Masalha R, Merkin-Zaborsky H, Matar M, Zirkin H J, Wirguin I, Herishanu Y O
Department of Neurology, Soroka Medical Centre, Beer-Sheva, Israel.
J Neurol. 1998 Oct;245(10):665-8. doi: 10.1007/s004150050264.
Murine typhus is a febrile systemic illness, presenting with headache and undulating fever. Neurological involvement is considered a rare complication. During 1994 and 1995, 34 patients admitted to our hospital were diagnosed as having murine typhus. Five of these patients presented with a syndrome of subacute "aseptic" meningitis or meningoencephalitis. Three had bilateral papilloedema and 2 had focal neurological signs. None had a rash or other systemic findings suggestive of rickettsial disease. The diagnosis was based on serum and cerebrospinal fluid serology and on prompt response to doxycycline therapy. These cases suggest that neurological involvement in murine typhus is more common than previously suspected and that murine typhus should be included in the differential diagnosis of subacute meningitis in endemic areas.
鼠型斑疹伤寒是一种发热性全身性疾病，表现为头痛和弛张热。神经系统受累被认为是一种罕见的并发症。在1994年至1995年期间，我院收治的34例患者被诊断为鼠型斑疹伤寒。其中5例患者表现为亚急性“无菌性”脑膜炎或脑膜脑炎综合征。3例有双侧视乳头水肿，2例有局灶性神经体征。无一例有皮疹或其他提示立克次体病的全身表现。诊断基于血清和脑脊液血清学检查以及对强力霉素治疗的迅速反应。这些病例表明，鼠型斑疹伤寒的神经系统受累比以前怀疑的更为常见，在流行地区，鼠型斑疹伤寒应列入亚急性脑膜炎的鉴别诊断中。
