title: Characterization of rickettsia rickettsii in a case of fatal Brazilian spotted fever in the city of Rio de Janeiro, Brazil.
abstract: A lethal case of Brazilian spotted fever (BSF) is presented. Clinical features were initially of gastrointestinal involvement and evolved with progression to septic shock, meningoencephalitis and death on the 6th day of illness. Indirect immunofluorescence assay (IFA) for spotted fever group rickettsia (SFGR) was non-reactive. Diagnosis was confirmed by the polymerase chain reaction (PCR) and the nucleotide sequencing of a fragment of the ompA gene showed 100% homology to Rickettsia rickettsii. BSF has not been reported in the city of Rio de Janeiro in the last three decades, and the present description should alert the clinicians to its presence in urban Rio de Janeiro, and to the differential diagnosis with dengue fever, gastroenteritis, leptospirosis and bacterial septic shock, among others.
authors.affiliation: Laboratory of Hantaviruses and Rickettsiosis (Fiocruz), Rio de Janeiro, RJ, Brazil. cristianelamas@gmail.com
authors.forename: Cristiane
authors.initials: C
authors.lastname: Lamas
authors.forename: Alexsandra
authors.initials: A
authors.lastname: Favacho
authors.forename: Tatiana
authors.initials: T
authors.lastname: Rozental
authors.forename: Márcio N
authors.initials: MN
authors.lastname: Bóia
authors.forename: Andrei H
authors.initials: AH
authors.lastname: Kirsten
authors.forename: Alexandro
authors.initials: A
authors.lastname: Guterres
authors.forename: Jairo
authors.initials: J
authors.lastname: Barreira
authors.forename: Elba Regina S
authors.initials: ER
authors.lastname: de Lemos
mesh_terms: D000907:Antibodies, Bacterial / Q000097:blood*; D017809:Fatal Outcome; D006801:Humans; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D012284:Rickettsia rickettsii / Q000235:genetics / Q000276:immunology; D012373:Rocky Mountain Spotted Fever / Q000175:diagnosis*
chemical_list: D000907:Antibodies, Bacterial