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2008, Number 85

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Rev Enfer Infec Pediatr 2008; 21.22 (85)

Rocky Mountain spotted fever in children A clinical review of 115 case series

De Lara HJ, Cárdenas BR

Language: Spanish
References: 24
Page: 4-9
PDF size: 234.49 Kb.


ABSTRACT

Objectives: To present the clinical and laboratory findings in children with Rocky Mountain spotted fever as well as its treatment, which should be initiated at the earliest stage of the evolution of disease and thus be able to reduce the high mortality. In addition, to institute preventive measures to reduce the number of cases in the region of the Comarca Lagunera.
Materials and methods: A study of clinical research, prospective cross, with 115 cases of Rocky Mountain spotted fever in children treated at the Torreon, Coahuila University Children’s Hospital, in a period of 32 years (1975-2007) in Comarca Lagunera, one of the few areas of endemic disease in Mexico.
Results: Ages of patients ranged from two to 17 years, being more common in children under five years, with 34%. With regard to gender, there was female predominance (53%). The main symptoms were fever and rash (100%) and headache and myalgia (70%). Among the hematological disorders were found: leukocytosis, plaquetopenia, and elongated both prothrombin time (PT) and partial thromboplastin time (PTT). The agglutination test for Proteus 0x19 was conducted in 86% of patients, with positive result in 88% and negative in 12%. Living with dogs was found in 90% of patients. The most widely used treatment was with chloramphenicol, tetracycline (67%) and heparin (42%). Mortality was 55%.
Conclusions: This condition is most common in children under five years, contrary to data found in other studies. The clinical signs that were presented in all cases were fever and rash. Agglutination tests were positive in only 88% of cases. Poor prognosis data were thrombocytopenia, alteration of TP and PTT and neurological disorders. Mortality was high (over 50%), especially in cases where treatment was initiated after the sixth day of evolution. Preventive measures for the absolute control of the tick are the ideal way to eliminate this disease in endemic areas.


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