title: Noneruptive fever revealing murine typhus in a traveler returning from Tunisia.
abstract: Rickettsia species are increasingly being recognized as a cause of infection among returning travelers. Murine typhus (MT) was mistakenly thought to have disappeared in the 1970s in Tunisia, yet recent serological data show that Rickettsia typhi, the causative agent of MT, still circulates in the Tunisian population. We report here a case of MT in a woman returning from Tunisia and hospitalized in France. Her presentation was nonspecific, with acute noneruptive fever. Diagnosis was confirmed by cross-adsorption and immunoblotting. Clinicians taking care of returning travelers with fever should be aware of MT, and know how to diagnose and treat it.
authors.affiliation: Université Paris Descartes, Hôpital Universitaire Necker-Enfants Malades, Service des Maladies Infectieuses et Tropicales, Centre d'Infectiologie Necker-Pasteur, Institut Imagine, Assistance Publique-Hôpitaux de Paris, Paris, France.
authors.forename: Laura
authors.initials: L
authors.lastname: Gastellier
authors.forename: Fanny
authors.initials: F
authors.lastname: Lanternier
authors.forename: Aurélie
authors.initials: A
authors.lastname: Renvoisé
authors.forename: Sébastien
authors.initials: S
authors.lastname: Rivière
authors.forename: Didier
authors.initials: D
authors.lastname: Raoult
authors.forename: Olivier
authors.initials: O
authors.lastname: Lortholary
authors.forename: Marc
authors.initials: M
authors.lastname: Lecuit
mesh_terms: D000328:Adult; D000818:Animals; D004318:Doxycycline / Q000627:therapeutic use*; D005260:Female; D005334:Fever / Q000382:microbiology*; D006801:Humans; D012286:Rickettsia typhi; D014195:Travel; D014416:Tunisia; D014437:Typhus, Endemic Flea-Borne / Q000175:diagnosis* / Q000188:drug therapy; D058260:Xenopsylla
chemical_list: D004318:Doxycycline