NCBISkiptomaincontentSkiptonavigationResourcesHowToAboutNCBIAccesskeysMyNCBISignintoNCBISignOutTryoutPMCLabsandtelluswhatyouthink.LearnMore.JournalListWestJEmergMedv.10(3);2009AugPMC2729230WestJEmergMed.2009Aug;10(3):207.doi: 10.1111/j.1442-2026.1998.tb00616.xPMCID:PMC2729230PMID:19718391What’sHot,withSpotsandRedAllOver?MurineTyphusJulieA.Gorchynski,MD,MSc,*CarlyleLanghorn,MD,†MichaelSimmons,MD,†andDanielRoberts,MD†JulieA.Gorchynski*UniversityofTexas,Southwestern,DepartmentofEmergencyMedicine;JPSHealthNetwork,FortWorth,TXFindarticlesbyJulieA.GorchynskiCarlyleLanghorn†TexasA&M,CorpusChristi,DepartmentofEmergencyMedicineFindarticlesbyCarlyleLanghornMichaelSimmons†TexasA&M,CorpusChristi,DepartmentofEmergencyMedicineFindarticlesbyMichaelSimmonsDanielRoberts†TexasA&M,CorpusChristi,DepartmentofEmergencyMedicineFindarticlesbyDanielRobertsAuthorinformationArticlenotesCopyrightandLicenseinformationDisclaimer*UniversityofTexas,Southwestern,DepartmentofEmergencyMedicine;JPSHealthNetwork,FortWorth,TX†TexasA&M,CorpusChristi,DepartmentofEmergencyMedicineAddressforCorrespondence:JulieGorchynski,MD,MSc.JPSHealthNetwork,MedicalDirector,DepartmentofEmergencyMedicine,DirectorofResearch,1500SouthMainSt.,FortWorth,TX76104.Email:[email protected];Revised2008Oct25;Accepted2008Dec15.Copyright©2009theauthors.ThisisanopenaccessarticledistributedinaccordancewiththetermsoftheCreativeCommonsAttribution(CCBY4.0)License.See:http://creativecommons.org/licenses/by-nc/4.0/.ThisarticlehasbeencitedbyotherarticlesinPMC.A17-year-oldmalepresentedtotheemergencydepartmentwithcomplaintsoffever,rashthatoriginatedontheabdomen,malaise,andacoughfor10dayspriortoevaluation.Thepatientreportedanencounterwithanopossumthreedayspriortotheonsetofsymptoms.Vitalsignswereatemperatureof101.2°F,aheartrateof129beatsperminute,12respirationsperminuteandabloodpressureof123/76mmHg.Dermatologicexamrevealedarashontheface,trunk,back,extremitiesandpalmsthatconsistedofmultiplesmall,erythematousmaculopapules.Rapidplas