Fatal viscerotropic Rocky Mountain spotted fever. Report of a case diagnosed by immunofluorescence

William R. Green, David Walker, Barbara G. Cain

Research output: Contribution to journalArticle

35 Citations (Scopus)

Abstract

A case of fatal viscerotropic Rocky Mountain spotted fever with virtual absence of cutaneous lesions was diagnosed at autopsy by specific immunofluorescent demonstration of Rickettsia rickettsii in spleen, kidney, epididymis and skin. The clinical presentation was that of insidious onset of fever, renal failure, hypotension, hyponatremia and obtundation over a 10 day period. The patient had respiratory insufficiency, hypocalcemia, increases in creatinine phosphokinase (CPK), serum glutamic oxaioacetic transaminase (SGOT), serum glutamic pyruvic transaminase (SGPT), lactic dehydrogenase (LDH), alkaline phosphatase, bilirubin and serum phosphate, grand mal seizure, myalgia and unremitting shock with death occurring on day 12 of illness. Postmortem examination revealed severe vasculitis with interstitial nephritis and multifocal tubular necrosis, pericholangitis with bile stasis, glial nodules in the brain, multifocal rhabdomyonecrosis, interstitial pneumonitis and mild interstitial myocarditis. Risk factors which this patient shared with other patients with fatal Rocky Mountain spotted fever were failure to recognize a rash, failure to obtain a tick bite history, male sex, black race and age greater than 30 years.

Original languageEnglish (US)
Pages (from-to)523-528
Number of pages6
JournalThe American Journal of Medicine
Volume64
Issue number3
DOIs
StatePublished - 1978
Externally publishedYes

Fingerprint

Rocky Mountain Spotted Fever
Fluorescent Antibody Technique
Autopsy
Rickettsia rickettsii
Serum
Tick Bites
Interstitial Nephritis
Skin
Sick Leave
Hypocalcemia
Hyponatremia
Epididymis
Myalgia
Interstitial Lung Diseases
Myocarditis
Vasculitis
Transaminases
Exanthema
Alanine Transaminase
Bile

ASJC Scopus subject areas

  • Nursing(all)

Cite this

Fatal viscerotropic Rocky Mountain spotted fever. Report of a case diagnosed by immunofluorescence. / Green, William R.; Walker, David; Cain, Barbara G.

In: The American Journal of Medicine, Vol. 64, No. 3, 1978, p. 523-528.

Research output: Contribution to journalArticle

@article{b3746e190e1547e287d5114c28eaf7a9,
title = "Fatal viscerotropic Rocky Mountain spotted fever. Report of a case diagnosed by immunofluorescence",
abstract = "A case of fatal viscerotropic Rocky Mountain spotted fever with virtual absence of cutaneous lesions was diagnosed at autopsy by specific immunofluorescent demonstration of Rickettsia rickettsii in spleen, kidney, epididymis and skin. The clinical presentation was that of insidious onset of fever, renal failure, hypotension, hyponatremia and obtundation over a 10 day period. The patient had respiratory insufficiency, hypocalcemia, increases in creatinine phosphokinase (CPK), serum glutamic oxaioacetic transaminase (SGOT), serum glutamic pyruvic transaminase (SGPT), lactic dehydrogenase (LDH), alkaline phosphatase, bilirubin and serum phosphate, grand mal seizure, myalgia and unremitting shock with death occurring on day 12 of illness. Postmortem examination revealed severe vasculitis with interstitial nephritis and multifocal tubular necrosis, pericholangitis with bile stasis, glial nodules in the brain, multifocal rhabdomyonecrosis, interstitial pneumonitis and mild interstitial myocarditis. Risk factors which this patient shared with other patients with fatal Rocky Mountain spotted fever were failure to recognize a rash, failure to obtain a tick bite history, male sex, black race and age greater than 30 years.",
author = "Green, {William R.} and David Walker and Cain, {Barbara G.}",
year = "1978",
doi = "10.1016/0002-9343(78)90247-4",
language = "English (US)",
volume = "64",
pages = "523--528",
journal = "American Journal of Medicine",
issn = "0002-9343",
publisher = "Elsevier Inc.",
number = "3",

}

TY - JOUR

T1 - Fatal viscerotropic Rocky Mountain spotted fever. Report of a case diagnosed by immunofluorescence

AU - Green, William R.

AU - Walker, David

AU - Cain, Barbara G.

PY - 1978

Y1 - 1978

N2 - A case of fatal viscerotropic Rocky Mountain spotted fever with virtual absence of cutaneous lesions was diagnosed at autopsy by specific immunofluorescent demonstration of Rickettsia rickettsii in spleen, kidney, epididymis and skin. The clinical presentation was that of insidious onset of fever, renal failure, hypotension, hyponatremia and obtundation over a 10 day period. The patient had respiratory insufficiency, hypocalcemia, increases in creatinine phosphokinase (CPK), serum glutamic oxaioacetic transaminase (SGOT), serum glutamic pyruvic transaminase (SGPT), lactic dehydrogenase (LDH), alkaline phosphatase, bilirubin and serum phosphate, grand mal seizure, myalgia and unremitting shock with death occurring on day 12 of illness. Postmortem examination revealed severe vasculitis with interstitial nephritis and multifocal tubular necrosis, pericholangitis with bile stasis, glial nodules in the brain, multifocal rhabdomyonecrosis, interstitial pneumonitis and mild interstitial myocarditis. Risk factors which this patient shared with other patients with fatal Rocky Mountain spotted fever were failure to recognize a rash, failure to obtain a tick bite history, male sex, black race and age greater than 30 years.

AB - A case of fatal viscerotropic Rocky Mountain spotted fever with virtual absence of cutaneous lesions was diagnosed at autopsy by specific immunofluorescent demonstration of Rickettsia rickettsii in spleen, kidney, epididymis and skin. The clinical presentation was that of insidious onset of fever, renal failure, hypotension, hyponatremia and obtundation over a 10 day period. The patient had respiratory insufficiency, hypocalcemia, increases in creatinine phosphokinase (CPK), serum glutamic oxaioacetic transaminase (SGOT), serum glutamic pyruvic transaminase (SGPT), lactic dehydrogenase (LDH), alkaline phosphatase, bilirubin and serum phosphate, grand mal seizure, myalgia and unremitting shock with death occurring on day 12 of illness. Postmortem examination revealed severe vasculitis with interstitial nephritis and multifocal tubular necrosis, pericholangitis with bile stasis, glial nodules in the brain, multifocal rhabdomyonecrosis, interstitial pneumonitis and mild interstitial myocarditis. Risk factors which this patient shared with other patients with fatal Rocky Mountain spotted fever were failure to recognize a rash, failure to obtain a tick bite history, male sex, black race and age greater than 30 years.

UR - http://www.scopus.com/inward/record.url?scp=0018134770&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0018134770&partnerID=8YFLogxK

U2 - 10.1016/0002-9343(78)90247-4

DO - 10.1016/0002-9343(78)90247-4

M3 - Article

VL - 64

SP - 523

EP - 528

JO - American Journal of Medicine

JF - American Journal of Medicine

SN - 0002-9343

IS - 3

ER -