ABSTRACT
Fever is a widely recognised presenting symptom of COVID-19. Consequently, other febrile illnesses may be difficult to distinguish from COVID-19-leading to delays in diagnosis and treatment. One such illness is murine typhus, a fleaborne illness with worldwide distribution caused by Rickettsia typhi It often presents with fever, headache and myalgia, all of which have been commonly reported with COVID-19. Although the disease is usually mild with a good prognosis, there have been reports of severe illness and death. I present a case of murine typhus in a young male who had 2 weeks of headaches and daily fevers during the COVID-19 pandemic. He was ultimately tested for murine typhus when his occupation as a dog trainer was queried, and he experienced resolution of symptoms after treatment with doxycycline. During this pandemic, clinicians must be vigilant of other febrile illnesses whose symptoms overlap with COVID-19.
Subject(s)
Coronavirus Infections/diagnosis , Doxycycline/administration & dosage , Fever/diagnosis , Occupational Exposure/analysis , Pneumonia, Viral/diagnosis , Rickettsia typhi/isolation & purification , Typhus, Endemic Flea-Borne , Adult , Ambulatory Care/methods , Animals , Anti-Bacterial Agents/administration & dosage , Betacoronavirus , COVID-19 , Diagnosis, Differential , Disease Reservoirs/microbiology , Disease Transmission, Infectious , Dogs , Fever/etiology , Humans , Male , Pandemics , SARS-CoV-2 , Treatment Outcome , Typhus, Endemic Flea-Borne/diagnosis , Typhus, Endemic Flea-Borne/drug therapy , Typhus, Endemic Flea-Borne/microbiology , Typhus, Endemic Flea-Borne/physiopathologyABSTRACT
Sudden onset sensorineural hearing loss (SSNHL) is frequently seen by otolaryngologists. The exact pathophysiology of the disease is still unknown, with the most likely causative factor being following a viral infection. Immediate steroids are the best treatment to improve prognosis. Despite a plethora of papers in the literature describing SSNHL, there are only a few reported cases of hearing loss following COVID-19, none of which have been reported in the UK. This paper presents the first UK case of SSNHL following COVID-19. Physical examination and imaging excluded any other cause of hearing loss. A literature review showed that four other cases have been previously described. Hearing loss can be a significant cause of morbidity and can easily be missed in the intensive care setting. Being aware and screening for SSNHL following COVID-19 enables an early course of steroids, which offers the best chance of recovering hearing.