title: Murine typhus in elderly patients: a prospective study of 49 patients.
abstract: BACKGROUND
  The characteristics of Rickettsia typhi infection in elderly patients have not been extensively described in the literature.
  
  
  METHODS
  We conducted a prospective study on murine typhus in patients > 65 years old in two endemic areas of Greece.
  
  
  RESULTS
  Forty-nine elderly patients were analyzed, including 30 (61.2%) males. The clinical triad of fever (100% of patients), headache (83.7%), and rash (73.5%), occurred in 63% of patients, whereas malaise (85.7%), anorexia (65.3%), and myalgia (59.2%) were also common. Frequent laboratory findings were transaminasemia (89.8%), lactate dehydrogenase elevation (65.3%), hematuria (55.1%), thrombocytopenia (53.1%), anemia (51%), leucopenia (40.8%), and mild hyponatremia (23.5%). Complications developed in 16 patients (32.7%); no deaths were recorded.
  
  
  CONCLUSIONS
  The main clinical and laboratory characteristics of murine typhus are similar in elderly and younger adults. However, elderly patients have a more severe clinical picture, evidenced by a higher complication rate and longer duration of fever, even with appropriate treatment. To our knowledge, this is the first study to focus on murine typhus in a geriatric population.
authors.affiliation: From the Department of Internal Medicine, Infectious Diseases Unit, University Hospital of Heraklion , Crete , Greece.
authors.forename: Constantinos
authors.initials: C
authors.lastname: Tsioutis
authors.forename: George
authors.initials: G
authors.lastname: Chaliotis
authors.forename: Sofia
authors.initials: S
authors.lastname: Kokkini
authors.forename: Stephanos
authors.initials: S
authors.lastname: Doukakis
authors.forename: Yannis
authors.initials: Y
authors.lastname: Tselentis
authors.forename: Anna
authors.initials: A
authors.lastname: Psaroulaki
authors.forename: Achilleas
authors.initials: A
authors.lastname: Gikas
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D019353:Endemic Diseases; D005260:Female; D006115:Greece / Q000453:epidemiology; D006801:Humans; D008297:Male; D011446:Prospective Studies; D014437:Typhus, Endemic Flea-Borne / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology
chemical_list: D000900:Anti-Bacterial Agents
keywords: Rickettsia typhi; endemic typhus; epidemiology; geriatric patients; older population