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Case Reports
. 2024 Apr 15:36:e01955.
doi: 10.1016/j.idcr.2024.e01955. eCollection 2024.

Severe flea-borne typhus complicated by hemophagocytic lymphohistiocytosis: A case report and review of literature

Rolando A Zamora Gonzalez  1 , Mark S Mayo  2 , Arthur C Jeng  3
Affiliations
Case Reports

Severe flea-borne typhus complicated by hemophagocytic lymphohistiocytosis: A case report and review of literature

Rolando A Zamora Gonzalez et al. IDCases. .

Abstract

Flea-borne typhus (FBT), also known as murine typhus, is a zoonotic infection caused by R. typhi with world-wide distribution. In the United States, the infection is uncommon but remains endemic in some areas, including Los Angeles County. It typically manifests as a benign acute febrile illness but can be complicated in a minority of cases. Associated hemophagocytic lymphohistiocytosis (HLH) has been described in a limited number of cases. Here, we present a case of a patient with FBT complicated by HLH treated empirically with doxycycline with subsequent resolution of HLH. Also included is a review of the literature of other published cases.

Keywords: Flea-borne typhus; Hemophagocytic lymphohistiocytosis.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Bone marrow biopsy showing hemophagocytosis.
See this image and copyright information in PMC

References

    1. Blanton L.S. The rickettsioses: a practical update. Infect Dis Clin North Am. 2019;33(1):213–229. doi: 10.1016/j.idc.2018.10.010. PMID: 30712763; PMCID: PMC6364315. - DOI - PMC - PubMed
    1. Blanton L.S., Dumler J.S., Walker D.H. Elsevier/Saunders; Philadelphia, PA: 2019. Rickettisa typhi (Murine typhus). Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases.
    1. Anstead G.M. History, rats, fleas, and opossums. ii. the decline and resurgence of flea-borne typhus in the United States, 1945-2019. Trop Med Infect Dis. 2020;6(1):2. doi: 10.3390/tropicalmed6010002. PMID: 33379251; PMCID: PMC7839051. - DOI - PMC - PubMed
    1. Cascio A., Giordano S., Dones P., Venezia S., Iaria C., Ziino O. Haemophagocytic syndrome and rickettsial diseases. J Med Microbiol. 2011;60(Pt 4):537–542. doi: 10.1099/jmm.0.025833-0. Epub 2010 Dec 16. PMID: 21163825. - DOI - PubMed
    1. Chandramohan D., Awobajo M., Fisher O., Dayton C.L., Anstead G.M. Flea-borne typhus causing hemophagocytic lymphohistiocytosis: an autopsy case. Infect Dis Rep. 2023;15(1):132–141. doi: 10.3390/idr15010014. PMID: 36826354; PMCID: PMC9956947. - DOI - PMC - PubMed

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