Severe flea-borne typhus complicated by hemophagocytic lymphohistiocytosis: A case report and review of literature

Rolando A Zamora Gonzalez; Mark S Mayo; Arthur C Jeng

doi:10.1016/j.idcr.2024.e01955

Severe flea-borne typhus complicated by hemophagocytic lymphohistiocytosis: A case report and review of literature

IDCases. 2024 Apr 15:36:e01955. doi: 10.1016/j.idcr.2024.e01955. eCollection 2024.

Authors

Rolando A Zamora Gonzalez¹, Mark S Mayo², Arthur C Jeng³

Affiliations

¹ Infectious Diseases, University of California Los Angeles, Los Angeles, USA.
² Department of Medicine, University of Washington, Seattle, USA.
³ Infectious Diseases, Olive View-UCLA Medical Center, Los Angeles, USA.

Abstract

Flea-borne typhus (FBT), also known as murine typhus, is a zoonotic infection caused by R. typhi with world-wide distribution. In the United States, the infection is uncommon but remains endemic in some areas, including Los Angeles County. It typically manifests as a benign acute febrile illness but can be complicated in a minority of cases. Associated hemophagocytic lymphohistiocytosis (HLH) has been described in a limited number of cases. Here, we present a case of a patient with FBT complicated by HLH treated empirically with doxycycline with subsequent resolution of HLH. Also included is a review of the literature of other published cases.

Keywords: Flea-borne typhus; Hemophagocytic lymphohistiocytosis.

Publication types

Case Reports