Histopathology and immunohistologic demonstration of the distribution of Rickettsia typhi in fatal murine typhus

David Walker, F. M. Parks, T. G. Betz, J. P. Taylor, J. W. Muehlberger

Research output: Contribution to journalArticle

83 Citations (Scopus)

Abstract

An 81-year-old woman had chills, fever, nausea, vomiting, and epigastric pain. On day 3 she had hematuria and was treated with trimethoprim-sulfamethoxazole. On day 5 she had a cough, hypotension, anemia, azotemia, and elevated hepatic enzyme levels. Her condition deteriorated with thrombocytopenia, anuria requiring dialysis, edema, and hypoalbuminemia. Treatment with chloramphenicol and doxycycline was started on day 10. By day 11, she was in hypotensive shock; on day 12 she had seizures and died. Murine typhus was diagnosed by demonstration of antibodies to Rickettsia typhi by indirect immunofluorescence. Necropsy revealed interstitial pneumonia, pulmonary edema, hyaline membranes, alveolar hemorrhages, petechiae and vasculitis in the central nervous system, interstitial myocarditis, multifocal interstitial nephritis and hemorrhages, splenomegaly, portal triaditis, and mucosal hemorrhages in urinary tract. Immunofluorescent R. typhi were demonstrated in the lungs, brain, kidneys, liver, and heart. This unusual death occurred in an elderly patient without rash who was treated too late with anti-rickettsial drugs.

Original languageEnglish (US)
Pages (from-to)720-724
Number of pages5
JournalAmerican Journal of Clinical Pathology
Volume91
Issue number6
StatePublished - 1989

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Rickettsia typhi
Endemic Flea-Borne Typhus
Hemorrhage
Central Nervous System Vasculitis
Azotemia
Anuria
Interstitial Nephritis
Hypoalbuminemia
Chills
Hyalin
Purpura
Doxycycline
Liver
Splenomegaly
Interstitial Lung Diseases
Sulfamethoxazole Drug Combination Trimethoprim
Myocarditis
Hematuria
Pulmonary Edema
Chloramphenicol

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

Cite this

Histopathology and immunohistologic demonstration of the distribution of Rickettsia typhi in fatal murine typhus. / Walker, David; Parks, F. M.; Betz, T. G.; Taylor, J. P.; Muehlberger, J. W.

In: American Journal of Clinical Pathology, Vol. 91, No. 6, 1989, p. 720-724.

Research output: Contribution to journalArticle

Walker, David ; Parks, F. M. ; Betz, T. G. ; Taylor, J. P. ; Muehlberger, J. W. / Histopathology and immunohistologic demonstration of the distribution of Rickettsia typhi in fatal murine typhus. In: American Journal of Clinical Pathology. 1989 ; Vol. 91, No. 6. pp. 720-724.
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