Wachs Stephanie, Kuiper Brandon
Internal Medicine, Brooke Army Medical Center, Fort Sam Houston, USA.
Gastroenterology, Brooke Army Medical Center, Fort Sam Houston, USA.
Cureus. 2021 Jul 27;13(7):e16661. doi: 10.7759/cureus.16661. eCollection 2021 Jul.
Murine typhus is a vector-borne disease transmitted to humans via fleas and typically causes an infection hallmarked by nonspecific, mild symptoms of fever, rash, and headache. More severe diseases, while rare, can occur. We present a complicated case of murine typhus resulting in liver and renal failure. Our patient was a healthy 64-year-old Hispanic gentleman who presented to his local emergency department (ED) in Southwest Texas for fevers, chills, and myalgia progressing to dyspnea, fatigue, and jaundice. He was transferred to a Central Texas transplant hospital given concern for impending liver failure as well as acute kidney injury later requiring hemodialysis. Broad-spectrum antibiotics were narrowed to empiric doxycycline with eventual improvement in his lab values and symptoms. The return of antibody lab values later revealed murine typhus to be the cause of his disease.
鼠型斑疹伤寒是一种通过跳蚤传播给人类的媒介传播疾病，通常会引发以发热、皮疹和头痛等非特异性轻微症状为特征的感染。更严重的疾病虽然罕见，但也可能发生。我们报告了一例导致肝肾功能衰竭的复杂鼠型斑疹伤寒病例。我们的患者是一位64岁健康的西班牙裔男性，因发热、寒战和肌痛，随后发展为呼吸困难、疲劳和黄疸，前往德克萨斯州西南部当地的急诊科就诊。由于担心即将出现肝功能衰竭以及后来需要进行血液透析的急性肾损伤，他被转至德克萨斯州中部的一家移植医院。广谱抗生素被调整为经验性使用强力霉素，最终他的实验室检查值和症状有所改善。后来抗体实验室检查值的恢复显示鼠型斑疹伤寒是其疾病的病因。
