title: [Murine typhus in Tenerife. Clinicoepidemiological study and differential clinical features with Q fever].
abstract: OBJECTIVE
  Our aim was to conduct a study to define the clinical and epidemiological characteristics of patients with murine typhus in Tenerife island (Canary islands, Spain). Moreover, we investigated the differential clinical features of this disease with regard to Q fever.
  
  
  METHODS
  5-year prospective study of patients with murine typhus (1998-2002) admited in a reference hospital in Tenerife, Spain.
  
  
  RESULTS
  Thirty two patients were included. Flea bite and rat exposure were iuncommon (6.25%). The monthly distribution showed a peak of incidence in January, August and September, without a clear seasonal prevalence. Fever and headache were the most common clinical features. Rash was present in 28% of the cases. Both an increase in liver enzyme levels (88%) and thrombocytopenia (37.5%) were the most relevant laboratory findings. Organ complications were uncommon (18.75%). Antibiotics were administered to 90% of patients and cure was achieved in all them. Compared with Q fever, patients with murine typhus more commonly had rash (p = 0.006) and thrombocytopenia (p < 0.001).
  
  
  CONCLUSIONS
  Murine typhus is an emerging rickettsiosis in Tenerife and must be considered in the differential diagnosis with Q fever.
authors.affiliation: Sección de Medicina Interna. Unidad de Enfermedades Infecciosas. Hospital Nuestra Señora de la Candelaria. Santa Cruz de Tenerife. España. MMIGUELEZ@telefonica.net
authors.forename: Máximo
authors.initials: M
authors.lastname: Miguélez
authors.forename: Pedro
authors.initials: P
authors.lastname: Laynez
authors.forename: Manuel
authors.initials: M
authors.lastname: Linares
authors.forename: Marcelino
authors.initials: M
authors.lastname: Hayek
authors.forename: Lucy
authors.initials: L
authors.lastname: Abella
authors.forename: Ignacio
authors.initials: I
authors.lastname: Marañez
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011778:Q Fever / Q000175:diagnosis*; D013030:Spain; D014437:Typhus, Endemic Flea-Borne / Q000175:diagnosis* / Q000453:epidemiology*