{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T23:41:07Z","timestamp":1792194067167,"version":"4.4.0"},"reference-count":10,"publisher":"Georg Thieme Verlag KG","issue":"04","license":[{"start":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T00:00:00Z","timestamp":1791763200000},"content-version":"vor","delay-in-days":11,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["AJP Rep"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Background Murine typhus, a flea-borne rickettsiosis endemic to southern Texas, can cause headache, thrombocytopenia, and transaminitis that overlap with the criteria for preeclampsia with severe features.<\/jats:p>\n                  <jats:p>Case A 22-year-old gravida 5 with gestational hypertension presented at 325\/7 weeks of gestation with 5 days of fever and headache. Worsening thrombocytopenia, transaminitis, and refractory headache were initially attributed to preeclampsia with severe features, and magnesium sulfate was administered. Persistent fever prompted empiric doxycycline for suspected murine typhus; defervescence occurred within 48 hours, and acute serology supported the diagnosis. She delivered a healthy neonate at 37 weeks.<\/jats:p>\n                  <jats:p>Conclusion In endemic regions, murine typhus should be considered in febrile pregnant patients with preeclampsia-like laboratory findings, and empiric doxycycline should not be delayed for serologic confirmation.<\/jats:p>","DOI":"10.1055\/a-2977-4190","type":"journal-article","created":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T00:01:16Z","timestamp":1791849676000},"page":"e200-e202","source":"Crossref","is-referenced-by-count":0,"title":["Murine Typhus Mimicking Preeclampsia with Severe Features"],"prefix":"10.1055","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-2960-8163","authenticated-orcid":false,"given":"Ryan","family":"Findlay","sequence":"additional","affiliation":[{"name":"The University of Texas Medical Branch, Texas, United States","place":["Galveston"],"department":["Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alysha","family":"Panjwani","sequence":"additional","affiliation":[{"name":"John Sealy School of Medicine, The University of Texas Medical Branch, Texas, United States","place":["Galveston"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis","family":"Pacheco","sequence":"additional","affiliation":[{"name":"The University of Texas Medical Branch, Texas, United States","place":["Galveston"],"department":["Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,10,16]]},"reference":[{"issue":"06","key":"ref1","doi-asserted-by":"crossref","first-page":"913","DOI":"10.1086\/527443","article-title":"Murine typhus: an unrecognized suburban vectorborne disease","volume":"46","author":"R Civen","year":"2008","journal-title":"Clin Infect Dis"},{"issue":"08","key":"ref2","doi-asserted-by":"crossref","first-page":"1268","DOI":"10.3201\/eid2308.161861","article-title":"Acute febrile illness and complications due to murine typhus, Texas, USA","volume":"23","author":"Z Afzal","year":"2017","journal-title":"Emerg Infect Dis"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1016\/j.actatropica.2016.10.018","article-title":"Clinical and laboratory characteristics, epidemiology, and outcomes of murine typhus: a systematic review","volume":"166","author":"C Tsioutis","year":"2017","journal-title":"Acta Trop"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1097\/AOG.0b013e3181e24bea","article-title":"Murine typhus in a pregnant woman","volume":"116","author":"J A Jolley","year":"2010","journal-title":"Obstet Gynecol"},{"issue":"06","key":"ref5","doi-asserted-by":"crossref","first-page":"e237","DOI":"10.1097\/AOG.0000000000003891","article-title":"Gestational hypertension and preeclampsia: ACOG practice bulletin no. 222","volume":"135","year":"2020","journal-title":"Obstet Gynecol"},{"issue":"11","key":"ref6","doi-asserted-by":"crossref","first-page":"e3327","DOI":"10.1371\/journal.pntd.0003327","article-title":"Pregnancy outcome in relation to treatment of murine typhus and scrub typhus infection: a fever cohort and a case series analysis","volume":"8","author":"R McGready","year":"2014","journal-title":"PLoS Negl Trop Dis"},{"issue":"02","key":"ref7","doi-asserted-by":"crossref","first-page":"e185","DOI":"10.1055\/a-2330-4249","article-title":"Ischemic hepatitis and septic shock secondary to murine typhus infection in pregnancy","volume":"14","author":"M Berry","year":"2024","journal-title":"AJP Rep"},{"key":"ref8","volume-title":"Tickborne Diseases of the United States: A Reference Manual for Health Care Providers","author":"Centers for Disease Control and Prevention, Division of Vector-Borne Diseases","year":"2022"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"1","DOI":"10.15585\/mmwr.rr6502a1","article-title":"Diagnosis and management of tickborne rickettsial diseases: Rocky Mountain spotted fever and other spotted fever group rickettsioses, ehrlichioses, and anaplasmosis\u2014United States","volume":"65","author":"H M Biggs","year":"2016","journal-title":"MMWR Recomm Rep"},{"issue":"03","key":"ref10","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1517\/14740338.2016.1133584","article-title":"Revisiting doxycycline in pregnancy and early childhood\u2014time to rebuild its reputation?","volume":"15","author":"R Cross","year":"2016","journal-title":"Expert Opin Drug Saf"}],"container-title":["American Journal of Perinatology Reports"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2977-4190.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T22:50:29Z","timestamp":1792191029000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2977-4190"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10]]},"references-count":10,"journal-issue":{"issue":"04","published-online":{"date-parts":[[2026,10,16]]},"published-print":{"date-parts":[[2026,10]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2977-4190","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["2157-6998","2157-7005"],"issn-type":[{"value":"2157-6998","type":"print"},{"value":"2157-7005","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,10,12]]},"published":{"date-parts":[[2026,10]]}}}