Joshi Harshal Satish, Thomas Mathew, Warrier Anup, Kumar Suresh
Department of Internal Medicine, Kerala Institute of Medical Sciences, Trivandrum, Kerala, India.
BMJ Case Rep. 2012 Dec 18;2012:bcr2012007295. doi: 10.1136/bcr-2012-007295.
Gangrene is an uncommon complication in cases of rickettsial spotted fever. We report three cases of spotted fever from south India, presumably caused by Rickettsia conorii subspecies indica. Along with gangrene, these cases had severe manifestations of sepsis and multiorgan dysfunction syndrome (MODS) like acute kidney injury, liver dysfunction, delirium and seizure. One patient died while the other two recovered well. This case series is being reported to highlight the occurrence of gangrene in spotted fever rickettsiosis and the importance of appropriate management at the earliest.
坏疽是立克次体斑疹热病例中一种罕见的并发症。我们报告了3例来自印度南部的斑疹热病例，推测由印度康氏立克次体亚种引起。除坏疽外，这些病例还出现了严重的败血症表现和多器官功能障碍综合征（MODS），如急性肾损伤、肝功能障碍、谵妄和癫痫发作。1例患者死亡，另外2例恢复良好。报告该病例系列是为了强调斑疹热立克次体病中坏疽的发生情况以及尽早进行适当治疗的重要性。
