[Rickettsiosis of the typhus fever type. Its joint appearance with a left-ventricular thrombus and single-vessel coronary disease].
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.
Sitzler
G
G
Klinik III für Innere Medizin, Universität Köln.
Winter
U J
UJ
Peters
G
G
Gheorghiu
T
T
Hilger
H H
HH
D000328:Adult; D003131:Combined Modality Therapy; D003327:Coronary Disease / Q000175:diagnosis* / Q000628:therapy; D003937:Diagnosis, Differential; D004359:Drug Therapy, Combination; D005076:Exanthema / Q000175:diagnosis / Q000188:drug therapy; D005858:Germany / Q000208:ethnology; D006331:Heart Diseases / Q000175:diagnosis* / Q000628:therapy; D006352:Heart Ventricles; D006801:Humans; D008002:Libya; D008297:Male; D013927:Thrombosis / Q000175:diagnosis* / Q000628:therapy; D014438:Typhus, Epidemic Louse-Borne / Q000175:diagnosis* / Q000188:drug therapy
Rickettsiose vom Fleckfiebertyp. Gemeinsames Auftreten mit einem linksventrikulären Thrombus und einer koronaren Ein-Gefäss-Krankheit.