Licona-Enríquez Jesús David, Delgado-de la Mora Jesús, Álvarez-Hernández Gerardo
Universidad de Sonora, Departamento de Medicina y Ciencias de la Salud. Hermosillo, Sonora, México
Rev Med Inst Mex Seguro Soc. 2018 Oct 25;56(3):320-322.
Rocky Mountain spotted fever (RMSF) is a disease spread by an infected tick and it is lethal if patient is not treated on time. Symptom similarities with other exanthematous diseases may delay the diagnosis, which leads to its mortality.
We show the lethal case of a patient with medical record of high blood pressure and no history of travel, who lived in Sonora, Mexico. At the beginning, it was suspected that the patient had a dengue virus infection, which was confirmed positive by an ELISA test. Patient’s rapid deterioration, multi-organic failure and the characteristics of her exanthema led to the suspicion of the presence of RMSF. We started doxycycline treatment; however, patient died after seven days of evolution. It was confirmed a co-infection of Rickettssia spp. and dengue virus.
In rickettsial endemic zones, treatment with doxycycline should be employed in patients with similar symptoms, even though there is evidence of the presence of other etiologic agents.
落基山斑疹热(RMSF)是一种由受感染蜱虫传播的疾病,如果患者未及时接受治疗,该病会致命。与其他发疹性疾病的症状相似性可能会延误诊断,从而导致其死亡率上升。
我们展示了一名有高血压病史且无旅行史的患者的致死病例,该患者居住在墨西哥索诺拉州。起初,怀疑该患者感染了登革热病毒,酶联免疫吸附测定(ELISA)检测证实呈阳性。患者的迅速恶化、多器官衰竭以及皮疹特征引发了对落基山斑疹热的怀疑。我们开始使用强力霉素治疗;然而,患者在病程七天后死亡。确诊为立克次体属细菌和登革热病毒的合并感染。
在立克次体病流行地区,对于有类似症状的患者,即使有证据表明存在其他病原体,也应采用强力霉素进行治疗。