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2026, Number 2

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Med Crit 2026; 40 (2)

Severe Rickettsiosis with multiple organ failure in a young immunocompetent patient. Case report

Velasco-Moreno JJ, Arrambí-Díaz C, Ramírez-Campaña JC

Language: Spanish
References: 14
Page: 158-161
PDF size: 823.53 Kb.


ABSTRACT

Introduction: Rickettsia rickettsii infection is a vector-borne disease with high mortality, especially in endemic regions of northern Mexico. Early recognition and treatment are crucial, as delayed therapy is associated with poor prognosis. Our objective is to highlight the importance of early clinical recognition, the need for a therapeutic approach, and the impact of early empirical treatment on the evolution of patients with this potentially fatal infection. Clinical case: a previously healthy 36-year-old man with a 15-day history of fever, general malaise, generalized rash, and urinary symptoms. Initially managed as hemorrhagic dengue; however, he rapidly deteriorated to septic shock with neurological compromise, requiring invasive mechanical ventilation and multiple vasopressor support. Empirical treatment for rickettsiosis with doxycycline was initiated. The diagnosis was confirmed by blood PCR. Following treatment, the patient showed clinical improvement. Conclusions: this case highlights the importance of suspecting and empirically treating rickettsiosis to improve survival in severe presentations.


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