Murine (Endemic) Typhus

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Chest Xray 40 yr old male acute respiratory distress syndrome as a complication of murine typhus. 13-1421-F1.jpg
Chest radiograph of 40-year-old man with acute respiratory distress syndrome as a complication of murine typhus. By Thomas W. van der Vaart, Pieter P.A.M. van Thiel, Nicole P. Juffermans, Michèle van Vugt, Suzanne E. Geerlings, Martin P. Grobusch, and Abraham Goorhuis –, Public Domain,

OpenStax Microbiology

Murine typhus (also known as endemic typhus) is caused by Rickettsia typhi and is transmitted by the bite of the rat flea, Xenopsylla cheopis, with infected rats as the main reservoir. Clinical signs and symptoms of murine typhus include a rash and chills accompanied by headache and fever that last about 12 days. Some patients also exhibit a cough and pneumonia-like symptoms. Severe illness can develop in immunocompromised patients, with seizures, coma, and renal and respiratory failure.

Clinical diagnosis of murine typhus can be confirmed from a biopsy specimen from the rash. Diagnostic tests include indirect immunofluorescent antibody (IFA) staining, PCR for R. typhi, and acute and convalescent serologic testing. Primary treatment is doxycycline, with chloramphenicol as the second choice.


Parker, N., Schneegurt, M., Thi Tu, A.-H., Forster, B. M., & Lister, P. (n.d.). Microbiology. Houston, Texas: OpenStax. Access for free at: