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.
Subject(s)
Siphonaptera , Typhus, Endemic Flea-Borne , Typhus, Epidemic Louse-Borne , Humans , Animals , Typhus, Epidemic Louse-Borne/drug therapy , Typhus, Endemic Flea-Borne/diagnosis , Rickettsia typhi , Anti-Bacterial Agents/therapeutic use , Siphonaptera/microbiologyABSTRACT
A 66-year-old male with a history of low back pain was found to have discitis and osteomyelitis. Biopsy and PCR testing revealed Streptococcus cristatus infection. This bacteria does not typically cause disease, and only a few cases in the literature have reported it to cause infection in the bones or joints. This case illustrates that vertebral osteomyelitis with a rare causative agent, S. cristatus, is possible and can be identified with PCR. Treatment typically requires long-term antibiotics tailored to the causative agent for a minimum of 6 weeks and can sometimes include surgical management.
ABSTRACT
Coccidioides is a dimorphic fungus that can cause various clinical presentations, mainly pulmonary, skin, musculoskeletal, and in the central nervous system; most reports are in the southwestern area of the USA. We present a case of a young male with a perianal abscess in the absence of any pulmonary or constitutional symptoms. Perianal abscess as initial manifestation is a novel presentation of coccidioidomycosis in the literature.
