We report an inpatient case of flea-borne typhus (FBT) and normal pressure hydrocephalus in a 75-year-old male patient with a prior diagnosis of mixed Alzheimer and vascular dementia, who presented with acute onset of altered mental status, behavioral changes, Parkinsonism symptoms, and abnormal physical exam findings. Throughout his 11 day hospitalization, the patient demonstrated mixed hyperactive/hypoactive delirium in addition to his baseline dementia, resulting in a complex and unique presentation of FBT in a geriatric patient. The patient was treated with doxycycline, and his physical and cognitive symptoms improved over the course of his hospitalization.
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