A Palmoplantar Puzzle: Murine Typhus Involving the Palms and Soles
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Keywords
Murine Typhus, Tick-Borne diseases, Endemic typhus, Rickettsial infections, Cutaneous Rickettsial infections
Abstract
Murine typhus, also known as “flea-borne” or “endemic” typhus, is a zoonotic infection caused by Rickettsia typhi. It is characterized by fever, headache, and a non-pruritic maculopapular rash that typically spreads centrifugally across the trunk while sparing the palms and soles. We present the case of a 51-year-old female with serologically confirmed murine typhus, who exhibited atypical cutaneous manifestations, including a purpuric rash involving her palms and soles. This case highlights how palmoplantar involvement, although rare, should not exclude murine typhus from diagnostic consideration. Dermatologists should be aware of atypical presentations of murine typhus and start empiric treatment with doxycycline while awaiting serologic confirmation.
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