Torres RPB, Gutiérrez CDM, Cortés EOD, Raya GLP, Alvarado VLB

Language: Spanish
References: 12
Page: 19-25
PDF size: 274.01 Kb.

ABSTRACT

Introduction: Rocky Mountain spotted fever (RMSF) is an infectious disease caused by the etiologic agent Rickettsia rickettsii and transmitted primarily through tick bites. Objective: to describe the clinical presentation of patients with RMSF in a second level care hospital. Material and methods: observational study of a series of confirmed cases of RMSF. The clinical-epidemiological characteristics, laboratory findings, complications and outcome were analyzed, as well as an inferential analysis of the different symptoms and complications and the outcome of the patients. Results: eight patients with RMSF were reported. The clinical picture of the patients included fever in 100%, exanthema in 87%, as well as convulsive crises, nausea and vomiting in 75%. All patients developed septic shock, of which six (75%) died. The elevation of azotemia at clinical presentation was significantly associated with a fatal outcome. Conclusion: the presence of fever and exanthema in pediatric patients should raise the diagnostic suspicion of Rickettsia infection, and medical treatment should be immediate if there is a significant diagnostic suspicion.

REFERENCES

1. Drexler N, Miller M, Gerding J, Todd S, Adams L, Dahlgren FS et al. Community-based control of the brown dog tick in a region with high rates of Rocky Mountain spotted fever, 2012–2013. PLoS One. 2014; 9 (12): e112368.

2. Dirección General de Epidemiología. Boletín Epidemiológico Semana 52 2022. Secretaria de Salud; 2022. https://www.gob.mx/salud/acciones-y-programas/direccion-general-de-epidemiologia-boletin-epidemiologico

3. Walker DH, Blanton LS. Rickettsia rickettsii and other spotted fever group Rickettsiae (Rocky Mountain Spotted Fever and Other Spotted Fevers). Elsevier; 2014.

4. Álvarez-Hernández G, Roldán JFG, Milan NSH, Lash RR, Behravesh CB, Paddock CD. Rocky Mountain spotted fever in Mexico: past, present, and future. Lancet Infect Dis. 2017; 17 (6): e189-e196.

5. Manual de Procedimientos Estandarizados para la Vigilancia Epidemiológica de las Enfermedades Transmitidas por Vectores. Dirección General de Epidemiología. 2020.

6. Buckingham SC, Marshall GS, Schutze GE, Woods CR, Jackson MA, Patterson LER et al. Clinical and laboratory features, hospital course, and outcome of Rocky Mountain spotted fever in children. J Pediatr. 2007; 150 (2): 180-184, 184.e1.

7. AAP Committee on Infectious Diseases. Red book (2012): Report of the committee on infectious diseases. Pickering LK, Baker CJ, Kimberlin DW, editores. American Academy of Pediatrics; 2012.

8. Regan JJ, Traeger MS, Humpherys D, Mahoney DL, Martinez M, Emerson GL et al. Risk factors for fatal outcome from Rocky Mountain Spotted Fever in a highly endemic area-Arizona, 2002-2011. Clin Infect Dis. 2015; 60 (11): 1659-1666.

9. Drexler NA, Yaglom H, Casal M, Fierro M, Kriner P, Murphy B et al. Fatal Rocky Mountain spotted fever along the United States-Mexico border, 2013–2016. Emerg Infect Dis. 2017; 23 (10): 1621-1626.

10. Santamaría-Arza C, Reyes-Gómez U, Reyes-Hernández K, López-Cruz G, Lópezdías A, Reyes- Hernández D et al. Rickettsiosis conceptos básicos. Sal Jal. 2018; 5 (2): 113-121.

11. López-Castillo DC, Vaquera-Aparicio D, González-Soto MA, Martínez-Ramírez R, Rodríguez-Muñoz L, Solórzano-Santos F. Fiebre manchada de montañas rocosas: experiencia en 5 años de vigilancia activa en un hospital pediátrico de segundo nivel en el noreste de México. Bol Med Hosp Infant Mex. 2019; 75(5): 303-308.

12. Blanton LS. The Rickettsioses: a practical update. Infect Dis Clin North Am. 2019; 33 (1): 213-229.