Case Report: Cardiovascular Manifestations due to Flea-Borne Typhus

Christian Olivo-Freites Division of Infectious Diseases, David Geffen School of Medicine, University of California, Los Angeles, California;

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Kusha Davar Division of Infectious Diseases, David Geffen School of Medicine, University of California, Los Angeles, California;

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Oscar Gallardo-Huizar Internal Medicine Department, Olive View Medical Center, University of California, Los Angeles, California

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Tara Vijayan Division of Infectious Diseases, David Geffen School of Medicine, University of California, Los Angeles, California;

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Ramee Younes Division of Infectious Diseases, David Geffen School of Medicine, University of California, Los Angeles, California;

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ABSTRACT.

Flea-borne typhus is a vector-borne disease caused by Rickettsia typhi that occurs worldwide, except in Antarctica. In the United States, most cases are restricted to California, Hawaii, and Texas. The syndrome is characterized by nonspecific signs and symptoms: fever, headache, rash, arthralgia, cough, hepatosplenomegaly, diarrhea, and abdominal pain. Although flea-borne typhus can cause pulmonary, neurological, and renal complications, the cardiovascular system is rarely affected. We present a case of endocarditis resulting from flea-borne typhus diagnosed by blood microbial cell-free DNA testing that required valve replacement and antibiotic therapy for 6 months. In addition, we review 20 cases of presumed and confirmed cardiovascular manifestations resulting from flea-borne typhus in the literature.

Author Notes

Authors’ addresses: Christian Olivo-Freites, Kusha Davar, Tara Vijayan, and Ramee Younes, Division of Infectious Diseases, David Geffen School of Medicine, University of California, Los Angeles, CA, E-mails: christianolivofreites@gmail.com, kdavar@dhs.lacounty.gov, tvijayan@mednet.ucla.edu, and ryounes@mednet.ucla.edu. Oscar Gallardo-Huizar, Internal Medicine Department, Olive View Medical Center, University of California, Los Angeles, CA, E-mail: ogallardohuizar@dhs.lacounty.gov.

Address correspondence to Kusha Davar, 1200 North State St. A6137, Los Angeles, CA 90033. E-mail: kdavar@dhs.lacounty.gov
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