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[Rickettsiosis of the typhus fever type. Its joint appearance with a left-ventricular thrombus and single-vessel coronary disease].

Abstract
A 44-year-old German fell ill in Libya, where he had been living for 10 years, with high fever, rigor and a nonitching centrifugally spreading macular rash, which had spared the head, hands and soles. In addition, a systolic cardiac murmur was heard. The Weil-Felix reaction had a titre rising within 3 days from 1:160 to 1:640, confirming the diagnosis of rickettsial disease, the total clinical picture indicating typhus. On treatment with chloramphenicol (1 g three times daily i.v.) the fever subsided within 5 days. On the ninth day treatment was changed to oral doxycyclin, 200 mg daily for 3 weeks. Echocardiography surprisingly revealed a floating thrombus, about 4 x 8 cm, attached to the hypo- and even akinetic apex of the left ventricle. In addition there was single-vessel coronary disease. Since the segmental contraction abnormality persisted after the typhus had been cured, a causal connection with the rickettsial disease is unlikely. The thrombus was removed at the time of a aortocoronary bypass operation: his course has been unremarkable since then.
AuthorsG Sitzler, U J Winter, G Peters, T Gheorghiu, H H Hilger
JournalDeutsche medizinische Wochenschrift (1946) (Dtsch Med Wochenschr) Vol. 119 Issue 12 Pg. 418-22 (Mar 25 1994) ISSN: 0012-0472 [Print] Germany
Vernacular TitleRickettsiose vom Fleckfiebertyp. Gemeinsames Auftreten mit einem linksventrikulären Thrombus und einer koronaren Ein-Gefäss-Krankheit.
PMID8143556 (Publication Type: Case Reports, English Abstract, Journal Article, Review)
Topics
  • Adult
  • Combined Modality Therapy
  • Coronary Disease (diagnosis, therapy)
  • Diagnosis, Differential
  • Drug Therapy, Combination
  • Exanthema (diagnosis, drug therapy)
  • Germany (ethnology)
  • Heart Diseases (diagnosis, therapy)
  • Heart Ventricles
  • Humans
  • Libya
  • Male
  • Thrombosis (diagnosis, therapy)
  • Typhus, Epidemic Louse-Borne (diagnosis, drug therapy)

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