Fatal Spotted Fever Rickettsiosis, Minas Gerais, Brazil

Abstract

The emergence and reemergence of a serious infectious disease are often associated with a high case-fatality rate because of misdiagnosis and inappropriate or delayed treatment. The current reemergence of spotted fever rickettsiosis caused by Rickettsia rickettsii in Brazil has resulted in a high proportion of fatal cases. We describe two familial clusters of Brazilian spotted fever in the state of Minas Gerais, involving six children 9 months to 15 years of age; five died. Immunohistochemical investigation of tissues obtained at necropsy of a child in each location, Novo Cruzeiro and Coronel Fabriciano municipalities, established the diagnosis by demonstration of disseminated endothelial infection with spotted fever group rickettsiae. The diagnosis in the two fatal cases from Coronel Fabriciano and the surviving patient from Novo Cruzeiro was further supported by immunofluorescence serologic tests.

Riquetsioses no Brasil e Portugal: ocorrência, distribuição e diagnóstico

“…This disease was first reported in 1929 in the state of São Paulo, 31 and cases have also been reported in Minas Gerais, Rio de Janeiro, Espírito Santo, and Bahia. 11,[13][14][15][20][21][22]35,38, * , ** Only the states of Minas Gerais and São Paulo have implemented a disease surveillance system.…”

A fatal case of Brazilian spotted fever in a non-endemic area in Brazil: the importance of having health professionals who understand the disease and its areas of transmission

“…Fatal cases of Rickettsia rickettsii infection have thus far been reported inonly four Brazilian states, all of which are located in the Southeastern region of the country: São Paulo (6) , Minas Gerais (7) , Rio de Janeiro (8) , and Espírito Santo (9) . The case-fatality rate has been found to range from 30% to 50% (5) .…”

Aproximación clínica y principales rickettsiosis transmitidas por garrapatas presentes en Latinoamérica

“…Se han documentado casos humanos de R. rickettsii en los siguientes países de la región: Brasil, donde es conocida como fiebre manchada brasileña [6][7][8][9][10] Los síntomas suelen iniciarse entre 5 y 10 días después de la picadura de la garrapata, y dado que gran parte de estas picaduras pueden pasar desapercibidas, se debe tener un alto índice de sospecha. El cuadro clínico incluye fiebre elevada de aparición súbita, con escalofríos, malestar general, mialgias, artralgias, cefalea, vómitos, fotofobia y exantema.…”

“…La frecuencia de exantema es variable en las distintas series, habiéndose descrito entre 18 y 100% 8,12,13,20,23,25 . Se han observado manifestaciones gastrointestinales, en especial en los niños, consistentes en náuseas, vómitos y dolor abdominal 9,10,13,15,25,27 . En un paciente se describió Infectología al Día edema periorbitario con corioretinitis 27 .…”