The pathology of fatal Mediterranean spotted fever

[EN]A 77-year-old woman from rural Spain had a febrile summertime disease develop with rash, eschar, and pulmonary, abdominal, and neurologic signs and symptoms. Mediterranean spotted fever (MSF) was diagnosed late in the course, and antirickettsial treatment was given only during the last 30 hours...

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Detalles Bibliográficos
Autores: Walker, David H., Herrero Herrero, José Ignacio, Ruiz Beltrán, R., Bullón Sopelana, A., Ramos Hidalgo, Almudena
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:1987
País:España
Institución:Universidad de Salamanca (USAL)
Repositorio:GREDOS. Repositorio Institucional de la Universidad de Salamanca
OAI Identifier:oai:gredos.usal.es:10366/169168
Acceso en línea:http://hdl.handle.net/10366/169168
Access Level:acceso embargado
Palabra clave:Mediterranean spotted fever
Rickettsia conorii infection
Pathology
Boutonneuse fever
Aged
Vasculitis
Boutonneuse Fever
Humans
Thrombosis
32 Ciencias Médicas
humanos
anciano
fiebre botonosa
trombosis
vasculitis
Descripción
Sumario:[EN]A 77-year-old woman from rural Spain had a febrile summertime disease develop with rash, eschar, and pulmonary, abdominal, and neurologic signs and symptoms. Mediterranean spotted fever (MSF) was diagnosed late in the course, and antirickettsial treatment was given only during the last 30 hours of life. Clinical manifestations of severe disseminated vascular injury included thrombocytopenia, hypoalbuminemia, edema of the lungs and legs, and severe prerenal azotemia. The diagnosis was documented by specific serology. Necropsy revealed vascular injury with perivascular lymphohistiocytic infiltrates suggestive of rickettsiosis in the central nervous system, lung, heart, kidneys, esophagus, stomach, colon, pancreas, spleen, and thyroid. Gastric hemorrhage and acute pneumonia contributed to the patient's death on day 18 of illness. Antimicrobial treatment and host defenses apparently reduced rickettsiae to an undetectable quantity. MSF has increased in incidence in the Mediterranean basin and has been reported in travelers returning to the United States.