Emerg Infect Dis. 2018 May;24(5):835-840. doi: 10.3201/eid2405.171992.
We report a series of 5 case-patients who had Israeli spotted fever, of whom 2 had purpura fulminans and died. Four case-patients were given a diagnosis on the basis of PCR of skin biopsy specimens 3-4 days after treatment with doxycycline; 1 case-patient was given a diagnosis on the basis of seroconversion. Rickettsia spp. from the 2 case-patients who died were sequenced and identified as Rickettsia conorii subsp. israelensis. Purpura fulminans has been described in association with R. rickettsii and R. indica, but rarely with R. conorii subsp. israelensis.
我们报告了 5 例伊氏立克次体斑疹热病例，其中 2 例发生暴发性紫癜并死亡。4 例病例患者在使用强力霉素治疗 3-4 天后，通过皮肤活检标本的 PCR 检测做出诊断；1 例病例患者通过血清学转换做出诊断。从 2 例死亡病例患者中分离出的立克次体属物种被测序并鉴定为康氏立克次体亚种。暴发性紫癜已被描述与 R. rickettsii 和 R. indica 相关，但与康氏立克次体亚种相关的情况很少见。
