2016, Number 6
<< Back Next >>
Gac Med Mex 2016; 152 (6)
Complications and cause of death in mexican children with rocky mountain spotted fever
Martínez-Medina MÁ, Rascón-Alcantar A
Language: Spanish
References: 29
Page: 789-795
PDF size: 247.21 Kb.
ABSTRACT
Background: Rocky Mountain spotted fever is a life threatening disease caused by Rickettsia rickettsia, characterized by
multisystem involvement.
Methods: We studied 19 dead children with Rocky Mountain spotted fever. All children who were
suspected of having rickettsial infections were defined as having Rocky Mountain spotted fever by serology test and clinical
features. Through the analysis of each case, we identified the clinical profile and complications associated to the death of a
patient.
Results: In nine (69.2%) of 13 cases that died in the first three days of admission, the associated condition was
septic shock. Others complications included respiratory distress causes by non-cardiogenic pulmonary edema, renal impairment,
and multiple organ damage.
Conclusions: The main cause of death in this study was septic shock. The fatality rate
from Rocky Mountain spotted fever can be related to the severity of the infection, delay in diagnosis, and delay in initiation
of antibiotic therapy. Pulmonary edema and cerebral edema can be usually precipitated by administration of excess intravenous
fluids.
REFERENCES
Feigin RD, Zinder RL, Edwards MS. Rickettsial diseases. En: Feigin RD, Cherry JD. Textbook of Pediatric Infectious Diseases. 3.a ed. Filadelfia: WB Saunders Co.; 1992. p. 1847-53.
Mariotte CD, Bustamante ME. Hallazgo del Rhipicephalus sanguineus infectado naturalmente con fiebre manchada en Sonora (México). Rev Inst Salud Enf Trop. 1944;5:297-330.
Martínez-Medina MA, Padilla-Zamudio G, Solís-Gallardo LP, Guevara-Tovar M. Fiebre manchada de las Montañas Rocosas: reporte de dos casos. Gac Med Mex. 2005;141(4):309-12.
Martínez MM, Álvarez HG, Padilla ZG, Rojas GM. Fiebre manchada de las Montañas Rocosas: consideraciones clínicas y epidemiológicas. Gac Med Mex. 2007;143:137-40.
Álvarez-Hernández G. La fiebre manchada de las Montañas Rocosas, una epidemia olvidada. Salud Publica Mex. 2010;52(1):1-3.
Openshaw JJ, Smerdlow DL, Krebs JW, et al. Rocky Mountain spotted fever in the United States-2007: interpreting contemporary increases in incidence. Am J Trop Med Hyg. 2010;83:174-82.
Alvarez Hernández G, Contreras Soto. Letalidad por fiebre manchada por Rickettsia rickettsii en pacientes de un hospital pediátrico del Estado de Sonora, 2004-2012. Salud Publica Mex. 2013; 55(2):151-2.
Kirkland KB, Wilkinson WE, Sexton DJ, Therapeutic delay and mortality in cases of Rocky Mountain spotted fever. Clin Infect Dis. 1995;20:1118-21.
Hand WL, Miller JB, Reinarz JA, Sanford JP. Rocky Mountain spotted fever. A vascular disease. Arch Intern Med. 1970;125(5):879-82.
Samuels LA, Newell KL. Case 32-1997-a 43 year old woman with rapidly changing pulmonary infiltrates and markedly increased intracranial pressure. N Engl J Med. 1997;337:1149-56.
Walker DH. Rickettsiae and rickettsial infections: the current state of knowledge. Clin Infect Dis. 2007;45(Suppl 1):s39-44.
Chen LF, Sexton DJ. What’s New in Rocky Mountain spotted fever? Infect Dis Clin N Am. 2008;22:415-32.
Centers for Disease Control and Prevention. Laboratory detection of Rocky Mountain spotted fever. [Internet] Disponible en: http:// www.cdc. gov/ncidod/dvrd/rmsf.
Walker DH, Paddock CD. Fatal Rocky Mountain spotted fever in a 2-yearold child. Pathology Case Reviews. 2011;16:238-41.
Goldstein B, Giroir B, Randolph A. International pediatric sepsis consensus conference: definitions for sepsis and organ dysfunction in pediatrics. Pediatr Crit Care. 2005;6:2-8.
Walker DH, Ismail D. Emerging and re-emerging rickettsioses: endothelial cell infection and early disease events. Nat Rev Microbiol. 2008;6: 375-86.
Cunha BA. Clinical features of Rocky Mountain spotted fever. Lancet. 2008;8:143-4.
Buckingham SC, Marshall GS, Schutze GE, Woods CR, Jackson MA, Patterson LE. Clinical and laboratory features, hospital course, and outcome of Rocky Mountain spotted fever in children. J Pediatr. 2007; 150:180-4.
Dahlgren SF, Holman RC, Paddock CD, Callinan LS, McQuiston JH. Fatal Rocky Mountain spotted fever in the United States, 199-2007. Am J Trop Med Hyg. 2012;86:713-9.
Wynn J, Cornell TT, Wong HR, Shanley TP, Wheeler DS. The host response to sepsis and developmental impact. Pediatrics. 2010;125: 1031-41.
Walker DH, Olano JP, Feng HN. Critical role of cytotoxic T lymphocytes in immune clearance of rickettsial infection. Infect Inmmun. 2001;69: 1841-6.
Walker DH, Crawford CG, Cain BG. Rickettsial infection of the pulmonary microcirculation: basis for interstitial of the pneumonitis in Rocky Mountain spotted fever. Human Pathol. 1980;11:263-72.
Liu CT, Hilmas DE, Griffin MJ, Pedersen CE, Haddick CL, Beisbel WR. Alterations of body fluid compartments and distribution of tissue water and electrolytes in Rhesus monkeys wit Rocky Mountain spotted fever. J Infect Dis. 1978;138:42-8.
Feltes TF, Wilcox WD, Feldman WE. M-mode echocardiographic abnormalities in Rocky Mountain spotted fever. South Med J. 1984;77:1130-2.
Marin JG. Left ventricular dysfunction in Rocky Mountain spotted fever. Clin Cardiol. 1983;6:501-6.
Kumar K, Krishnamurthy S, Delhikumar CG, Narayanan P, Biswal N, Srinivasan S. Scrub typhus in children al a tertiary hospital in southern India: clinical profile and complications. J Infect Public Health. 2012;5:82-8.
Ceneviva G, Paschall JA, Maffei F, Carcillo JA. Hemodinamic support in fluid refractory pediatric septic shock. Pediatrics. 1998;102:1-6.
Conlon PJ, Procop WG, Fowler V, Eloubeidi MA, Smith SR, Sexton DJ. Predictors of prognosis and risk of acute renal failure in patients with Rocky Mountain spotted fever. Am J Med. 1996;101:621-6.
Villagómez AJ, Guzmán RG, Méndez RR, Cabrera AR, Marín AR. Terapia nutricional en sepsis. En: Carrillo Espere R, ed. Sepsis. Academia Mexicana de Cirugía. México: Editorial Alfil; 2010. p. 369-78.