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[Interstitial nephritis in typhus]

V Schumann1, E Fritschka, U Helmchen

  • 1Abteilung für Nieren- und Hochdruckkrankheiten, Universitätsklinikum Essen.

Deutsche Medizinische Wochenschrift (1946)
|June 18, 1993
PubMed
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A patient with typhus experienced acute kidney injury, but recovered after early doxycycline treatment. Prompt antibiotic intervention is crucial for preventing irreversible renal damage in typhus cases.

Area of Science:

  • Infectious Diseases
  • Nephrology
  • Microbiology

Background:

  • Typhus, a rickettsial infection, can present with diverse clinical manifestations.
  • Renal involvement in typhus is a recognized but potentially severe complication.

Observation:

  • A 58-year-old man presented with fever and rash following travel to Rhodos, consistent with typhus.
  • The patient developed acute kidney injury with a significant rise in serum creatinine.
  • Renal biopsy confirmed acute granulomatous interstitial nephritis, indicative of rickettsial infection.

Findings:

  • Early treatment with doxycycline led to rapid improvement in fever and general condition.
  • Despite initial deterioration, renal function recovered following a prolonged course of doxycycline.

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  • Antibody titers against Rickettsia species decreased over time, correlating with clinical recovery.
  • Implications:

    • This case highlights the importance of considering typhus in febrile illnesses with rash, especially after travel to endemic areas.
    • Early diagnosis and prompt antibiotic treatment, such as with doxycycline, are critical for managing typhus and preventing severe complications like acute kidney injury.
    • Timely intervention can lead to favorable renal outcomes and avoid long-term renal damage.