHMUK010177265 The plague flea - Xenopsylla cheopis cheopis (Rothschild, 1903).jpg\|thumb\|Microscopic image of rat flea.]]		[[File:NHMUK010177265 The plague flea - Xenopsylla cheopis cheopis (Rothschild, 1903).jpg\|thumb\|Microscopic image of rat [[flea]].]]
	*Also known as "'''endemic''' typhus" and "flea-borne typhus"		*Also known as "'''endemic''' typhus" and "flea-borne typhus"
	*Caused by Rickettsia typhi		*Caused by Rickettsia typhi
	**Gram negative, obligate, intracellular bacterium		**Gram negative, obligate, intracellular bacterium
	**Replicates in epithelial cells of flea's midgut		**Replicates in epithelial cells of [[flea]]'s midgut

	{{Typhus types chart}}		{{Typhus types chart}}

	===Vector===		===Vector===
	*Infection is transmitted by fleas		*Infection is transmitted by [[fleas]]
	**Typically rat fleas		**Typically rat [[fleas]]
	**Also Rickettsia felis (indistinguishable from R. typhi) carried by fleas on opossum and cats		**Also Rickettsia felis (indistinguishable from R. typhi) carried by fleas on opossum and cats
	*Feces containing R. typhi are deposited into wound made by flea bites		*Feces containing R. typhi are deposited into wound made by flea bites

Rossdonaldson1: /* Clinical Features */

2025-04-16T20:39:10Z

Clinical Features

← Revisión anterior		Revisión del 20:39 16 abr 2025
Línea 26:		Línea 26:

	==Clinical Features==		==Clinical Features==
	*Incubation period: 7-14 days
	[[File:Murine_Typhus.png\|thumb\|Rash of Murine Typhus]]		[[File:Murine_Typhus.png\|thumb\|Rash of Murine Typhus]]
	[[File:PMC2729230 wjem-10-207f1.png\|thumb\|Diffuse rash consisting of multiple, small, erythematous, and confluent macules.]]		[[File:PMC2729230 wjem-10-207f1.png\|thumb\|Diffuse rash consisting of multiple, small, erythematous, and confluent macules.]]
			*Incubation period: 7-14 days

	===Symptoms===		===Symptoms===
	*Variable and non-specific		*Variable and non-specific
Línea 34:		Línea 35:

	;Most Common Symptoms		;Most Common Symptoms
	*[[~~Fever~~]]		*High [[fever]]
	**Can last ~1 week		**Can last ~1 week
	*[[Rash]]		*[[Rash]]
Línea 44:		Línea 45:
	*[[Arthralgia]]s		*[[Arthralgia]]s

	;Other Symptoms		;Other Symptoms/Complications
	*[[Hepatomegaly]]		*[[Hepatomegaly]]
	*Splenomegaly		*Splenomegaly
Línea 51:		Línea 52:
	*[[Nausea/Vomiting]]		*[[Nausea/Vomiting]]
	*[[Abdominal pain]]		*[[Abdominal pain]]
	*[[Confusion]]		*[[Meningitis]]
			**[[Confusion]]
			*[[Endocarditis]]
			*Rarely [[death]] (<1% of cases)

	==Differential Diagnosis==		==Differential Diagnosis==

Rossdonaldson1: /* Management */

2025-04-16T20:16:16Z

Management

← Revisión anterior		Revisión del 20:16 16 abr 2025
Línea 75:		Línea 75:
	**Children - 2.2mg/kg BID		**Children - 2.2mg/kg BID
	*[[Chloramphenicol]] 50-100mg/kg/day div Q6hr (Max dose = 4g/day)		*[[Chloramphenicol]] 50-100mg/kg/day div Q6hr (Max dose = 4g/day)

			==Disposition==

	==See Also==		==See Also==

Rossdonaldson1: /* Background */

2025-04-16T20:13:52Z

Background

← Revisión anterior		Revisión del 20:13 16 abr 2025
Línea 1:		Línea 1:
	''Not to be confused with [[typhoid fever]], a distinct disease caused by a different genera of bacteria''		''Not to be confused with [[typhoid fever]], a distinct disease caused by a different genera of bacteria''
	==Background==		==Background==
			[[File:NHMUK010177265 The plague flea - Xenopsylla cheopis cheopis (Rothschild, 1903).jpg\|thumb\|Microscopic image of rat flea.]]
	*Also known as "'''endemic''' typhus" and "flea-borne typhus"		*Also known as "'''endemic''' typhus" and "flea-borne typhus"
	*Caused by Rickettsia typhi		*Caused by Rickettsia typhi

Rossdonaldson1: /* Background */

2025-04-16T20:08:42Z

Background

← Revisión anterior		Revisión del 20:08 16 abr 2025
Línea 1:		Línea 1:
	''Not to be confused with [[typhoid fever]], a distinct disease caused by a different genera of bacteria''		''Not to be confused with [[typhoid fever]], a distinct disease caused by a different genera of bacteria''
	==Background==		==Background==
	*Also known as "'''endemic''' typhus" and "~~fleaborne~~ typhus"		*Also known as "'''endemic''' typhus" and "flea-borne typhus"
	*Caused by Rickettsia typhi		*Caused by Rickettsia typhi
	**Gram negative, obligate, intracellular bacterium		**Gram negative, obligate, intracellular bacterium

Rossdonaldson1: /* Management */

2025-04-16T20:04:59Z

Management

← Revisión anterior		Revisión del 20:04 16 abr 2025
Línea 70:		Línea 70:

	==Management==		==Management==
			''May need to treat empirically while awaiting confirmatory testing.''
	*[[Doxycycline]] 100mg BID continue for 3 days after resolution of symptoms<ref>Civen R, Ngo V, 2008. Murine typhus: an unrecognized suburban vectorborne disease. Clin Infect Dis 46: 913–918.</ref>		*[[Doxycycline]] 100mg BID continue for 3 days after resolution of symptoms<ref>Civen R, Ngo V, 2008. Murine typhus: an unrecognized suburban vectorborne disease. Clin Infect Dis 46: 913–918.</ref>
	**Children - 2.2mg/kg BID		**Children - 2.2mg/kg BID

Rossdonaldson1: /* Clinical Features */

2023-09-13T16:15:31Z

Clinical Features

← Revisión anterior		Revisión del 16:15 13 sep 2023
Línea 31:		Línea 31:
	*Variable and non-specific		*Variable and non-specific
	*Often presents as acute, self-limited illness, with no complications<ref>Civen R, Ngo V, 2008. Murine typhus: an unrecognized suburban vectorborne disease. Clin Infect Dis 46: 913–918.</ref>		*Often presents as acute, self-limited illness, with no complications<ref>Civen R, Ngo V, 2008. Murine typhus: an unrecognized suburban vectorborne disease. Clin Infect Dis 46: 913–918.</ref>

	;Most Common Symptoms		;Most Common Symptoms
	*[[Fever]]~~- can~~ last ~1 week		*[[Fever]]
			**Can last ~1 week
	*[[Rash]]		*[[Rash]]
	**Macular or maculopapular, blanching, non-pruritic		**Macular or maculopapular, blanching, non-pruritic

Rossdonaldson1: /* Clinical Features */

2019-11-16T13:54:08Z

Clinical Features

← Revisión anterior		Revisión del 13:54 16 nov 2019
Línea 27:		Línea 27:
	*Incubation period: 7-14 days		*Incubation period: 7-14 days
	[[File:Murine_Typhus.png\|thumb\|Rash of Murine Typhus]]		[[File:Murine_Typhus.png\|thumb\|Rash of Murine Typhus]]
			[[File:PMC2729230 wjem-10-207f1.png\|thumb\|Diffuse rash consisting of multiple, small, erythematous, and confluent macules.]]
	===Symptoms===		===Symptoms===
	*Variable and non-specific		*Variable and non-specific

ClaireLewis at 16:02, 14 September 2019

2019-09-14T16:02:53Z

← Revisión anterior		Revisión del 16:02 14 sep 2019
Línea 31:		Línea 31:
	*Often presents as acute, self-limited illness, with no complications<ref>Civen R, Ngo V, 2008. Murine typhus: an unrecognized suburban vectorborne disease. Clin Infect Dis 46: 913–918.</ref>		*Often presents as acute, self-limited illness, with no complications<ref>Civen R, Ngo V, 2008. Murine typhus: an unrecognized suburban vectorborne disease. Clin Infect Dis 46: 913–918.</ref>
	;Most Common Symptoms		;Most Common Symptoms
	*Fever- can last ~1 week		*[[Fever]]- can last ~1 week
	*Rash		*[[Rash]]
	**Macular or maculopapular, blanching, non-pruritic		**Macular or maculopapular, blanching, non-pruritic
	**Starts centrally and moves to the extremities		**Starts centrally and moves to the extremities
	**Can involve palms/soles but usually sparing		**Can involve palms/soles but usually sparing
	**Starts 6-7 days after symptom onset (fever onset)		**Starts 6-7 days after symptom onset (fever onset)
	*Headache		*[[Headache]]
	*~~Arthralgias~~		*[[Arthralgia]]s

	;Other Symptoms		;Other Symptoms
	*~~Hepatomegally~~		*[[Hepatomegaly]]
	*~~Splenomegally~~		*Splenomegaly
	*Cough		*[[Cough]]
	*[[Diarrhea]]		*[[Diarrhea]]
	*Nausea/Vomiting		*[[Nausea/Vomiting]]
	*Abdominal pain		*[[Abdominal pain]]
	*Confusion		*[[Confusion]]

	==Differential Diagnosis==		==Differential Diagnosis==
	*Non-specific viral illness		*Non-specific [[viral syndrome\|viral illness]]
	*Most common admitting diagnosis in one case study was "fever of unknown origin"<ref>Civen R, Ngo V, 2008. Murine typhus: an unrecognized suburban vectorborne disease. Clin Infect Dis 46: 913–918.</ref>		*Most common admitting diagnosis in one case study was "fever of unknown origin"<ref>Civen R, Ngo V, 2008. Murine typhus: an unrecognized suburban vectorborne disease. Clin Infect Dis 46: 913–918.</ref>
	{{Tick borne illnesses DDX}}		{{Tick borne illnesses DDX}}
Línea 56:		Línea 56:

	==Evaluation==		==Evaluation==

	~~===Work up===~~
	*Infectious work up		*Infectious work up
	**Not sensitive or specific		**Not sensitive or specific
	**CBC- can show anemia and thrombocytopenia		**CBC- can show [[anemia]] and [[thrombocytopenia]]
	**LFTs- often elevated 3-5x normal		**[[LFTs]]- often elevated 3-5x normal
	**Lumbar ~~Puncture~~- resembles aseptic meningitis		**[[Lumbar puncture]]- resembles aseptic meningitis
	===Diagnostic labs===		===Diagnostic labs===
	*Immunofluorescent assay is the gold standard		*Immunofluorescent assay is the gold standard

Rossdonaldson1 at 10:06, 19 December 2016

2016-12-19T10:06:58Z

← Revisión anterior		Revisión del 10:06 19 dic 2016
Línea 1:		Línea 1:
	''~~Also known as "endemic typhus" and "fleaborne typhus"~~''		''Not to be confused with [[typhoid fever]], a distinct disease caused by a different genera of bacteria''
	==Background==		==Background==
			*Also known as "'''endemic''' typhus" and "fleaborne typhus"
	*Caused by Rickettsia typhi		*Caused by Rickettsia typhi
	**Gram negative, obligate, intracellular bacterium		**Gram negative, obligate, intracellular bacterium
	**Replicates in epithelial cells of flea's midgut		**Replicates in epithelial cells of flea's midgut

			{{Typhus types chart}}

	===Vector===		===Vector===