Murine typhus mistaken for COVID-19 in a young man.

Abstract

Fever is a widely recognised presenting symptom of COVID-19. Consequently, other febrile illnesses may be difficult to distinguish from COVID-19-leading to delays in diagnosis and treatment. One such illness is murine typhus, a fleaborne illness with worldwide distribution caused by Rickettsia typhi It often presents with fever, headache and myalgia, all of which have been commonly reported with COVID-19. Although the disease is usually mild with a good prognosis, there have been reports of severe illness and death. I present a case of murine typhus in a young male who had 2 weeks of headaches and daily fevers during the COVID-19 pandemic. He was ultimately tested for murine typhus when his occupation as a dog trainer was queried, and he experienced resolution of symptoms after treatment with doxycycline. During this pandemic, clinicians must be vigilant of other febrile illnesses whose symptoms overlap with COVID-19.

• Authors: Hemesh Mahesh Patel
• Journal: BMJ case reports (BMJ Case Rep) Vol. 13 Issue 11 (Nov 03 2020) ISSN: 1757-790X [Electronic] England
• PMID: 33148588 (Publication Type: Case Reports, Journal Article)
• Copyright: © BMJ Publishing Group Limited 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Chemical References

• Anti-Bacterial Agents
• Doxycycline

Topics

• Adult
• Ambulatory Care (methods)
• Animals
• Anti-Bacterial Agents (administration & dosage)
• Betacoronavirus
• COVID-19
• Coronavirus Infections (diagnosis)
• Diagnosis, Differential
• Disease Reservoirs (microbiology)
• Disease Transmission, Infectious
• Dogs
• Doxycycline (administration & dosage)
• Fever (diagnosis, etiology)
• Humans
• Male
• Occupational Exposure (analysis)
• Pandemics
• Pneumonia, Viral (diagnosis)
• Rickettsia typhi (isolation & purification)
• SARS-CoV-2
• Treatment Outcome
• Typhus, Endemic Flea-Borne (diagnosis, drug therapy, microbiology, physiopathology)