Fatal spotted fever group rickettsiosis due to Rickettsia conorii conorii mimicking a hemorrhagic viral fever in a South African traveler in Brazil

Update on Tick-Borne Rickettsioses around the World: a Geographic Approach

“…This patient recovered without antibiotics (353), but another MSF case mimicking a hemorrhagic viral fever had a fatal outcome for a South African man (390). In all these cases (353,390,391), the lack of a tick exposure report and the lack of pathognomonic signs such as an inoculation eschar or skin rash have contributed to the lack of any clinical suspicion. This absence of suspicion potentially led to the delayed introduction of a specific antimicrobial therapy.…”

“…conorii DNA was detected in a blood sample collected from a febrile 4-year-old girl with tachycardia, who was among 134 other febrile patients from Sine-Saloum, Senegal, who were analyzed (353). This patient recovered without antibiotics (353), but another MSF case mimicking a hemorrhagic viral fever had a fatal outcome for a South African man (390). In all these cases (353,390,391), the lack of a tick exposure report and the lack of pathognomonic signs such as an inoculation eschar or skin rash have contributed to the lack of any clinical suspicion.…”

Untitled

“…Only few cases were reported concerning association between Rickettsiosis and severe sepsis. [5][6][7][8][9] It is due to the capacity of this small Gram negative bacterium to invade capillaries, cause endothelial injury and stimulate coagulation process which results in occlusive vasculitis. The few cases reported in literature were severe leading to fatal outcomes.…”

“…10 We mention two cases: the first one about Rocky Mountain spotted fever that was associated to renal failure, coagulopathy and sepsis without history of exposure to tick bite or skin spot sign and the second one concerning a fatal spotted fever group rickettsiosis due to Rickettsia Conorii that simulated hemorrhagic viral fever. 8,9 Both of these cases were diagnosed unfortunately after death according to positivity in post mortem rickettsial PCR research. 8,9 For our patient, the ocular examination rectified the diagnosis.…”

“…8,9 Both of these cases were diagnosed unfortunately after death according to positivity in post mortem rickettsial PCR research. 8,9 For our patient, the ocular examination rectified the diagnosis. Retinitis characteristics were very suggestive of Rickettsiosis with typical lesions adjacent to retinal vessels.…”