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Fibrin ring granulomas in Rickettsia typhi infection.

Author(s): Restrepo MI, Vasquez EM, Echeverri C, Fiebelkorn KR, Anstead GM

Affiliation(s): Veterans Evidence Research Dissemination and Implementation Center (VERDICT), South Texas Veterans Health Care System, San Antonio, TX 78229, USA.

Publication date & source: 2010-03, Diagn Microbiol Infect Dis., 66(3):322-5. Epub 2010 Jan 13.

Publication type: Case Reports

We describe a 71-year-old man hospitalized for fever and productive cough. Laboratory investigation showed anemia, thrombocytopenia, elevated transaminases, hyponatremia, and hypoalbuminemia. Computerized tomography of the abdomen, thorax, and sinuses, echocardiography, and a gallium scan did not reveal the source of the fever. The patient remained febrile despite courses of piperacillin-tazobactam/azithromycin and ceftriaxone/vancomycin. A bone marrow biopsy showed fibrin ring granulomas, and 2 rickettsial serologic panels were positive for Rickettsia typhi infection and negative for Q fever. The patient was given doxycycline, and the fever resolved within 48 h. We propose that fibrin ring granulomas also occur in murine typhus. 2010 Elsevier Inc. All rights reserved.

Page last updated: 2010-10-05

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