The occurrence of eschars in Rocky Mountain spotted fever

David Walker, R. M. Gay, M. Valdes-Dapena

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Abstract

Two patients with fatal, laboratory-confirmed Rocky Mountain spotted fever (RMSF) were noted early in their course to have a skin lesion characteristic of a rickettsial eschar. Postmortem immunofluorescent and histopathologic studies demonstrated that the lesions were sites of extensive contiguous infection by Rickettsia rickettsii with associated injury to numerous local blood vessels. Rickettsial vasculitis and occlusive luminal thrombosis were associated with dermal and epidermal coagulative necrosis forming the eschars. Both eschars were noted to be the sites of a bite. In one case the arthropod was identified as a tick. The clinical importance of the search for an eschar in a patient suspected of having RMSF is that diagnostic skin biopsy immunofluorescent demonstration of R. rickettsii may be performed prior to the onset of the rash.

Original languageEnglish
Pages (from-to)571-576
Number of pages6
JournalJournal of the American Academy of Dermatology
Volume4
Issue number5
StatePublished - 1981
Externally publishedYes

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ASJC Scopus subject areas

  • Dermatology

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