title: Rickettsia typhi infection in childhood.
abstract: Rickettsia typhi infection (murine typhus) is generally underdiagnosed in childhood, as clinical presentations are often non-specific. We present the manifestations in nine children hospitalized in the Department of Paediatrics of the University Hospital, Heraklion, Crete, over a 3-y period from 1998 to 2000. Titres > 1:400 for IgM and >1:960 for IgG and/or a fourfold increase in a second sample were considered strongly suggestive of acute infection. Children presented with prolonged fever, hepatosplenomegaly and lymphadenopathy. Five children presented with a rash. Unusual manifestations included aseptic meningitis and Kawasaki-like presentation. Laboratory findings included anaemia, leucopenia, and thrombocytopenia. Three children were treated with appropriate antibiotic regimens and all nine had a complete recovery.
  
  
  CONCLUSIONS
  Rickettsia typhi infection should be considered in the differential diagnosis of children residing in or returning from Southern Europe countries who present with prolonged fever, rash and lymphadenopathy.
authors.affiliation: Department of Paediatrics, University of Crete, Heraklion, Greece.
authors.forename: M
authors.initials: M
authors.lastname: Bitsori
authors.forename: E
authors.initials: E
authors.lastname: Galanakis
authors.forename: A
authors.initials: A
authors.lastname: Gikas
authors.forename: E
authors.initials: E
authors.lastname: Scoulica
authors.forename: S
authors.initials: S
authors.lastname: Sbyrakis
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D005260:Female; D006115:Greece / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D012286:Rickettsia typhi / Q000187:drug effects / Q000302:isolation & purification*; D012307:Risk Factors; D012720:Severity of Illness Index; D017678:Sex Distribution; D014437:Typhus, Endemic Flea-Borne / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology*
chemical_list: D000900:Anti-Bacterial Agents