A case of murine typhus in Queensland

Objective To present a case of murine (endemic) typhus, the first to be reported within the last 30 years in Australia. Clinical features A 17-year-old pregnant woman presented with a viral-like illness and later developed a spotted rash, fever and headache. Investigation and outcome Sera taken on Day 7 and Day 30 of the illness showed seroconversion to Proteus OX19 (Weil–Felix) and to Rickettsia typhi (by immunofluorescence), indicating recent infection with Rickettsia of the typhus group. Her illness was clinically compatible with murine typhus. She responded well to erythromycin and delivered a normal infant at term. Conclusion Infection with Rickettsia typhi (murine typhus) still occurs in Australia. It can be diagnosed by means of specific serological tests for rickettsial disease, which are superior to the non-specific Weil–Felix test.