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KMID : 0882420130840050723
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Korean Journal of Medicine
2013 Volume.84 No. 5 p.723 ~ p.727
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Delayed-Onset Complete Atrioventricular Block in a Patient with Murine Typhus Myocarditis
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Kim Bo-Sung
Kim Su-Young
Han Seung-Hee
Park He-Kyung
Lee Dong-Hyun
Park Jong-Sung
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Abstract
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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.
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KEYWORD
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Rickettsia typhi, Myocarditis, Atrioventricular block
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