Severe Murine Typhus With Shock and Acute Respiratory Failure in a Japanese Traveler After Returning From Thailand


Corresponding Author: Fukumi Nakamura-Uchiyama, MD, PhD, Department of Pathogen, Infection and Immunity, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8521, Japan. E-mail:


We treated a case of severe murine typhus in a Japanese traveler after returning from Thailand. Although the disease is typically self-limited or mild, the patient showed shock and multiple organ failure including acute respiratory distress syndrome. Then the patient fully recovered following intensive care and administration of antirickettsial medicines.