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CC BY-NC-ND 4.0 · AJP Rep 2024; 14(02): e185-e187
DOI: 10.1055/a-2330-4249
Case Report

Ischemic Hepatitis and Septic Shock Secondary to Murine Typhus Infection in Pregnancy

Marissa Berry 
1   Division of Maternal Fetal Medicine, The Ohio State University, Columbus, Ohio
,
Amanda M. Wang
2   Division of Maternal-Fetal Medicine, The University of Texas Medical Branch, Galveston, Texas
,
Rana F. Lahham
2   Division of Maternal-Fetal Medicine, The University of Texas Medical Branch, Galveston, Texas
,
Xue Zhang
2   Division of Maternal-Fetal Medicine, The University of Texas Medical Branch, Galveston, Texas
,
Luis D. Pacheco
2   Division of Maternal-Fetal Medicine, The University of Texas Medical Branch, Galveston, Texas
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Abstract

Infection with murine typhus may be associated with significant morbidity. With nonspecific symptoms and laboratory abnormalities, diagnosis may be challenging. In this case, a pregnant patient presented with complaints of fevers and myalgias. Her laboratory results included severe transaminitis as well as thrombocytopenia and hyponatremia. She ultimately required vasopressor support and intensive care unit admission despite fluid resuscitation and broad-spectrum antibiotics. Empiric doxycycline was initiated due to suspicion for murine typhus, which laboratory testing later confirmed. Her clinical status improved with these interventions. This was a severe case of murine typhus resulting in septic shock and ischemic hepatitis. It is important to know the typical findings of murine typhus and consider it in a differential diagnosis, especially when practicing in endemic areas.

Keywords

murine typhus - ischemic hepatitis - septic shock

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Each author has confirmed compliance with the journal's requirements for authorship.




Publication History

Received: 21 February 2024

Accepted: 27 March 2024

Accepted Manuscript online:
21 May 2024

Article published online:
10 June 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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