title: Rocky Mountain spotted fever in Panama: a cluster description.
abstract: Rocky Mountain spotted fever (RMSF) is a tick-borne infection caused by Rickettsia rickettsii. We report a cluster of fatal cases of RMSF in 2007 in Panama, involving a pregnant woman and two children from the same family.  The woman presented with a fever followed by respiratory distress, maculopapular rash, and an eschar at the site from which a tick had been removed.  She died four days after disease onset.  This is the second published report of an eschar in a patient confirmed by PCR to be infected with R. rickettsii.  One month later, the children presented within days of one another with fever and rash and died three and four days after disease onset. The diagnosis was confirmed by immunohistochemistry, PCR and sequencing of the genes of R. rickettsii in tissues obtained at autopsy.
authors: Genomics and Proteomics Department, Gorgas Memorial Institute for Health Studies, Panama. maritribaldos@gmail.com
authors: Maribel
authors: M
authors: Tribaldos
authors: Yamitzel
authors: Y
authors: Zaldivar
authors: Sergio
authors: S
authors: Bermudez
authors: Franklyn
authors: F
authors: Samudio
authors: Yaxelis
authors: Y
authors: Mendoza
authors: Alexander A
authors: AA
authors: Martinez
authors: Rodrigo
authors: R
authors: Villalobos
authors: Marina E
authors: ME
authors: Eremeeva
authors: Christopher D
authors: CD
authors: Paddock
authors: Kathleen
authors: K
authors: Page
authors: Rebecca E
authors: RE
authors: Smith
authors: Juan Miguel
authors: JM
authors: Pascale
mesh_terms: D002675:Child, Preschool; D016000:Cluster Analysis; D004269:DNA, Bacterial / Q000235:genetics / Q000302:isolation & purification; D005192:Family Health; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008853:Microscopy; D010176:Panama / Q000453:epidemiology; D016133:Polymerase Chain Reaction; D011247:Pregnancy; D012284:Rickettsia rickettsii / Q000235:genetics / Q000302:isolation & purification*; D012373:Rocky Mountain Spotted Fever / Q000453:epidemiology* / Q000473:pathology; D017422:Sequence Analysis, DNA; D012867:Skin / Q000473:pathology; D055815:Young Adult
chemical_list: D004269:DNA, Bacterial