The pathology of fatal Mediterranean spotted fever

David Walker, J. I. Herrero-Herrero, R. Ruiz-Beltrán, A. Bullón-Sopelana, A. Ramos-Hidalgo

Research output: Contribution to journalArticle

48 Citations (Scopus)

Abstract

A 77-year-old woman from rural Spain had a febrile summertime disease develop with rash, eschar, and pulmonary, abdominal, and neurologic signs and symptoms. Mediterranean spotted fever (MSF) was diagnosed late in the course, and antirickettsial treatment was given only during the last 30 hours of life. Clinical manifestations of severe disseminated vascular injury included thrombocytopenia, hypoalbuminemia, edema of the lungs and legs, and severe prerenal azotemia. The diagnosis was documented by specific serology. Necropsy revealed vascular injury with perivascular lymphohistiocytic infiltrates suggestive of rickettsiosis in the central nervous system, lung, heart, kidneys, esophagus, stomach, colon, pancreas, spleen, and thyroid. Gastric hemorrhage and acute pneumonia contributed to the patient's death on day 18 of illness. Antimicrobial treatment and host defenses apparently reduced rickettsiae to an undetectable quantity. MSF has increased in incidence in the Mediterranean basin and has been reported in travelers returning to the United States.

Original languageEnglish (US)
Pages (from-to)669-672
Number of pages4
JournalAmerican Journal of Clinical Pathology
Volume87
Issue number5
StatePublished - 1987
Externally publishedYes

Fingerprint

Boutonneuse Fever
Vascular System Injuries
Pathology
Lung
Stomach
Azotemia
Rickettsia
Hypoalbuminemia
Sick Leave
Serology
Neurologic Manifestations
Exanthema
Thrombocytopenia
Spain
Esophagus
Pancreas
Edema
Leg
Pneumonia
Thyroid Gland

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

Cite this

Walker, D., Herrero-Herrero, J. I., Ruiz-Beltrán, R., Bullón-Sopelana, A., & Ramos-Hidalgo, A. (1987). The pathology of fatal Mediterranean spotted fever. American Journal of Clinical Pathology, 87(5), 669-672.

The pathology of fatal Mediterranean spotted fever. / Walker, David; Herrero-Herrero, J. I.; Ruiz-Beltrán, R.; Bullón-Sopelana, A.; Ramos-Hidalgo, A.

In: American Journal of Clinical Pathology, Vol. 87, No. 5, 1987, p. 669-672.

Research output: Contribution to journalArticle

Walker, D, Herrero-Herrero, JI, Ruiz-Beltrán, R, Bullón-Sopelana, A & Ramos-Hidalgo, A 1987, 'The pathology of fatal Mediterranean spotted fever', American Journal of Clinical Pathology, vol. 87, no. 5, pp. 669-672.
Walker D, Herrero-Herrero JI, Ruiz-Beltrán R, Bullón-Sopelana A, Ramos-Hidalgo A. The pathology of fatal Mediterranean spotted fever. American Journal of Clinical Pathology. 1987;87(5):669-672.
Walker, David ; Herrero-Herrero, J. I. ; Ruiz-Beltrán, R. ; Bullón-Sopelana, A. ; Ramos-Hidalgo, A. / The pathology of fatal Mediterranean spotted fever. In: American Journal of Clinical Pathology. 1987 ; Vol. 87, No. 5. pp. 669-672.
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