Concomitant Plasmodium vivax malaria and murine typhus infection with pulmonary involvement.

Research paper by Chayasin C Mansanguan, Weerapong W Phumratanaprapin

Indexed on: 21 Dec '18Published on: 21 Dec '18Published in: BMJ case reports


We report a case of and murine typhus coinfection in a 30-year-old woman who presented with intermittent, high-grade fever. Her peripheral blood smear showed ring-form trophozoites of , with an initial murine typhus serological test being negative. Although infection was successfully treated, she still had intermittent, high-grade fever, developed dyspnoea and bilateral interstitial pneumonitis shown in the chest X-ray. Thus, coinfection was suspected, and empirical antibiotics were given. The second serological test confirmed the concomitant murine typhus infection, and antibiotics treatment were successful with the complete recovery. This case emphasises that an initial negative murine typhus serological test does not necessarily rule out the presence of the disease. A follow-up murine typhus serological or molecular test within 1-2 weeks is therefore recommended. © BMJ Publishing Group Limited 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.