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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.<\/jats:p>","DOI":"10.1155\/2024\/9914306","type":"journal-article","created":{"date-parts":[[2024,2,14]],"date-time":"2024-02-14T17:50:09Z","timestamp":1707933009000},"page":"1-9","source":"Crossref","is-referenced-by-count":3,"title":["Flea-Borne Typhus as a COVID-19 Mimic: A Report of Four Cases"],"prefix":"10.1155","volume":"2024","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-8501-3546","authenticated-orcid":true,"given":"Bradley V.","family":"Dye","sequence":"first","affiliation":[{"name":"Department of Medicine, University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-9378-8217","authenticated-orcid":true,"given":"Jose Alejandro","family":"Coba","sequence":"additional","affiliation":[{"name":"San Antonio Infectious Diseases Consultants, 8042 Wurzbach Road, San Antonio, TX 78229, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3407-0213","authenticated-orcid":true,"given":"Christopher L.","family":"Dayton","sequence":"additional","affiliation":[{"name":"Division of Pulmonary Diseases and Critical Care, Department of Medicine, University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA"},{"name":"Department of Emergency Medicine, University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-8167-4376","authenticated-orcid":true,"given":"Jose","family":"Cadena","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA"},{"name":"Division of Infectious Diseases, Medical Service, South Texas Veterans Health Care System, San Antonio, TX 78229, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5473-9375","authenticated-orcid":true,"given":"Gregory M.","family":"Anstead","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA"},{"name":"Division of Infectious Diseases, Medical Service, South Texas Veterans Health Care System, San Antonio, TX 78229, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","reference":[{"key":"1","doi-asserted-by":"publisher","DOI":"10.1186\/s13071-016-1511-8"},{"key":"2","doi-asserted-by":"publisher","DOI":"10.3390\/tropicalmed6010002"},{"key":"3","first-page":"19","article-title":"A One Health perspective on the resurgence of flea-borne typhus in Texas in an era of climate change and human population growth","volume":"90","author":"G. 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