72-year-old man • fever • new-onset urinary frequency • altered mental state • Dx?
The Journal of Family Practice. 2021 November;70(9):457-458 | doi: 10.12788/jfp.0306
November 9, 2021|The Journal of Family Practice
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► Fever
► New-onset urinary frequency
► Altered mental state
THE TAKEAWAY
Rickettsia diseases, such as murine typhus, should be considered in the differential if a patient presents with a worsening clinical picture of unresolved delirium; fever despite use of broad-spectrum antibiotics, antifungals, and antivirals; and a history of potential outdoor exposure. Sources include opossums or cats when flea contact is likely. Rickettsia diseases belong in the differential when there is a history of travel to tropical areas, as well. All suspected cases should be reported to the local health department.
CORRESPONDENCE
Tenzin Tsewang MD, 5200 Harry Hines Boulevard, Dallas, TX 75235; tenzin.tsewang@phhs.org
