WACO, Texas (KWTX) – A 12-year-old Waco athlete spent six days at McLane Children\u2019s Hospital after flea-borne typhus triggered septic shock, and her infectious disease specialist says he is seeing higher-than-usual numbers of the illness across Central Texas this summer.<\/p>\n
Hope Smith returned from youth camp tired and flushed. Within days, her fever climbed to nearly 106 degrees and refused to break. Doctors initially suspected hand, foot, and mouth disease, then strep throat \u2014 but antibiotics did not help. By the ninth day, Hope had stopped eating, her urine had turned dark, and her breathing changed.<\/p>\n
From the ER to the pediatric ICU<\/p>\n
At McLane Children\u2019s Hospital, Hope\u2019s oxygen and blood pressure dropped. She was rushed to the pediatric intensive care unit, where the infection triggered septic shock.<\/p>\n
\u201cThere\u2019s three people working on my child and they\u2019re not speaking. And then there\u2019s five and then there\u2019s six. And that just more and more people kept coming in and no one was talking to us. And it was scary,\u201d said Jennifer Smith, Hope\u2019s mother.<\/p>\n
Pediatric infectious disease specialist Dr. Gueorgui Dubrocq recognized a pattern: high fever, rash, low sodium, and abnormalities in Hope\u2019s white blood cell count and platelets.<\/p>\n
\u201cYes, when I first met Hope, she was very sick. She was in the ICU. We were worried about her because she had problems with her blood pressure,\u201d Dubrocq said.<\/p>\n
The diagnosis: murine typhus<\/p>\n
The diagnosis was murine typhus \u2014 not typhoid fever, and not a tick-borne illness. The bacteria is carried by infected fleas and can enter the body through irritated or broken skin contaminated by flea feces.<\/p>\n
Dubrocq said confirmation testing can take a week or longer to return results, so he began treatment with doxycycline before the test came back.<\/p>\n
\u201cLike, say this week, I already have four potential cases. The only problem with diagnosing this is that when you send a test, it doesn\u2019t come back until a week later sometimes,\u201d Dubrocq said.<\/p>\n
He said he diagnoses the illness in patients from a 100-mile radius \u2014 including Bell and McLennan counties \u2014 almost every other day, and attributes the increased numbers in part to mild winters that fail to reduce flea and tick populations.<\/p>\n
Symptoms and risk factors<\/p>\n
Dubrocq said symptoms of murine typhus include persistent fever, headaches, muscle pain, rash, abdominal pain, vomiting, and extreme fatigue. He said the combination of symptoms closely mimics other common illnesses, which can delay diagnosis.<\/p>\n
He said people most at risk are those who spend time outdoors in areas with weeds, vegetation, or visible insects without taking precautions \u2014 including walking barefoot outside.<\/p>\n
Dubrocq said strep tests can return false positives in patients with typhus due to the body\u2019s hyperinflammatory response to the infection.<\/p>\n
What parents can do<\/p>\n
Dubrocq said families can reduce their risk by keeping pets current on flea prevention, treating flea problems inside the home, maintaining overgrown yards, wearing shoes outdoors, and avoiding stray animals.<\/p>\n
He said parents should not panic but should seek medical care when symptoms do not improve after treatment or continue to worsen.<\/p>\n
Hope\u2019s parents said they sought help multiple times before the correct diagnosis was made and now have a message for other families.<\/p>\n
\u201cIf they have a high fever, push for your kid. If you don\u2019t think the diagnosis is right, push, push. Be an advocate for your child,\u201d Jennifer Smith said.<\/p>\n
Dubrocq said the Smith family did everything correctly by repeatedly seeking care and following up with multiple providers.<\/p>\n
Hope improved after receiving doxycycline and was discharged after six days. She still has weeks of recovery ahead before returning to sports.<\/p>\n
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