History, Physical Examination, and Clinical Course of 5 Children With Murine Typhus

Case 1Case 2Case 3Case 4Case 5
Age in y171612108
Days of fever5106109
Abdominal painNoYesNoNoNo
Other symptomsMalaiseDiarrheaFatigueFatigueDecreased appetite
Eye rednessVomiting
Decreased appetiteCough
VomitingNeck stiffness
Eye redness
ExposureMultiple animals, including puppy with fleasDogs2 cats and 1 dog previously treated for fleas2 dogs1 dog
Rats1 catNo known fleas
Home treated for fleasNo known fleas
Physical examination at presentationFeverFeverDry lipsAbdomen tender to palpation in the right upper quadrant and epigastric areaFever
TachycardiaTachycardiaEczematous patches and excoriationsFew scattered maculesTachycardia
Maculo-papular rash on trunk, back, and extremitiesTachypneaInjected conjunctivae
Conjunctival injection
Abdominal tenderness
Days to fever resolution after doxycycline initiation32122
Recurrence of symptoms after dischargeNoneNoneNoneNoneNone
  • —, not applicable.