An 11-year-old boy with a fever and non-pruritic rash. Diagnosis: murine typhus.

摘要

An 11-year-old boy presented to the emergency department with a 9-day history of fever to 104.5° F (40.2° C) and a 2-day history of a non-pruritic rash that began on his trunk and spread to all four extremities. The rash was most prominent when he was febrile. He complained of headaches, myalgias, and joint pain, which also worsened with his fevers. After 2 days of fever, before the onset of his rash, he was evaluated and diagnosed with a viral illness and sent home with no further workup or treatment. Over the preceding few weeks, he reported being exposed to stray cats, turtles, and a rat infestation in his backyard.