Abstract
Murine typhus is a flea-borne disease of worldwide distribution with a recent reemergence in the United States of America. There are limited data about the presentation, treatment, and outcomes in the pregnant population. We report on two cases of murine typhus during pregnancy and review the literature to compile previously reported cases. A comprehensive search was performed via the PubMed database for published articles between 1990 and 2020. Seven articles met the criteria of symptomatic pregnant murine typhus infection. A total of 37 patients were identified. Patients frequently presented with a prolonged duration of fevers prior to presentation, headache, and elevated hepatic transaminases. The diagnosis was predominantly based on serology. Treatment varied. Overall, the pregnancy outcome was favorable. Murine typhus can mimic other pregnancy-related pathologies. More exclusive and large-scale studies are needed to learn more of murine typhus during pregnancy.
Highlights
Pathogens 2021, 10, 219. https://Murine typhus (MT) is a flea-borne disease caused by Rickettsia typhi [1]
In the past few years, there has been a reemergence of R. typhi infections in the United States (USA), likely due to shifts in the reservoir and vector [4,5]
In the past several years, there has been an increase in reports describing scrub typhus during pregnancy associated with poor fetal outcomes [16,21,23]
Summary
Murine typhus (MT) is a flea-borne disease caused by Rickettsia typhi [1]. It is known to be prevalent in cities and ports where rats (Rattus spp.) and their fleas (Xenopsylla cheopis) thrive [3]. In the United States, the disease is endemic in Texas, Southern California, and Hawaii. In the past few years, there has been a reemergence of R. typhi infections in the United States (USA), likely due to shifts in the reservoir and vector [4,5]. Prior studies on the prevalence of R. typhi-infected fleas in cats have been contradictory, but even the low infection rates cannot exclude the role of cats in the transmission of the disease [7]. In Texas, R. typhi-infected cat fleas are carried mainly by opossums [4,7] (Figure 1)
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