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Lauren Rash, MD1, Luay Boulahouache2, Nathaniel Giles2, Robert Atmar2, 1Baylor College of Medine, TX, Houston, 2Baylor College of Medicine, Background: Murine typhus, a flea-borne rickettsial disease traditionally found in warm, humid climates, is increasingly reported in non-endemic regions due to factors such as climate change and urbanization. 7 patients were excluded if they were outpatient, had an incomplete chart to review, were diagnosed and cared for outside of Harris Health, had too low of titers to make the diagnosis, or diagnosis was not consistent with murine typhus. Demographics, clinic and admission dates, length of stay, comorbidities and medications, animal exposures, symptoms, vitals, physical exams, labs, imaging, treatment course, illness complications, timing and antibiotic selection, whether infectious disease was consulted, and fever clearance time was documented. Infectious Disease team was consulted 57% of the time with an average day of consult on day 3 and Infectious Disease team consulted resulted in doxycycline being started 100% of the time.