Journal Article Epublish
PubMed: 42725118 DOI: 10.1155/crcc/1267884
A 16-Year-Old Boy With ARDS and Septic Shock, an Atypical Presentation of Murine Typhus: Case Report and Review of the Literature.
Case Rep Crit Care 2026:1267884
Authors: Pierre H François, Thalia Leclerc, Manon Jaboyedoff, Onya Opota, Gilbert Greub, Guillaume Maitre, Vivianne Chanez
Affiliations
- Pediatric Intensive Care Unit, Department Women-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland, chuv.ch.
- Unit of Pediatric Infectious Diseases and Vaccinology, Service of Pediatrics, Department Women-Mother-Child, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland, chuv.ch.
- Institute of Microbiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland, chuv.ch.
- Infectious Diseases Service, Department of Internal Medicine, Lausanne University of Lausanne, Lausanne, Switzerland.
Abstract
Murine typhus is a flea-borne disease caused by the bacteria Rickettsia typhi that occurs worldwide, but predominantly in endemic areas. The clinical presentation of typhus is often nonspecific, leading to delays in diagnosis and treatment. The severity of the disease varies widely. Most cases are relatively mild, but some patients develop a very severe form and may die. We report a case of severe murine typhus complicated by septic shock, alveolar hemorrhage, and acute respiratory distress syndrome in a teenager who was born in Somalia and had immigrated from Kenya to Switzerland. Diagnosis was suspected upon admission in the pediatric intensive care unit and was confirmed by PCR. The patient improved with doxycycline treatment. Rickettsial disease should be considered in the differential diagnosis of patients returning from endemic areas, and anti-rickettsial treatment should be started without delay to ensure rapid recovery and avoid severe complications.
MeSH
Shock, Septic, Diagnosis, Therapeutics, Typhus, Endemic Flea-Borne, Child