ABSTRACT
Rickettia typhi is an obligate intracellular organism and usually seen microscopically as gram-negative pleomorphic coccobacilli. Murine typhus is an acute febrile illness caused by R. typhi and transmitted to human by fleas. Fever, skin rash, headache, and myalgia characterize the clinical illness. The risk for laboratory personnel is from exposure to infectious aerosols, accidental inoculation, or exposure to bites by infected ectoparasites. A 27-year old man was admitted to the hospital because of fever and myalgia. He had worked with R. typhi in a laboratory and was exposed to R. typhi 10 days ago. The present illness began seven days before admission, when he developed high fever and conjunctival injection. One day before admission, he developed generalized erythematous skin rash and generalized edema. Immunofluorescence test with rickettsial antigen was positive at 1:4,096 on admission. He received 200 mg of doxycycline for 7 days and became afebrile on the third day after treatment.