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Murine typhus, also known as endemic typhus or flea-borne typhus, is a form of typhus spread by fleas ( like Xenopsylla cheopis), usually on rats, in contrast to epidemic typhus which is usually spread by lice.[1][2] A headache and rash are usual symptoms. Usual treatment is doxycycline until the improvement is observed in the individual.[3]


Symptoms may resemble those of measles, rubella, or possibly Rocky Mountain spotted fever. Symptoms of endemic typhus include the following: headache, fever, muscle pain , joint pain and nausea.[4][5]


Among possible complications of Murine typhus we find the following:bronchiolitis, pneumonia, meningitis, septic shock and pancreatitis.[6][7]


It is caused by the bacterium Rickettsia typhi, and is transmitted by the fleas that infest rats. While rat fleas are the most common vectors, cat fleas and mouse fleas are less common modes of transmission, these fleas are not affected by the infection. [8][9][10]


In terms of the mechanism of Murine typhus we find that it shares the same pathophysiology as epidemic typhus, but milder.Rickettsia enter endothelial cells of blood vessels, and then begin to spread and cause endothelial cellular expansion which results in multiorgan vasculitis. [11]


In terms of the diagnosis we find that evaluation of the affected individual, biopsy and blood tests are done.[12]

Differential diagnosis

The differential diagnosis for Murine typhus is as follows:Rocky Mountain spotted fever ,Epidemic typhus,Scrub typhus and African tick typhus.[13]


The most effective antibiotics for treatment include tetracycline and chloramphenicol. In the United States, the CDC recommends doxycycline.[14][15]


In the United States , murine typhus is found most commonly in southern California,[16] Texas and Hawaii. In some studies, up to 13 percent of children were found to have serological evidence of infection.[17]


  1. Li, Li; Li, Guiying (2015), Li, Hongjun (ed.), "Epidemic and Endemic Typhus", Radiology of Infectious Diseases: Volume 2, Dordrecht: Springer Netherlands, pp. 89–94, doi:10.1007/978-94-017-9876-1_8, ISBN 978-94-017-9876-1, archived from the original on 2021-10-18, retrieved 2021-02-27
  2. "Epidemic typhus". Centers for Disease Control and Prevention. 2020-11-13. Archived from the original on 2017-03-26. Retrieved 2021-02-27.
  3. "Murine (Endemic) Typhus - Infectious Diseases". Merck Manual Professional Edition. Retrieved 13 June 2024.
  4. Tsioutis, Constantinos; Zafeiri, Maria; Avramopoulos, Asimakis; Prousali, Efthymia; Miligkos, Michael; Karageorgos, Spyridon A. (February 2017). "Clinical and laboratory characteristics, epidemiology, and outcomes of murine typhus: A systematic review". Acta Tropica. 166: 16–24. doi:10.1016/j.actatropica.2016.10.018. ISSN 1873-6254. PMID 27983969. Archived from the original on 25 July 2023. Retrieved 24 July 2023.
  5. Doppler, Johannes F.; Newton, Paul N. (14 September 2020). "A systematic review of the untreated mortality of murine typhus". PLOS Neglected Tropical Diseases. 14 (9): e0008641. doi:10.1371/journal.pntd.0008641. ISSN 1935-2735. Archived from the original on 17 June 2022. Retrieved 2 August 2023.
  6. Afzal, Zeeshan; Kallumadanda, Sunand; Wang, Feng; Hemmige, Vagish; Musher, Daniel (August 2017). "Acute Febrile Illness and Complications Due to Murine Typhus, Texas, USA1,2". Emerging Infectious Diseases. 23 (8): 1268–1273. doi:10.3201/eid2308.161861. ISSN 1080-6059. PMC 5547806. PMID 28726607.
  7. Moraru, Gail Miriam; II, Jerome Goddard (4 March 2019). The Goddard Guide to Arthropods of Medical Importance. CRC Press. ISBN 978-1-351-63014-6. Archived from the original on 24 July 2023. Retrieved 23 July 2023.Google books offers no page number
  8. Snowden, Jessica; Ladd, Megan; King, Kevin C. (2023). "Rickettsial Infection". StatPearls. StatPearls Publishing. PMID 28613765. Archived from the original on 2023-07-24. Retrieved 2023-07-22.
  9. McLeod, MP; Qin, X; Karpathy, SE; Gioia, J; Highlander, SK; Fox, GE; McNeill, TZ; Jiang, H; Muzny, D; Jacob, LS; Hawes, AC; Sodergren, E; Gill, R; Hume, J; Morgan, M; Fan, G; Amin, AG; Gibbs, RA; Hong, C; Yu, XJ; Walker, DH; Weinstock, GM (September 2004). "Complete genome sequence of Rickettsia typhi and comparison with sequences of other rickettsiae". Journal of bacteriology. 186 (17): 5842–55. doi:10.1128/JB.186.17.5842-5855.2004. PMID 15317790. Retrieved 30 July 2023.
  10. "Concept 48283". Archived from the original on 2 August 2023. Retrieved 31 July 2023.
  11. "Typhus: Background, Pathophysiology, Epidemiology". Medscape. 12 July 2023. Archived from the original on 29 May 2023. Retrieved 21 July 2023.
  12. "Murine (Endemic) Typhus - Murine (Endemic) Typhus". MSD Manual Consumer Version. Retrieved 18 June 2024.
  13. "Overview of Rickettsial and Related Infections - Infectious Diseases". MSD Manual Professional Edition. Archived from the original on 10 May 2023. Retrieved 25 July 2023.
  14. "About Murine Typhus". Typhus Fevers. 5 June 2024. Retrieved 19 June 2024.
  15. "Typhus Treatment & Management: Medical Care, Activity, Prevention". Medscape. 12 July 2023. Archived from the original on 31 January 2023. Retrieved 26 July 2023.
  16. "Murine (endemic) Typhus" (PDF). California Department of Public Health. Archived from the original (PDF) on 4 February 2012. Retrieved 30 May 2012.
  17. The Pediatric Infectious Disease Journal (Impact Factor: 3.57). 07/2000; 19(6):535−8.