A Aouam1, A Toumi2, H Ben Brahim3, C Loussaief1, B Jelliti4, F Ben Romdhane3, S Ben Yahia4, M Khairallah4, M Chakroun3. 1. Department of Infectious Diseases, Fattouma Bourguiba University Hospital, 5019 Monastir, Tunisia. 2. Department of Infectious Diseases, Fattouma Bourguiba University Hospital, 5019 Monastir, Tunisia; Unité de recherche UR12SP41, Fattouma Bourguiba University Hospital, 5019 Monastir, Tunisia. Electronic address: adnene_toumi@yahoo.fr. 3. Department of Infectious Diseases, Fattouma Bourguiba University Hospital, 5019 Monastir, Tunisia; Unité de recherche UR12SP41, Fattouma Bourguiba University Hospital, 5019 Monastir, Tunisia. 4. Department of Ophthalmology, Fattouma Bourguiba University Hospital, 5019 Monastir, Tunisia.
Abstract
OBJECTIVE: Murine typhus is an endemic zoonosis. It is difficult to diagnose because of its non-specific clinical manifestations. Our objective was to describe the epidemiological, clinical, laboratory, and treatment features of murine typhus. METHODS: We conducted a retrospective study of 73 adult patients hospitalized for murine typhus from 2006 to 2011. The diagnosis was confirmed by a single titer of IgM≥128 or by seroconversion to typhus group antigen identified by indirect fluorescent assay. RESULTS: The mean age of patients was 33.1 years (range, 13-68 years). Thirty-eight patients (52%) lived in rural or suburban areas; neither fleabites nor exposure to rats were reported. The most common clinical symptoms were: fever, headache, and myalgia. A maculopapular and non-confluent rash was observed in 47 patients (64.4%). No inoculation eschar was observed in any patient. Eight patients presented with interstitial pneumonia and two with lymphocytic meningitis. The diagnosis was confirmed by indirect fluorescence assay in every case. A single titer of IgM ≥ 128 was found in 62 (84.9%) cases. The other 11 cases were diagnosed by seroconversion. All patients were given antibiotics. Tetracyclines were prescribed in 57 cases (78%). The two patients presenting with meningitis were treated with fluoroquinolone. The outcome was favorable for all patients and no relapse was observed. CONCLUSION: The features of murine typhus are non-specific. The definitive diagnosis is based on serologic testing by indirect fluorescent assay. Cyclins were the most prescribed antibiotics.
OBJECTIVE:Murine typhus is an endemic zoonosis. It is difficult to diagnose because of its non-specific clinical manifestations. Our objective was to describe the epidemiological, clinical, laboratory, and treatment features of murine typhus. METHODS: We conducted a retrospective study of 73 adult patients hospitalized for murine typhus from 2006 to 2011. The diagnosis was confirmed by a single titer of IgM≥128 or by seroconversion to typhus group antigen identified by indirect fluorescent assay. RESULTS: The mean age of patients was 33.1 years (range, 13-68 years). Thirty-eight patients (52%) lived in rural or suburban areas; neither fleabites nor exposure to rats were reported. The most common clinical symptoms were: fever, headache, and myalgia. A maculopapular and non-confluent rash was observed in 47 patients (64.4%). No inoculation eschar was observed in any patient. Eight patients presented with interstitial pneumonia and two with lymphocytic meningitis. The diagnosis was confirmed by indirect fluorescence assay in every case. A single titer of IgM ≥ 128 was found in 62 (84.9%) cases. The other 11 cases were diagnosed by seroconversion. All patients were given antibiotics. Tetracyclines were prescribed in 57 cases (78%). The two patients presenting with meningitis were treated with fluoroquinolone. The outcome was favorable for all patients and no relapse was observed. CONCLUSION: The features of murine typhus are non-specific. The definitive diagnosis is based on serologic testing by indirect fluorescent assay. Cyclins were the most prescribed antibiotics.
Authors: Benjamin E Stephens; Meilinh Thi; Rahaf Alkhateb; Apeksha Agarwal; Francis E Sharkey; Christopher Dayton; Gregory M Anstead Journal: Am J Trop Med Hyg Date: 2018-06-21 Impact factor: 2.345
Authors: Nam Le Van; Chung Pham Van; Manh Nguyen Dang; Thang Dao Van; Quyen Le T Do; Hung Vu Hoang; Tien Tran Viet; Binh Nhu Do Journal: Infect Drug Resist Date: 2020-07-06 Impact factor: 4.003