A case of murine typhus associated with large vessel infarct of the spleen

We present a case of Rickettsia typhi infection (the causative agent of endemic typhus) associated with an isolated splenic infarction. Large vessel infarction is a rare complication of murine typhus, unlike infections caused by Rickettsia rickettsii and Rickettsia conorii (the spotted fever group rickettsias) which are known to cause hemostatic changes that lead to coagulopathies and thrombotic events. This case adds to the scarce data in the literature on the association between large vessels infarction and endemic typhus and also highlights the importance of considering rickettsial infection in the differential diagnosis in the appropriate clinical settings.