Flea-Borne Typhus Presenting with Acalculous Cholecystitis and Severe Anemia
Background. Flea-borne typhus (FBT), an uncommon illness in the United States, typically presents as a high continuous fever with commonly associated symptoms including headache, myalgias, and rashes on the trunk and extremities. Patients infected with FBT may also present with atypical symptoms. As...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2023-01-01
|
| Series: | Case Reports in Infectious Diseases |
| Online Access: | http://dx.doi.org/10.1155/2023/5510295 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849396404894564352 |
|---|---|
| author | Ramya Varadarajan Ashmi P. Patel Keyvon Rashidi Albert Oh Rashmeen Rahman Ryan Neal |
| author_facet | Ramya Varadarajan Ashmi P. Patel Keyvon Rashidi Albert Oh Rashmeen Rahman Ryan Neal |
| author_sort | Ramya Varadarajan |
| collection | DOAJ |
| description | Background. Flea-borne typhus (FBT), an uncommon illness in the United States, typically presents as a high continuous fever with commonly associated symptoms including headache, myalgias, and rashes on the trunk and extremities. Patients infected with FBT may also present with atypical symptoms. As such, the combination of its relatively low incidence in the United States coupled with its variability in associated symptoms poses a diagnostic challenge for clinicians; early empiric treatment with doxycycline is warranted prior to a definitive diagnosis to reduce the risk of damage to vital organs. Case Report. This case describes a 54-year-old male who presented to an emergency room in Houston, Texas, with one week of constant right upper quadrant abdominal pain and fevers up to 40°C. The patient was initially diagnosed with Grade III severe acute cholangitis after abdominal ultrasound revealed gallbladder sludge and wall thickening without ductal dilatation, but a subsequent endoscopic retrograde cholangiopancreatography was unremarkable. Following intermittent fevers and worsening anemia, the patient was started on oral doxycycline for atypical infection, and an infectious disease workup subsequently returned a positive titer for Rickettsia typhi. He experienced rapid symptomatic and clinical improvement, and the patient was discharged home with a final diagnosis of flea-borne typhus. Conclusion. Albeit uncommon, the presentation of this patient’s symptoms and final diagnosis of flea-borne typhus demonstrates the importance of (1) keeping atypical infections such as FBT in the differential diagnosis and (2) beginning empiric treatment to prevent damage to vital organs if suspicion of FBT is high. |
| format | Article |
| id | doaj-art-b295230ae55b4e7e8a40d4e84ac5cdd2 |
| institution | Kabale University |
| issn | 2090-6633 |
| language | English |
| publishDate | 2023-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Infectious Diseases |
| spelling | doaj-art-b295230ae55b4e7e8a40d4e84ac5cdd22025-08-20T03:39:21ZengWileyCase Reports in Infectious Diseases2090-66332023-01-01202310.1155/2023/5510295Flea-Borne Typhus Presenting with Acalculous Cholecystitis and Severe AnemiaRamya Varadarajan0Ashmi P. Patel1Keyvon Rashidi2Albert Oh3Rashmeen Rahman4Ryan Neal5Texas A&M College of MedicineDepartment of MedicineTexas A&M College of MedicineTexas A&M College of MedicineDepartment of EndocrinologyDepartment of MedicineBackground. Flea-borne typhus (FBT), an uncommon illness in the United States, typically presents as a high continuous fever with commonly associated symptoms including headache, myalgias, and rashes on the trunk and extremities. Patients infected with FBT may also present with atypical symptoms. As such, the combination of its relatively low incidence in the United States coupled with its variability in associated symptoms poses a diagnostic challenge for clinicians; early empiric treatment with doxycycline is warranted prior to a definitive diagnosis to reduce the risk of damage to vital organs. Case Report. This case describes a 54-year-old male who presented to an emergency room in Houston, Texas, with one week of constant right upper quadrant abdominal pain and fevers up to 40°C. The patient was initially diagnosed with Grade III severe acute cholangitis after abdominal ultrasound revealed gallbladder sludge and wall thickening without ductal dilatation, but a subsequent endoscopic retrograde cholangiopancreatography was unremarkable. Following intermittent fevers and worsening anemia, the patient was started on oral doxycycline for atypical infection, and an infectious disease workup subsequently returned a positive titer for Rickettsia typhi. He experienced rapid symptomatic and clinical improvement, and the patient was discharged home with a final diagnosis of flea-borne typhus. Conclusion. Albeit uncommon, the presentation of this patient’s symptoms and final diagnosis of flea-borne typhus demonstrates the importance of (1) keeping atypical infections such as FBT in the differential diagnosis and (2) beginning empiric treatment to prevent damage to vital organs if suspicion of FBT is high.http://dx.doi.org/10.1155/2023/5510295 |
| spellingShingle | Ramya Varadarajan Ashmi P. Patel Keyvon Rashidi Albert Oh Rashmeen Rahman Ryan Neal Flea-Borne Typhus Presenting with Acalculous Cholecystitis and Severe Anemia Case Reports in Infectious Diseases |
| title | Flea-Borne Typhus Presenting with Acalculous Cholecystitis and Severe Anemia |
| title_full | Flea-Borne Typhus Presenting with Acalculous Cholecystitis and Severe Anemia |
| title_fullStr | Flea-Borne Typhus Presenting with Acalculous Cholecystitis and Severe Anemia |
| title_full_unstemmed | Flea-Borne Typhus Presenting with Acalculous Cholecystitis and Severe Anemia |
| title_short | Flea-Borne Typhus Presenting with Acalculous Cholecystitis and Severe Anemia |
| title_sort | flea borne typhus presenting with acalculous cholecystitis and severe anemia |
| url | http://dx.doi.org/10.1155/2023/5510295 |
| work_keys_str_mv | AT ramyavaradarajan fleabornetyphuspresentingwithacalculouscholecystitisandsevereanemia AT ashmippatel fleabornetyphuspresentingwithacalculouscholecystitisandsevereanemia AT keyvonrashidi fleabornetyphuspresentingwithacalculouscholecystitisandsevereanemia AT albertoh fleabornetyphuspresentingwithacalculouscholecystitisandsevereanemia AT rashmeenrahman fleabornetyphuspresentingwithacalculouscholecystitisandsevereanemia AT ryanneal fleabornetyphuspresentingwithacalculouscholecystitisandsevereanemia |