Fibrin ring granulomas in Rickettsia typhi infection

Marcos I. Restrepo, E. Martin Vasquez, Carolina Echeverri, Kristin R. Fiebelkorn, Gregory M. Anstead

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)322-325
Number of pages4
JournalDiagnostic Microbiology and Infectious Disease
Issue number3
StatePublished - Mar 2010


  • Fever of unknown origin
  • Fibrin ring granuloma
  • Murine typhus
  • Rickettsia typhi

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases


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