Rocky Mountain spotted fever in Panama: a cluster description.

Tribaldos, Maribel; Zaldívar, Yamitzel; Bermúdez, Sergio; Samudio, Franklyn; Mendoza, Yaxelis; Martínez, Alexander A.; Villalobos, Rodrigo; Eremeeva, Marina E.; Paddock, Christopher D.; Page, Kathleen R.; Smith, R. W.; Pascale, Juan Miguel

doi:10.3855/jidc.2189

Cited by 44 publications

(31 citation statements)

References 22 publications

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“…10 In R. rickettsii infection, the presence of an inoculation eschar is an unusual finding (only five cases reported in the literature from 1981 to 2012). [11][12][13][14] The geographical distribution of R. rickettsii, the most pathogenic species of the tick-borne rickettsiae, is limited to the Western Hemisphere where its primary vectors are ticks of the genera Dermacentor, Rhipicephalus, and Amblyomma (Table 1). 15 …”

Section: With Centripetal Rash Distributionmentioning

confidence: 99%

Syndromic classification of rickettsioses: an approach for clinical practice

Faccini-Martínez

García‐Álvarez

Hidalgo

et al. 2014

International Journal of Infectious Diseases

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Rickettsioses share common clinical manifestations, such as fever, malaise, exanthema, the presence or absence of an inoculation eschar, and lymphadenopathy. Some of these manifestations can be suggestive of certain species of Rickettsia infection. Nevertheless none of these manifestations are pathognomonic, and direct diagnostic methods to confirm the involved species are always required. A syndrome is a set of signs and symptoms that characterizes a disease with many etiologies or causes. This situation is applicable to rickettsioses, where different species can cause similar clinical presentations. We propose a syndromic classification for these diseases: exanthematic rickettsiosis syndrome with a low probability of inoculation eschar and rickettsiosis syndrome with a probability of inoculation eschar and their variants. In doing so, we take into account the clinical manifestations, the geographic origin, and the possible vector involved, in order to provide a guide for physicians of the most probable etiological agent.

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Section: With Centripetal Rash Distributionmentioning

confidence: 99%

Syndromic classification of rickettsioses: an approach for clinical practice

Faccini-Martínez

García‐Álvarez

Hidalgo

et al. 2014

International Journal of Infectious Diseases

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“…Unfortunately, although BSF is a reportable disease, a lack of prompt initiation of the anti-rickettsial treatment has been frequently observed in Brazil, where BSF has wrongly been approached as a diagnosis of exclusion. Family clusters are a well-recognized feature of rickettsial disease caused by R. rickettsii and other SFGR, but few cases associated with occupational exposure have been described [7,[12][13][14]. However, studies demonstrate that workers occupationally exposed to tick bites are under significantly increased risk of other SFGR infections [4].…”

Section: Casementioning

confidence: 99%

A cluster ofRickettsia rickettsiiinfection at an animal shelter in an urban area of Brazil

et al. 2014

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Rickettsia rickettsii infection is being increasingly recognized as an important cause of fatal acute illness in Brazil, where this tick-borne disease is designated Brazilian spotted fever (BSF). In this study we report five fatal cases of BSF in employees of an animal shelter in an urban area in the municipality of Rio de Janeiro in southeast Brazil after a natural disaster on 11 January 2011. Four of the cases occurred from 27 January to 11 April 2011, while the fifth fatal case was identified in April 2012. Three cases were confirmed by molecular analysis and two by epidemiological linkage. An investigation of BSF was performed in the animal shelter, and blood samples were collected from 115 employees and 117 randomly selected dogs. The presence of high levels (1024-4096) of antibodies against spotted fever group rickettsiae was found in three (2·6%) employees and 114 (97·5%) dogs. These findings emphasize the need to consider BSF as a possible cause of undifferentiated febrile illness, especially dengue and leptospirosis, in patients occupationally exposed to dogs heavily infested by ticks, mainly working at kennels and animal shelters that have inadequate space for the animals housed and frequently providing an environment conducive to exposure to pathogens such as R. rickettsii.

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“…1). Interestingly, while low-, mild-, and high-virulent strains of R. rickettsii have been reported in the eastern and western parts of the United States (20,22), only highvirulent strains, responsible for high fatality rates, have been reported in Central/South America, regardless of the tick vector (2,(23)(24)(25)(26)(27)(28)(29). While our results of no polymorphisms among Central/ South American isolates was biased because most of these isolates were derived from fatal cases, a recent study reported the same clade distribution as shown in our Fig.…”

mentioning

confidence: 99%