Murine typhus mimicking acute cholecystitis in a traveller

Suttor, Vidyut P; Feller, Robert B

doi:10.5694/j.1326-5377.2006.tb00327.x

Topics

To the Editor: Rickettsia typhi is an endemic cause of atypical pyrexial illness worldwide.1 Its non-specific presentation can lead to misdiagnoses, with overseas reports of unwarranted laparotomies in affected patients.2,3 We describe a patient with R. typhi infection presenting as cholecystitis, in whom a cholecystectomy was avoided by vigilance for R. typhi.

St Vincent's Hospital, Sydney, NSW.

Correspondence: vidyutpinge@hotmail.com

1. Jensenius M, Fournier PE, Raoult D. Rickettsioses and the international traveller. Clin Infect Dis 2004; 39: 1493-1499.
2. Silpapojakul K, Mitarnun W, Ovartlarnporn B, et al. Liver involvement in murine typhus. QJM 1996; 89: 623-629.

3. Devriendt J, Staroukine M. Abdominal involvement in rickettsial diseases. Arch Intern Med 1986; 146: 1447.

4. Freedman DO, Weld LH, Kozarsky PE, et al. Spectrum of disease and relation to place of exposure among ill returned travelers. N Engl J Med 2006; 354: 119-130.

5. O’Connor LF, Kelly HA, Lubich JM, et al. A cluster of murine typhus cases in Western Australia. Med J Aust 1996; 165: 24-26.

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