[Murine typhus - rare cause of fever return from Egypt]

Authors present a case report of 42-year male who spent 14 days in August of 2003 in Egyptian seaside summer town Hurghada and later he was admitted to the Infectious Disease Department Prague with the fever lasting 4 days. His symptoms were as follows: strong headache and dry cough. On the 7th and 8th day appeared transient maculopapular rash, laboratory test revealed a slightly elevated C reactive protein and elevation of amino transferases up to 5 times higher than range values, chest X-ray showed hypoventilation opacities on the lower lung fields, other findings were non-specifically changed or normal. The fever dropped after 15 days without any response to administered antibiotics-amoxicillin/clavulanate, clarithromycin a ofloxacin. Weil-Felix reaction with antigen Proteus OX19 (1 : 5120) was highly positive and positive antibodies IgG and IgM against Rickettsia typhi were positive. Later doxycycline was given, problems fully subsided, laboratory values were normalised up to six weeks from the beginning of the disease. Diagnosis was completed as murine typhus. The patient excluded arthropode bit. The authors considered the possibility of inhaled contaminated dust during his visit of the port. The above given case was firstly referred in the Czech Republic and still it is the only case.