Fibrin ring granulomas in Rickettsia typhi infection

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

doi:10.1016/j.diagmicrobio.2009.10.019

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 journal › Article › peer-review

11 Scopus citations

Abstract

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 language	English (US)
Pages (from-to)	322-325
Number of pages	4
Journal	Diagnostic Microbiology and Infectious Disease
Volume	66
Issue number	3
DOIs	https://doi.org/10.1016/j.diagmicrobio.2009.10.019
State	Published - Mar 2010

Keywords

Fever of unknown origin
Fibrin ring granuloma
Murine typhus
Rickettsia typhi

ASJC Scopus subject areas

Microbiology (medical)
Infectious Diseases

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10.1016/j.diagmicrobio.2009.10.019

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title = "Fibrin ring granulomas in Rickettsia typhi infection",

abstract = "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.",

keywords = "Fever of unknown origin, Fibrin ring granuloma, Murine typhus, Rickettsia typhi",

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AU - Restrepo, Marcos I.

AU - Vasquez, E. Martin

AU - Echeverri, Carolina

AU - Fiebelkorn, Kristin R.

AU - Anstead, Gregory M.

PY - 2010/3

Y1 - 2010/3

N2 - 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.

AB - 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.

KW - Fever of unknown origin

KW - Fibrin ring granuloma

KW - Murine typhus

KW - Rickettsia typhi

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Fibrin ring granulomas in Rickettsia typhi infection

Abstract

Keywords

ASJC Scopus subject areas

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