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Journal of Neurology

, Volume 245, Issue 10, pp 665–668 | Cite as

Murine typhus presenting as subacute meningoencephalitis

  • R. Masalha
  • Helena Merkin-Zaborsky
  • Mike Matar
  • Howard J. Zirkin
  • Itzhak Wirguin
  • Yuval O. Herishanu
Original communication

Abstract

Murine typhus is a febrile systemic illness, presenting with headache and undulating fever. Neurological involvement is considered a rare complication. During 1994 and 1995, 34 patients admitted to our hospital were diagnosed as having murine typhus. Five of these patients presented with a syndrome of subacute “aseptic” meningitis or meningoencephalitis. Three had bilateral papilloedema and 2 had focal neurological signs. None had a rash or other systemic findings suggestive of rickettsial disease. The diagnosis was based on serum and cerebrospinal fluid serology and on prompt response to doxycycline therapy. These cases suggest that neurological involvement in murine typhus is more common than previously suspected and that murine typhus should be included in the differential diagnosis of subacute meningitis in endemic areas.

Key wordsRickettsia typhi Meningoencephalitis Aseptic meningitis Papilloedema 

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Copyright information

© Springer-Verlag Berlin Heidelberg 1998

Authors and Affiliations

  • R. Masalha
    • 1
  • Helena Merkin-Zaborsky
    • 1
  • Mike Matar
    • 3
  • Howard J. Zirkin
    • 2
  • Itzhak Wirguin
    • 1
  • Yuval O. Herishanu
    • 1
  1. 1.Department of Neurology, Soroka Medical Centre, P.O. Box 151, Beer-Sheva 84101, Israel Tel.: +972-7-6400660 Fax: +972-7-6283914IL
  2. 2.Department of Pathology, Soroka Medical Centre, P.O. Box 151, Beer-Sheva 84101, IsraelIL
  3. 3.Beer-Sheva Mental Hospital, Goldman Faculty of Health Sciences. Ben-Gurion University of the Negev, Beer-Sheva, IsraelIL

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