title: Fatal Brazilian spotless fever caused by Rickettsia rickettsii in a dark-skinned patient.
abstract: Brazilian spotted fever (BSF) is the most important and frequent rickettsial disease in Brazil. A fatal case of BSF is reported in a 32-year-old black man, who died of irreversible shock after five days of fever, severe headache and abdominal pain with no rash. Spleen, kidney and heart samples collected at autopsy were positive for Rickettsia rickettsii by PCR and sequencing. The authors emphasize the need for a high index of diagnostic suspicion for spotted fever in black patients. Absence of a skin rash should not dissuade clinicians from considering the possibility of BSF and initiating empirical therapy.
authors.affiliation: Laboratório de Hantaviroses e Rickettsioses, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil. afavacho@ioc.fiocruz.br
authors.forename: Alexsandra Rodrigues de Mendonça
authors.initials: AR
authors.lastname: Favacho
authors.forename: Tatiana
authors.initials: T
authors.lastname: Rozental
authors.forename: Simone Berger
authors.initials: SB
authors.lastname: Calic
authors.forename: Maria Aparecida Mota
authors.initials: MA
authors.lastname: Scofield
authors.forename: Elba Regina Sampaio de
authors.initials: ER
authors.lastname: Lemos
mesh_terms: D000328:Adult; D044383:Black People; D017809:Fatal Outcome; D006801:Humans; D008297:Male; D012282:Rickettsia Infections / Q000175:diagnosis* / Q000382:microbiology; D012284:Rickettsia rickettsii / Q000235:genetics / Q000276:immunology; D012772:Shock, Septic / Q000382:microbiology*