Acute Renal Failure in Rocky Mountain Spotted Fever

David H. Walker, William D. Mattern

Research output: Contribution to journalArticle

48 Scopus citations

Abstract

Review of clinical and pathologic data from ten fatal cases of Rocky Mountain spotted fever (RMSF) revealed the importance of acute renal failure in the clinical course and of multifocal perivascular interstitial nephritis as the principal pathologic lesion. In nine cases, Rickettsia rickettsii were demonstrated by immunofluorescence in the areas of vasculitis. Evidence was lacking for the role of disseminated intravascular coagulation, glomerulonephritis, or myoglobinuria in the pathogenesis of acute renal failure in these cases. Rickettsia-induced vascular injury led to acute renal failure by several mechanisms. Hypovolemia early in the course resulted in reversible, prerenal azotemia. Transient hypotension in midcourse produced acute tubular necrosis. In fulminant cases, preterminal circulatory collapse was associated with coma and oliguria. The interstitial nephritis could not be demonstrated conclusively to contribute to the acute renal failure.

Original languageEnglish (US)
Pages (from-to)443-448
Number of pages6
JournalArchives of Internal Medicine
Volume139
Issue number4
DOIs
StatePublished - Apr 1979
Externally publishedYes

ASJC Scopus subject areas

  • Internal Medicine

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