1336. Six-Year Clinical Experience of Pediatric Murine Typhus in Houston, TX

Abstract Background Murine typhus is a flea-borne rickettsial disease endemic to gulf states. It shares clinical features of Kawasaki (KD) and multisystem inflammatory syndrome in children (MIS-C). We sought explore the six-year experience with murine among living Houston, TX. Methods conducted retrospective chart review identify laboratory from January 2015 July 2021. Cases were identified by positive Rickettsia typhi serology single IgG >=1:256, IgM >=1:128, or increase 1:64 1:28 convalescent sera. Results 162 cases pediatric identified. Most (85, 52.5%) occurred summer. There was bimodal distribution age, peaks at 4 17 years (Figure 1). (96, 59.3%) required hospitalization; 11 admitted intensive care, 3 intubation. All had fever; mean duration fever presentation 8.9 days (+/-2.9). Only 67 (41.4%) combination fever, headache, rash (Table 64 (39.5%) documented flea opossum exposure. The most common abnormalities elevated serum liver transaminases, hypoalbuminemia, thrombocytopenia, hyponatremia Cardiac not uncommon: 20/59 (33.9%) an abnormal electrocardiogram, 5/50 (10.0%) troponin >0.04 ng/mL, 4/50 (8.0%) b-type natriuretic protein >100 pg/mL (149, 92.0%) diagnosed based on initial serological testing. Nine (5.6%) received intravenous immunoglobulin for diagnosis KD before diagnosed. median hospitalization (IQR 2,5), treated doxycycline (146, 90.1%). Figure 1.Histogram age time diagnosis.Table 1.Clinical Laboratory Features Children Diagnosed Typhus. Conclusion cause prolonged unexplained areas MIS-C. are uncommon, severity illness can range outpatient care. Lack exposure lack headache does rule out infection. Therefore, high index suspicion warranted, testing may accelerate fever. Disclosures Authors: No reported disclosures.