Galvâo Márcio Antonio Moreira, Dumler J Stephen, Mafra Cláudio Lísias, Calic Simone Berger, Chamone Chequer Buffe, Cesarino Filho Gracco, Olano Juan Pablo, Walker David H
Universidade Federal de Ouro Preto, Minas Gerais, Brazil.
Emerg Infect Dis. 2003 Nov;9(11):1402-5. doi: 10.3201/eid0911.030193.
The emergence and reemergence of a serious infectious disease are often associated with a high case-fatality rate because of misdiagnosis and inappropriate or delayed treatment. The current reemergence of spotted fever rickettsiosis caused by Rickettsia rickettsii in Brazil has resulted in a high proportion of fatal cases. We describe two familial clusters of Brazilian spotted fever in the state of Minas Gerais, involving six children 9 months to 15 years of age; five died. Immunohistochemical investigation of tissues obtained at necropsy of a child in each location, Novo Cruzeiro and Coronel Fabriciano municipalities, established the diagnosis by demonstration of disseminated endothelial infection with spotted fever group rickettsiae. The diagnosis in the two fatal cases from Coronel Fabriciano and the surviving patient from Novo Cruzeiro was further supported by immunofluorescence serologic tests.
严重传染病的出现和再次出现往往与高病死率相关，原因是误诊以及治疗不当或延误。目前巴西由立氏立克次体引起的斑点热立克次体病再次出现，导致了高比例的死亡病例。我们描述了米纳斯吉拉斯州两例巴西斑点热的家族聚集病例，涉及6名9个月至15岁的儿童；其中5人死亡。对来自新克鲁塞罗市和法布里西阿诺上校市的每个地点的一名儿童尸检时获得的组织进行免疫组织化学研究，通过证明斑点热群立克次体的弥漫性内皮感染来确诊。来自法布里西阿诺上校市的两例死亡病例和来自新克鲁塞罗市的幸存患者的诊断通过免疫荧光血清学检测得到进一步支持。
