Dye Bradley V, Coba Jose Alejandro, Dayton Christopher L, Cadena Jose, Anstead Gregory M
Department of Medicine, University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA.
San Antonio Infectious Diseases Consultants, 8042 Wurzbach Road, San Antonio, TX 78229, USA.
Case Rep Infect Dis. 2024 Feb 14;2024:9914306. doi: 10.1155/2024/9914306. eCollection 2024.
Flea-borne typhus (FBT), due to and , is an infection causing fever, headache, rash, hepatitis, thrombocytopenia, and diverse organ manifestations. Cough occurs in about 30% of patients with FBT, and chest X-ray abnormalities are seen in 17%. Severe pulmonary manifestations have also been reported in FBT, including adult respiratory distress syndrome and pulmonary embolism. Because of these pulmonary manifestations, FBT can mimic Coronavirus Illness 2019 (COVID-19), a febrile illness with prominent respiratory involvement. Flea-borne typhus and COVID-19 may also have similar laboratory abnormalities, including elevated ferritin, C-reactive protein, and D-dimer. However, elevated transaminase levels, rash, and thrombocytopenia are more common in FBT. Herein, we present four cases of patients with FBT who were initially suspected to have COVID-19. These cases illustrate the problem of availability bias, in which the clinician thinks a particular common condition (COVID-19 in this case) is more prevalent than it actually is.
蚤传斑疹伤寒（FBT）由[具体病原体1]和[具体病原体2]引起，是一种可导致发热、头痛、皮疹、肝炎、血小板减少及多种器官表现的感染性疾病。约30%的FBT患者会出现咳嗽，17%的患者胸部X线有异常表现。FBT还曾有严重肺部表现的报道，包括成人呼吸窘迫综合征和肺栓塞。由于这些肺部表现，FBT可能会被误诊为2019冠状病毒病（COVID - 19），后者是一种以呼吸道受累为突出表现的发热性疾病。蚤传斑疹伤寒和COVID - 19在实验室检查中也可能有相似异常，包括铁蛋白、C反应蛋白和D - 二聚体升高。然而，转氨酶水平升高、皮疹和血小板减少在FBT中更为常见。在此，我们报告4例最初被怀疑患有COVID - 19的FBT患者。这些病例说明了可得性偏差问题，即临床医生认为某种特定的常见疾病（在本例中为COVID - 19）比实际情况更普遍。
