Rickettsia parkeri rickettsiosis and its clinical distinction from Rocky Mountain spotted fever

Christopher D. Paddock, Richard W. Finley, Cynthia S. Wright, Howard N. Robinson, Barbara J. Schrodt, Carole C. Lane, Okechukwu Ekenna, Mitchell A. Blass, Cynthia L. Tamminga, Christopher A. Ohl, Susan McLellan, Jerome Goddard, Robert C. Holman, John J. Openshaw, John W. Sumner, Sherif R. Zaki, Marina E. Eremeeva

Research output: Contribution to journalArticle

150 Citations (Scopus)

Abstract

Background. Rickettsia parkeri rickettsiosis, a recently identified spotted fever transmitted by the Gulf Coast tick (Amblyomma maculatum), was first described in 2004. We summarize the clinical and epidemiological features of 12 patients in the United States with confirmed or probable disease attributable to R. parkeri and comment on distinctions between R. parkeri rickettsiosis and other United States rickettsioses. Methods. Clinical specimens from patients in the United States who reside within the range of A. maculatum for whom an eschar or vesicular rash was described were evaluated by ≥1 laboratory assays at the Centers for Disease Control and Prevention (Atlanta, GA) to identify probable or confirmed infection with R. parkeri. Results. During 1998-2007, clinical samples from 12 patients with illnesses epidemiologically and clinically compatible with R. parkeri rickettsiosis were submitted for diagnostic evaluation. Using indirect immunofluorescence antibody assays, immunohistochemistry, polymerase chain reaction assays, and cell culture isolation, we identified 6 confirmed and 6 probable cases of infection with R. parkeri. The aggregate clinical characteristics of these patients revealed a disease similar to but less severe than classically described Rocky Mountain spotted fever. Conclusions. Closer attention to the distinct clinical features of the various spotted fever syndromes that exist in the United States and other countries of the Western hemisphere, coupled with more frequent use of specific confirmatory assays, may unveil several unique diseases that have been identified collectively as Rocky Mountain spotted fever during the past century. Accurate assessments of these distinct infections will ultimately provide a more valid description of the currently recognized distribution, incidence, and case-fatality rate of Rocky Mountain spotted fever.

Original languageEnglish (US)
Pages (from-to)1188-1196
Number of pages9
JournalClinical Infectious Diseases
Volume47
Issue number9
DOIs
StatePublished - Nov 1 2008
Externally publishedYes

Fingerprint

Rocky Mountain Spotted Fever
Rickettsia
Fever
Infection
Cell Separation
Ticks
Centers for Disease Control and Prevention (U.S.)
Indirect Fluorescent Antibody Technique
Exanthema
Cell Culture Techniques
Immunohistochemistry
Polymerase Chain Reaction
Mortality
Antibodies
Incidence

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

Cite this

Paddock, C. D., Finley, R. W., Wright, C. S., Robinson, H. N., Schrodt, B. J., Lane, C. C., ... Eremeeva, M. E. (2008). Rickettsia parkeri rickettsiosis and its clinical distinction from Rocky Mountain spotted fever. Clinical Infectious Diseases, 47(9), 1188-1196. https://doi.org/10.1086/592254

Rickettsia parkeri rickettsiosis and its clinical distinction from Rocky Mountain spotted fever. / Paddock, Christopher D.; Finley, Richard W.; Wright, Cynthia S.; Robinson, Howard N.; Schrodt, Barbara J.; Lane, Carole C.; Ekenna, Okechukwu; Blass, Mitchell A.; Tamminga, Cynthia L.; Ohl, Christopher A.; McLellan, Susan; Goddard, Jerome; Holman, Robert C.; Openshaw, John J.; Sumner, John W.; Zaki, Sherif R.; Eremeeva, Marina E.

In: Clinical Infectious Diseases, Vol. 47, No. 9, 01.11.2008, p. 1188-1196.

Research output: Contribution to journalArticle

Paddock, CD, Finley, RW, Wright, CS, Robinson, HN, Schrodt, BJ, Lane, CC, Ekenna, O, Blass, MA, Tamminga, CL, Ohl, CA, McLellan, S, Goddard, J, Holman, RC, Openshaw, JJ, Sumner, JW, Zaki, SR & Eremeeva, ME 2008, 'Rickettsia parkeri rickettsiosis and its clinical distinction from Rocky Mountain spotted fever', Clinical Infectious Diseases, vol. 47, no. 9, pp. 1188-1196. https://doi.org/10.1086/592254
Paddock CD, Finley RW, Wright CS, Robinson HN, Schrodt BJ, Lane CC et al. Rickettsia parkeri rickettsiosis and its clinical distinction from Rocky Mountain spotted fever. Clinical Infectious Diseases. 2008 Nov 1;47(9):1188-1196. https://doi.org/10.1086/592254
Paddock, Christopher D. ; Finley, Richard W. ; Wright, Cynthia S. ; Robinson, Howard N. ; Schrodt, Barbara J. ; Lane, Carole C. ; Ekenna, Okechukwu ; Blass, Mitchell A. ; Tamminga, Cynthia L. ; Ohl, Christopher A. ; McLellan, Susan ; Goddard, Jerome ; Holman, Robert C. ; Openshaw, John J. ; Sumner, John W. ; Zaki, Sherif R. ; Eremeeva, Marina E. / Rickettsia parkeri rickettsiosis and its clinical distinction from Rocky Mountain spotted fever. In: Clinical Infectious Diseases. 2008 ; Vol. 47, No. 9. pp. 1188-1196.
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abstract = "Background. Rickettsia parkeri rickettsiosis, a recently identified spotted fever transmitted by the Gulf Coast tick (Amblyomma maculatum), was first described in 2004. We summarize the clinical and epidemiological features of 12 patients in the United States with confirmed or probable disease attributable to R. parkeri and comment on distinctions between R. parkeri rickettsiosis and other United States rickettsioses. Methods. Clinical specimens from patients in the United States who reside within the range of A. maculatum for whom an eschar or vesicular rash was described were evaluated by ≥1 laboratory assays at the Centers for Disease Control and Prevention (Atlanta, GA) to identify probable or confirmed infection with R. parkeri. Results. During 1998-2007, clinical samples from 12 patients with illnesses epidemiologically and clinically compatible with R. parkeri rickettsiosis were submitted for diagnostic evaluation. Using indirect immunofluorescence antibody assays, immunohistochemistry, polymerase chain reaction assays, and cell culture isolation, we identified 6 confirmed and 6 probable cases of infection with R. parkeri. The aggregate clinical characteristics of these patients revealed a disease similar to but less severe than classically described Rocky Mountain spotted fever. Conclusions. Closer attention to the distinct clinical features of the various spotted fever syndromes that exist in the United States and other countries of the Western hemisphere, coupled with more frequent use of specific confirmatory assays, may unveil several unique diseases that have been identified collectively as Rocky Mountain spotted fever during the past century. Accurate assessments of these distinct infections will ultimately provide a more valid description of the currently recognized distribution, incidence, and case-fatality rate of Rocky Mountain spotted fever.",
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