Outcomes of Hospitalized and Critically Ill Adults with Murine Typhus, Galveston, Texas, USA, 2019-2023.

Murine typhus is a reemerging infectious disease with the potential for severe manifestations. We conducted a retrospective study to examine severe illness in those hospitalized with murine typhus in Galveston, Texas. We identified 149 cases, of which 119 (79.8%) were hospitalized and 33 (28%) required admission to the intensive care unit (ICU). ICU patients were older than non-ICU patients (54.9 vs. 47.2 years; p<0.02). Thrombocytopenia was more severe in the ICU group (101 × 103 µ/L) compared to the non-ICU group (137 × 103 µ/L) (p<0.01). The median time from healthcare contact in the emergency department to initiation of appropriate antibiotics was similar for the ICU group (1 day) and non-ICU group (2 days) (p = 0.26). Two deaths (1.7%) in the ICU group were attributed to multiorgan failure and hemophagocytic lymphohistiocytosis. In murine typhus-endemic regions, early recognition and prompt treatment is imperative to mitigate adverse outcomes.