Delayed-Onset Complete Atrioventricular Block in a Patient with Murine Typhus Myocarditis.
- Author:
Bo Sung KIM
1
;
Su Young KIM
;
Seung Hee HAN
;
He Kyung PARK
;
Dong Hyun LEE
;
Jong Sung PARK
Author Information
1. Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea. thinkmed@dau.ac.kr
- Publication Type:Case Report
- Keywords:
Rickettsia typhi;
Myocarditis;
Atrioventricular block
- MeSH:
Atrioventricular Block;
Bundle-Branch Block;
Communicable Diseases;
Convalescence;
Doxycycline;
Dyspnea;
Female;
Fever;
Humans;
Magnetic Resonance Imaging;
Myocarditis;
Rickettsia typhi;
Syncope;
Troponin I;
Typhus, Endemic Flea-Borne;
United Nations
- From:Korean Journal of Medicine
2013;84(5):723-727
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Murine typhus is a flea-borne infectious disease caused by Rickettsia typhi, of which myocarditis is a rare complication in the acute disseminating phase. A 62-year-old female presented with a fever and was diagnosed with murine typhus. She was treated with doxycycline and discharged after complete resolution of the fever. However, recurrent presyncope and exertional dyspnea developed 6-8 weeks later. Complete atrioventricular (AV) block with a wide QRS escape rhythm and a left bundle branch block configuration was documented. Subacute myocarditis was diagnosed based on persistent cardiac troponin-I elevation and typical cardiac magnetic resonance imaging findings. A permanent pacemaker was implanted for symptomatic complete AV block. Few reports of myocarditis in murine typhus have been published. We report a case of murine typhus myocarditis complicated by complete AV block in the late convalescence phase.
