Abstract
Rocky Mountain spotted fever can present with predominantly abdominal symptoms including nausea, vomiting, diarrhea, and abdominal pain. Two elderly patients presented with an acute febrile illness and abdominal symptoms. Rash was not present initially. Workup disclosed cholelithiasis in one, and a thickened gallbladder wall surrounded by a sonolucent zone suggesting a pericholecystic abscess was found by ultrasonography in the other. Both patients underwent emergence laparotomy, with cholecystectomy in both and appendectomy in one. Both patients died several days postoperatively. Pathologic specimens reviewed later showed that multiple blood vessels of the gallbladder and the appendix were infected with Rickettsia rickettsii, and there was focal vascular thrombosis and hemorrhage. These documented direct rickettsial infections and lesions in the blood vessels of abdominal viscera suggest the basis for the abdominal symptoms in Rocky Mountain spotted fever.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 2194-2196 |
| Number of pages | 3 |
| Journal | Archives of Internal Medicine |
| Volume | 145 |
| Issue number | 12 |
| State | Published - 1985 |
| Externally published | Yes |
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ASJC Scopus subject areas
- Internal Medicine
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Rocky Mountain spotted fever mimicking acute cholecystitis. / Walker, David; Lesesne, H. R.; Varma, V. A.; Thacker, W. C.
In: Archives of Internal Medicine, Vol. 145, No. 12, 1985, p. 2194-2196.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Rocky Mountain spotted fever mimicking acute cholecystitis
AU - Walker, David
AU - Lesesne, H. R.
AU - Varma, V. A.
AU - Thacker, W. C.
PY - 1985
Y1 - 1985
N2 - Rocky Mountain spotted fever can present with predominantly abdominal symptoms including nausea, vomiting, diarrhea, and abdominal pain. Two elderly patients presented with an acute febrile illness and abdominal symptoms. Rash was not present initially. Workup disclosed cholelithiasis in one, and a thickened gallbladder wall surrounded by a sonolucent zone suggesting a pericholecystic abscess was found by ultrasonography in the other. Both patients underwent emergence laparotomy, with cholecystectomy in both and appendectomy in one. Both patients died several days postoperatively. Pathologic specimens reviewed later showed that multiple blood vessels of the gallbladder and the appendix were infected with Rickettsia rickettsii, and there was focal vascular thrombosis and hemorrhage. These documented direct rickettsial infections and lesions in the blood vessels of abdominal viscera suggest the basis for the abdominal symptoms in Rocky Mountain spotted fever.
AB - Rocky Mountain spotted fever can present with predominantly abdominal symptoms including nausea, vomiting, diarrhea, and abdominal pain. Two elderly patients presented with an acute febrile illness and abdominal symptoms. Rash was not present initially. Workup disclosed cholelithiasis in one, and a thickened gallbladder wall surrounded by a sonolucent zone suggesting a pericholecystic abscess was found by ultrasonography in the other. Both patients underwent emergence laparotomy, with cholecystectomy in both and appendectomy in one. Both patients died several days postoperatively. Pathologic specimens reviewed later showed that multiple blood vessels of the gallbladder and the appendix were infected with Rickettsia rickettsii, and there was focal vascular thrombosis and hemorrhage. These documented direct rickettsial infections and lesions in the blood vessels of abdominal viscera suggest the basis for the abdominal symptoms in Rocky Mountain spotted fever.
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UR - http://www.scopus.com/inward/citedby.url?scp=0022352242&partnerID=8YFLogxK
M3 - Article
C2 - 4074033
AN - SCOPUS:0022352242
VL - 145
SP - 2194
EP - 2196
JO - JAMA Internal Medicine
JF - JAMA Internal Medicine
SN - 2168-6106
IS - 12
ER -