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Volume 23, Number 8—August 2017
Synopsis

Acute Febrile Illness and Complications Due to Murine Typhus, Texas, USA1,2

Zeeshan AfzalComments to Author , Sunand Kallumadanda, Feng Wang, Vagish Hemmige, and Daniel Musher
Author affiliations: University of Texas Rio Grande Valley, McAllen, Texas, USA (Z. Afzal, S. Kallumadanda, F. Wang); Baylor College of Medicine, Houston, Texas, USA (V. Hemmige, D. Musher); M.E. DeBakey VA Medical Center, Houston (D. Musher)

Main Article

Table 1

Characteristics of 90 patients with murine typhus, Hidalgo County, Texas, USA, July 1, 2013–June 30, 2016*

Characteristic
 No. (%) patients
Age ≥18 y
 Age <18 y
 Total
 p value
Symptoms
Subjective fever/chills 53/54 (98) 36/36 (100) 89/90 (99) 1
Malaise 21/24 (88) 15/20 (75) 36/44 (82) 0.44
Headache 37/46 (80) 23/32 (72) 60/78 (77) 0.38
Fatigue 22/29 (76) 10/17 (59) 32/46 (70) 0.22
Myalgias 29/39 (74) 13/23 (57) 42/62 (68) 0.15
Nausea and/or vomiting 31/52 (60) 21/35 (60) 52/87 (60) 0.97
Cough 21/52 (40) 18/36 (50) 39/88 (44) 0.37
Abdominal pain 17/47(36) 10/33 (30) 27/80 (34) 0.58
Arthralgia 9/34 (26) 4/24 (17) 13/58 (22) 0.53
Diarrhea 9/50 (18) 1/35 (3) 10/85 (12) 0.04
Confusion
 6/42 (14)
 2/30 (7)
 8/72 (11)
 0.45
Signs
Temperature ≥100.4°F 48/54 (89) 34/36 (94) 82/90 (91) 0.47
Rash 16/51 (31) 18/36 (50) 34/87 (39) 0.12
Enlarged liver 1/44 (2) 1/32 (3) 2/76 (3) 1
Enlarged spleen
 0/44 (0)
 1/32 (3)
 1/76 (1)
 0.42
Laboratory findings
Leukocytes <6,000 cells/mm3 10/54 (19) 11/36 (31) 21/90 (23) 0.19
Leukocytes <3,000 cells/mm3 0 0 0 1
Platelets <120,000/mm3 37/54 (69) 12/36 (33) 49/90 (54) <0.01
Bilirubin ≥1.5 mg/dL 14/54 (26) 3/36 (8) 17/90 (19) 0.05
AST >50 IU/L 51/54 (94) 25/36 (69) 76/90 (84) <0.01
ALT >50 IU/L 45/54 (83) 22/36 (61) 67/90 (74) 0.02
Serum sodium ≤133 mmol/L 34/54 (63) 6/36 (17) 40/90 (44) <0.01
Serum albumin <3.5 g/dL 46/54 (85) 27/36 (75) 73/90 (81) 0.23
Serum procalcitonin >0.5 ng/mL 9/13 (69) 1/1 (100) 10/14 (71) 1
IgM ≥1:128 50/54 (93) 36/36 (100) 86/90 (96) 0.15
IgG ≥1:128 41/54 (76) 22/36 (61) 63/90 (70) 0.13
Complications 18/54 (33) 7/36 (19) 25/90 (28) 0.15

*ALT, alanine aminotransferase; AST, aspartate aminotransferase.

Main Article

1A poster form of this study was presented at the Annual Session and Primary Care Summit of Texas Academy of Family Physicians, November 4–6, 2016, Dallas, TX, USA.

2An abstract has been accepted for ID Week 2017, October 4–8, 2017, San Diego, CA, USA, for an oral presentation.

Page created: August 07, 2017
Page updated: August 07, 2017
Page reviewed: August 07, 2017
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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