Diagnosis of murine typhus by serology in peninsular Malaysia: A case report where rickettsial illnesses, leptospirosis and dengue co-circulate

• Main Authors: Blacksell, S.D (Author), Chotivanich, K. (Author), Hanboonkunupakarn, B. (Author), Paris, D.H (Author), Pukrittayakamee, S. (Author), Sonthayanon, P. (Author), Sujariyakul, P. (Author), Tanganuchitcharnchai, A. (Author), Yuhana, Y. (Author)
• Format: Article
• Language: English
• Published: MDPI AG 2019
• Subjects: adult; Article; case report; clinical article; dengue; Diagnosis; doxycycline; fever; headache; human; leptospirosis; Malaysia; male; murine typhus; Murine typhus; nonhuman; nucleic acid analysis; rash; rickettsiosis; RNA 16S; serology; Serology; suburban area; thrombocytopenia; urban area
• Online Access: View Fulltext in Publisher; View in Scopus
• ISBN: 24146366 (ISSN)
• ISSN: 24146366 (ISSN)
• DOI: 10.3390/tropicalmed4010023

Murine typhus is a rarely diagnosed cause of acute febrile illness in Malaysia, and its true disease burden is unknown. We report a case of an acute murine typhus infection in a patient living in a small city in Peninsular Malaysia, presenting with fever, rash, and headache. Unresponsive to the initial empirical treatment for leptospirosis, he showed a rapid response to doxycycline when murine typhus was diagnosed later. This case highlights the importance of considering murine typhus as a diagnostic in cases of acute febrile illness in urban and sub-urban areas, such as that of in Peninsular Malaysia. © 2019 by the authors.