en Infectious Diseases Infectious Diseases case report case report <span style="font-size:14px;"><span style="font-family:Times New Roman;"><span style="line-height:14pt"><b><i><span style="color:blue">Background:</span></i></b> Rickettsioses are infectious diseases which are caused by intracellular bacteria which belong to the family Rickettsiaceae. This zoonosis endemically prefers tropical and subtropical regions of which the Mediterranean is included. Murine typhus is a type of rickettsial disease that commonly presents with undulating fever, headache rash, chills, malaise, and myalgias. It can lead to complications such as multi-organ failure and has a lethality rate of <5% in such cases.</span><br> <span style="line-height:14pt"><b><i><span style="color:blue">Case Presentation:</span></i></b> A 70-year-old male was hospitalized at the Unit of Infectious Diseases, Mother Teresa Hospital, Tirana, Albania in a comatose condition. He had a seven-day history of fever up to 39-40&deg;C, headache, fatigue, anorexia, vomiting, cough, and myalgia. He was a farmer and had contact with animals. Upon admission, he had scleral hemorrhages, hepatosplenomegaly, jaundice, maculopapular rash over the trunk, abdomen, and palms of his hands as well as severe acidosis, depressed bicarbonate levels, alteration in liver, kidney, and pancreas function tests. He was urgently transferred to the Intensive care unit of the Infectious Diseases Department. He was hemodynamically unstable and was put immediately on vasoactive agents and mechanical ventilation. ELISA <i>Rickettsia typhi</i> IgM resulted positive. Supportive treatment along with antibiotics Levofloxacin and Ceftriaxone was initiated. However, the patient died on the 4^th day of hospitalization and the 11^th of the disease onset.</span><br> <span style="line-height:14pt"><b><i><span style="color:blue">Conclusion:</span></i></b><b> </b>Murine typhus should be included in the investigation of possible causes when dealing with patients presenting with fever and maculopapular rash complicated by multi-organ failure and coming from a typhus-endemic area, especially in the summer season.<b><i><span style="color:#0033cc"></span></i></b></span></span></span><br> &nbsp; rickettsial diseases, murine typhus, multi-organ failure 188 192 http://caspjim.com/browse.php?a_code=A-10-2783-1&slc_lang=en&sid=1 Ermira Muco ermiramuco@yahoo.com 100319475328460046604 100319475328460046604 Yes Department of Infectious Diseases, Hospital University Center “Mother Teresa”, Tirana, Albania Arta Karruli arta.karruli@gmail.com 100319475328460046605 100319475328460046605 No Anjeza Dajlani anjezadajlani@yahoo.com 100319475328460046606 100319475328460046606 No Arjana Zerja zerja.arjana@gmail.com 100319475328460046607 100319475328460046607 No Artan Bego art_bego@yahoo.com 100319475328460046608 100319475328460046608 No