A Systematic Review of Murine Typhus

Abstract

Murine typhus is a disease (brought on by infection with Rickettsia typhi) that has produced a surprising amount of morbidity when the relative dearth of literature on the subject is considered. Existing reviews of the subject are either relatively dated or surveys of all rickettsial disease with the majority of discussion dedicated to other agents, most often Rickettsia prowazekii or Rickettsia felis. This is likely due to the widespread consideration that Murine typhus is a “re-emergent organism” that was largely removed by the use of pesticides in the 1950s and has only recently re-emerged in much of the globe. I utilize a review of several databases to assess the literature regarding Murine typhus and to bring together summary information for a multitude of factors about the disease.

I found a remarkable heterogeneity of data regarding Murine typhus. Factors of specific note among the cases reviewed include the relatively high amount of probable exposures reported by patients, the difficulty at reaching the proper diagnosis experienced by physicians when attempting to ascertain the cause of symptoms, the many separate treatments used and differential efficacies of those treatments, and the disparate types of “severe” outcomes. This information may be of use in the coming years as Murine typhus continues to increase in incidence in many nations where it is present, and as it also appears in those nations where it has not been seen in the previous 50 years.