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Fleaborne (or murine) typhus is a zoonotic disease caused by Rickettsia typhi and transmitted by bites of infected fleas found primarily on cats. Presentation includes fever, headache, rash that spares the palms and soles, hepatitis, and thrombocytopenia. More-severe illness may involve hemophagocytic lymphohistiocytosis (HLH), myocarditis, and septic shock. The pathogen is susceptible to tetracyclines; mortality is <1% in patients receiving doxycycline. In California — where fleaborne typhus is endemic — case rates have been rising since 2010, and a high of 171 cases was reported in Los Angeles County in 2022. Three infected patients died of typhus complications during June–October 2022; all were positive for R. typhi on molecular testing.…