Acta Pediátrica de México

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>Journals >Acta Pediátrica de México >Year 2018, Issue 4

Delgado MJ, Licona EJD, Candia-Plata MC, Álvarez HG
Discussion of prognostic factors in two familial cases of Rocky Mountain spotted fever
Acta Pediatr Mex 2018; 39 (4)

Language: Español
References: 18
Page: 323-327
PDF: 423.34 Kb.

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Background: Rocky Mountain spotted fever is a public health problem in Mexico, with high regional case fatality rates. Little is known regarding prognostic factors such as nutritional and immunological condition, as well as bacterial inoculum.
Clinical cases: We report the cases of two siblings: a male of 9 (case 1) and a 10-yearold girl (case 2), from an urban location in southern Sonora, Mexico, with no heredofamilial or pathological history of relevance to the current condition. His diet included all the food groups, three times a day. They reported a history of contact with ticks, inside and outside their home, and living with ectoparasitized dogs with them. Both started with a similar clinical picture (fever, malaise and rash). Doxycycline was prescribed with the same scheme and day of evolution; however, one of the patients died and the other improved clinically, without apparent sequelae. According to clinical findings or laboratory tests, the diagnosis of Rocky Mountain Spotted Fever was established.
Conclusions: It is possible that the difference on the prognosis of some patients it is related to nutritional and immunological status, as well as to the magnitude of bacterial inoculum. Future research is necessary to examine the role of such factors in the prognosis of patients with Rocky Mountain spotted fever.

Key words: Rickettsia rickettsii, Tick-borne diseases, Prognosis.


  1. Biggs HM, Barton C, Bradley KK, Dahlgren FS, Drexler NA, Dumler JS, et al. Diagnosis and management of tick borne rickettsial diseases: Rocky Mountain spotted fever and other spotted fever group rickettsiosis, ehrlichiosis and anaplasmosis – United States. MMWR Recomm Rep 2016;65(2):1-44.

  2. Delgado-de la Mora J, Licona-Enríquez JD, Leyva-Gastélum M, Delgado-de la Mora D, Rascón-Alcantar A, Álvarez- Hernández G. Una serie fatal de casos de fiebre manchada de las Montañas Rocosas en Sonora, México. Biomédica 2018;38(1). DOI: http://dx.doi.org/10.7705/biomedica. v38i0.3507

  3. Ricketts HT. Some aspects of Rocky Mountain spotted fever as shown by recent investigations. 1909. Rev Infect Dis 1991;13(6):1227-40.

  4. Bustamante ME, Varela G. Características de la fiebre manchada de las Montañas Rocosas en Sonora y Sinaloa, México. Rev Inst Salub Enf Trop1944;5:129-136.

  5. Alvarez-Hernandez G, Murillo-Benitez C, Candia-Plata MC, Moro M. Clinical profile and predictors of fatal Rocky Mountain spotted fever in children from Sonora, Mexico. Pediatr Infect Dis J 2015;34(2):125-30.

  6. Raoult D, Parola P. Rocky mountain spotted fever in the USA: a benign disease or a common diagnostic error? Lancet Infect Dis 2008;8(10):587-9.

  7. Kirkland KB, Wilkinson WE, Sexton DJ. Therapeutic delay and mortality in cases of Rocky Mountain spotted fever. Clin Infect Dis 1995;20(5):1118-21.

  8. Dalton MJ, Clarke MJ, Holman RC, Krebs JW, Fishbein DB, Olson JG, et al. National surveillance for rocky mountain spotted fever, 1981-1992: epidemiologic summary and evaluation of risk factors for fatal outcome. Am J Trop Med Hyg 1995;52(5):405-13.

  9. Parola P, Socolovschi C, Jeanjean L, Bitam I, Fournier PE, Sotto A, et al. Warmer weather linked to tick attack and emergence of severe Rickettsioses. PLoS Negl Trop Dis 2008;2(11):e338.

  10. Clark TR, Noriea NF, Bublitz DC, Ellison DW, Martens C, Lutter EI, et al. Comparative genome sequencing of Rickettsia rickettsii strains that differ in virulence. Infect Immun 2015;83(4):1568-76.

  11. Walker DH, Hawkins HK, Hudson P. Fulminant Rocky Mountain spotted fever. Its pathologic characteristics associated with glucose-6-phosphate dehydrogenase deficiency. Arch Pathol Lab Med 1983;107(3):121-5.

  12. DuPont HL, Hornick RB, Dawkins AT, Heiner GG, Fabrikant IB, Wisseman CL, et al. Rocky Mountain spotted fever: a comparative study of the active immunity induced by inactivated and viable pathogenic Rickettsia rickettsii. J Infect Dis 1973;128:340-44.

  13. Raoult D, Paddock CD. Rickettsia parkeri infection and other spotted fever in the United States. N Engl J Med 2005;353(6):626-27.

  14. Secretaría de Salud. Prevención, diagnóstico y tratamiento de la fiebre manchada por Rickettsia rickettsii en población pediátrica y adulta, en el primer y segundo nivel de atención. México. 2013. [en línea]. Dirección URL: .

  15. Moncayo AC, Cohen SB, Fritzen CM, Huang E, Yabsley MJ, Freye JD, et al. Absence of Rickettsia rickettsii and occurrence of other spotted fever group Rickettsioses in ticks from Tennessee. Am J Trop Med Hyg 2010;83(3):653-57.

  16. Woods ME, Olano JP. Host defenses to Rickettsia rickettsii infection contribute to increased microvascular permeability in human cerebral endothelial cells. J Clin Immunol 2008;28(2):174-85.

  17. Medzhitov R. Recognition of microorganisms and activation of the immune response. Nature 2007;449(7164):819-26.

  18. Katona P, Katona-Apte J. The interaction between nutrition and infection. Clin Infect Dis 2008;46(10):1582-88.

>Journals >Acta Pediátrica de México >Year 2018, Issue 4

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