12-year-old girl survives septic shock from flea-borne illness after coming home from youth camp

WACO, Texas (KWTX/Gray News) - A 12-year-old girl from Texas spent six days in the hospital after flea-borne typhus triggered septic shock.

The infectious disease specialist who treated her said he is seeing higher-than-usual numbers of the illness this summer.

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, but antibiotics did not help. By the ninth day, Hope had stopped eating, her urine had turned dark and her breathing changed.

From the ER to the pediatric ICU

At McLane Children’s Hospital, Hope’s oxygen and blood pressure dropped. She was rushed to the pediatric intensive care unit, where the infection triggered septic shock.

“There’s three people working on my child and they’re not speaking. And then there’s five and then there’s six. And that just more and more people kept coming in and no one was talking to us. And it was scary,” Jennifer Smith, Hope’s mother, said.

Pediatric infectious disease specialist Dr. Gueorgui Dubrocq recognized a pattern: high fever, rash, low sodium and abnormalities in Hope’s white blood cell count and platelets.

“Yes, 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,” Dubrocq said.

The diagnosis: murine typhus

Hope was diagnosed with murine typhus, which is not typhoid fever nor 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.

Dubrocq said confirmation testing can take a week or longer to return results, so he began treatment with doxycycline before the test came back.

“Like, say this week, I already have four potential cases. The only problem with diagnosing this is that when you send a test, it doesn’t come back until a week later sometimes,” Dubrocq said.

He said he diagnoses the illness in patients from a 100-mile radius almost every other day, and attributes the increased numbers in part to mild winters that fail to reduce flea and tick populations.

Symptoms and risk factors

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.

He said people most at risk are those who spend time outdoors in areas with weeds, vegetation or visible insects without taking precautions, including walking barefoot outside.

Dubrocq said strep tests can return false positives in patients with typhus due to the body’s hyperinflammatory response to the infection.

What parents can do

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.

He said parents should not panic but should seek medical care when symptoms do not improve after treatment or continue to worsen.

Hope’s parents said they sought help multiple times before the correct diagnosis was made, and they now have a message for other families.

“If they have a high fever, push for your kid. If you don’t think the diagnosis is right, push, push. Be an advocate for your child,” Jennifer Smith said.

Dubrocq said the Smith family did everything correctly by repeatedly seeking care and following up with multiple providers.

Hope improved after receiving doxycycline and was discharged after six days. She still has weeks of recovery ahead before returning to sports.