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Murine typhus in a liver transplant recipient: report of a first case
Authors:P Phatharodom  S Limsrichamrern  J Kaewwinud  M Chayakulkeeree
Institution:1. Division of Infectious Diseases and Tropical Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand;2. Division of General Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand;3. Division of Respiratory Disease and Tuberculosis, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Abstract:Zoonoses, especially rickettsial diseases, are rarely reported in solid organ transplant recipients. We report here a case of murine typhus in a 69‐year‐old liver transplant recipient, who presented with acute febrile illness 5 years post transplantation. Although receiving treatment with broad‐spectrum antibiotics, he was still febrile and developed progressive dyspnea. Laboratory results showed elevated transaminases and his chest radiograph revealed bilateral interstitial infiltration. The diagnosis of murine typhus was made by a 4‐fold rise in specific Rickettsia typhi antibody, using indirect immunofluorescent assay. He dramatically improved after treatment with doxycycline for 7 days. To our knowledge, this is the first case report of murine typhus in a liver transplant recipient.
Keywords:murine typhus  liver transplant  rickettsia  rickettsial infection  riskettsiosis  systemic infection  solid organ transplant
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