A cluster of pediatric endemic typhus cases in Orange County, California.

Murine typhus is typically a mild febrile illness caused by Rickettsia typhi, generally confined to Texas and Southern California. Clinicians should consider early treatment with doxycycline when presented with a child having protracted fever, rash, and headache.We present 5 pediatric cases and a literature review highlighting the changing epidemiology and diagnostic difficulty of typhus.