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2009, Number 6

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Rev Mex Pediatr 2009; 76 (6)

Rocky Mountain spotted fever in children. Report of 18 cases

Gómez RN, Álvarez HG, García ZMG, Fonseca CI, Cano RMA, Villalobos GL, Vázquez PE, Pérez MGD

Language: Spanish
References: 31
Page: 245-250
PDF size: 108.95 Kb.


ABSTRACT

Objectives. To describe the clinical and laboratory findings of children with RMSF. Material and methods. The clinical files of 18 children were revised to obtain data about the clinical findings and laboratory results, time of treatment onset, complications, clinical follow-up and the risk of mortality. To establish a relationship between treatment onset time and survival rates, by statistic logistic regression analysis, selecting two groups: group one (G1) with 12 cases who survived and group two (G2) with six in the group two (G2) with those who died. Results. The lethality rate was of 33.3% (6/18). In both groups (1 and 2) the clinical characteristics at the start of the disease were similar. Group 2 patients, all of them presented; abdominal pain, encephalitis, vasculitis, pneumonitis that required mechanical ventilation (via orotracheal cannulation), hepatomegaly, septic shock and multiple organ failure. The logistic regression analysis showed that there is a significant relationship (p = 0.0023) between the time of treatment onset and patient survival rate (R2 = 0.45). Conclusions. It seems that the common dog ticks as a vector in the transmission of Rickettsia rickettsii to humans is now very concerning. This research shows the importance of early clinical suspect of RMSF because after there is a high fatality rate, specifically beyond 9 days after the start of symptoms; so if treatment onset is before 9 days of clinical symptoms becomes highly favorable showing greater survival rates.


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