Murine typhus in returned travelers: a report of thirty-two cases.
Murine typhus, caused by Rickettsia typhi and transmitted mainly by the rat fleas, Xenopsylla cheopis, has emerged in the field of travel medicine. We analyzed retrospectively the epidemiological, clinical, and biological characteristics of the 32 murine typhus cases that were diagnosed during the past 3 years at the World Health Organization Collaborative Center for Rickettsial diseases, Marseille, France. All of the cases occurred in travelers and most of them had returned from Africa (N = 13 of 32) and South-east Asia (N = 12 of 32). Exposure to rats was reported only in a few (N = 2 of 32) patients. Almost half of the cases were diagnosed in August and September. Only four patients presented the classic triad: fever, rash, and headache. Moreover, we report the first known cases of a hemophagocytic syndrome associated with this disease. Murine typhus must be considered as an etiologic agent of febrile illness in returning travelers, particularly in those with unspecific symptoms.
Unité de Recherche en Maladies Infectieuses et Tropicales Emergentes (URMITE), UMR CNRS-IRD, WHO Collaborative Center for Rickettsial Diseases and Other Arthropod-borne Bacterial Diseases, Marseille, France. gaellewalter@hotmail.fr
Gaëlle
G
Walter
Elisabeth
E
Botelho-Nevers
Cristina
C
Socolovschi
Didier
D
Raoult
Philippe
P
Parola
D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D004269:DNA, Bacterial; D004318:Doxycycline / Q000627:therapeutic use; D005260:Female; D005334:Fever / Q000382:microbiology; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012286:Rickettsia typhi / Q000302:isolation & purification / Q000472:pathogenicity; D012621:Seasons; D005423:Siphonaptera / Q000382:microbiology; D014195:Travel; D014416:Tunisia / Q000453:epidemiology; D014437:Typhus, Endemic Flea-Borne / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology* / Q000635:transmission; D055815:Young Adult
D000900:Anti-Bacterial Agents; D004269:DNA, Bacterial; D004318:Doxycycline