Murine Typhus Mimicking Kawasaki Disease in a Preadolescent Girl

Abstract

We report the case of an 11-year-old preadolescent girl presenting with prolonged fever, lymphadenitis, nonpurulent conjunctivitis, a generalized maculopapular rash, erythematous lips and edema of hands/feet. Although major diagnostic criteria for Kawasaki disease were met, local epidemiologic data suggested a possible vector-borne etiology. Treatment with doxycycline was initiated, and defervescence occurred. Laboratory investigation confirmed the diagnosis of Rickettsia typhi infection.

Thirteen-year-old Girl Presents With Kawasaki Disease-like Symptoms

“…13 Viral infections such as measles, cytomegalovirus, Epstein-Barr virus, enterovirus and coronavirus disease 2019, toxic shock syndrome, Stevens-Johnson syndrome, typhus and juvenile idiopathic arthritis are also diseases that can sometimes be confused with Kawasaki disease because of similar manifestations. [13][14][15][16] Nevertheless, when diagnostic criteria are met, early initiation of treatment of Kawasaki disease is desirable as delayed treatment increases the risk of coronary aneurysm. 17 Our patient's clinical picture was complicated due to the overlapping signs and symptoms of Kawasaki disease and scrub typhus.…”