Of the cases reported here, only one involved insect bites. Untreated patients may have fever and symptoms for 7 to 14 days and then rapidly convalesce. The treatment of choice is antibiotic therapy with tetracyclines. Like our patients, most murine typhus patients may have isolated fever and nonspecific biologic abnormalities. Consequently, the diagnosis of the disease is based on serologic testing.
Fever is a common problem in patients returning from travel abroad.
Our cases indicate that murine typhus should be considered in the diagnosis of febrile illness in travelers returning from disease-endemic areas, particularly if fever is present and blood smears show no malaria parasites. Increased development of tourism and travel to tropical countries should lead to an increase in the documentation of cases. Dr. Raoult is affiliated with the hospital of Universit de la M diterran e, in Marseille, France. His research interest is medical entomology. References Raoult D, Roux V. Rickettsioses as paradigms of new or emerging infectious diseases.