title: 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.
authors.affiliation: Universidade Federal de Ouro Preto, Minas Gerais, Brazil. mgalvao@enut.ufop.br
authors.forename: Márcio Antonio Moreira
authors.initials: MA
authors.lastname: Galvâo
authors.forename: J Stephen
authors.initials: JS
authors.lastname: Dumler
authors.forename: Cláudio Lísias
authors.initials: CL
authors.lastname: Mafra
authors.forename: Simone Berger
authors.initials: SB
authors.lastname: Calic
authors.forename: Chequer Buffe
authors.initials: CB
authors.lastname: Chamone
authors.forename: Gracco
authors.initials: G
authors.lastname: Cesarino Filho
authors.forename: Juan Pablo
authors.initials: JP
authors.lastname: Olano
authors.forename: David H
authors.initials: DH
authors.lastname: Walker
mesh_terms: D000293:Adolescent; D000907:Antibodies, Bacterial / Q000097:blood; D001938:Brazil / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D021821:Communicable Diseases, Emerging / Q000453:epidemiology* / Q000401:mortality / Q000473:pathology; D004196:Disease Outbreaks; D006801:Humans; D007223:Infant; D008297:Male; D012284:Rickettsia rickettsii / Q000276:immunology / Q000472:pathogenicity*; D012373:Rocky Mountain Spotted Fever / Q000453:epidemiology* / Q000401:mortality / Q000473:pathology
chemical_list: D000907:Antibodies, Bacterial