Rocky Mountain spotted fever mimicking acute cholecystitis

David Walker, H. R. Lesesne, V. A. Varma, W. C. Thacker

Research output: Contribution to journalArticle

24 Citations (Scopus)

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 languageEnglish (US)
Pages (from-to)2194-2196
Number of pages3
JournalArchives of Internal Medicine
Volume145
Issue number12
StatePublished - 1985
Externally publishedYes

Fingerprint

Rocky Mountain Spotted Fever
Acute Cholecystitis
Blood Vessels
Gallbladder
Rickettsia rickettsii
Appendectomy
Cholelithiasis
Viscera
Appendix
Cholecystectomy
Exanthema
Laparotomy
Abscess
Nausea
Abdominal Pain
Vomiting
Diarrhea
Ultrasonography
Thrombosis
Fever

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Walker, D., Lesesne, H. R., Varma, V. A., & Thacker, W. C. (1985). Rocky Mountain spotted fever mimicking acute cholecystitis. Archives of Internal Medicine, 145(12), 2194-2196.

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 journalArticle

Walker, D, Lesesne, HR, Varma, VA & Thacker, WC 1985, 'Rocky Mountain spotted fever mimicking acute cholecystitis', Archives of Internal Medicine, vol. 145, no. 12, pp. 2194-2196.
Walker, David ; Lesesne, H. R. ; Varma, V. A. ; Thacker, W. C. / Rocky Mountain spotted fever mimicking acute cholecystitis. In: Archives of Internal Medicine. 1985 ; Vol. 145, No. 12. pp. 2194-2196.
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