Fatal spotted fever rickettsiosis, Minas Gerais, Brazil.
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.
Galvâo
Márcio Antonio Moreira
MA
Universidade Federal de Ouro Preto, Minas Gerais, Brazil. mgalvao@enut.ufop.br
Dumler
J Stephen
JS
Mafra
Cláudio Lísias
CL
Calic
Simone Berger
SB
Chamone
Chequer Buffe
CB
Cesarino Filho
Gracco
G
Olano
Juan Pablo
JP
Walker
David H
DH
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
D000907:Antibodies, Bacterial