title: [Severe spotted fever by Rickettsia rickettsii, in tourist in the Argentine Northwest].
abstract: On the fifth day after leaving the Parque Nacional El Rey, province of Salta, Argentina, where she made rural tourism, a woman of Italian origin, aged 47, developed an acute fever followed by a petechial and purpuric rash that progressed rapidly to multiorgan failure. She died on the sixth day after hospitalization. There were references to tick bites and a skin lesion similar to tache noire was found. The autopsy showed generalized vasculitis, ascites, pulmonary edema, acute tubular necrosis and portal centrilobular necrosis. Spleen and liver tissue were processed for PCR Rickettsia spp, based on the detection of the gltA gene. The result was positive. The amplicons obtained were sequenced and the results were compared with the preset sequences on the BLAST program, 99% coinciding with R. rickettsii. The low sensitivity of the health system to recognize this disease and the insufficient information generated from tourism-related media are factors that affect the delay to implement effective treatment and appropriate prevention standards.
authors.affiliation: Servicio de Zoonosis, Hospital de Enfermedades Infecciosas F. J. Muñiz, Buenos Aires, Argentina, E-mail: ceijo@intramed.net.ar.
authors.forename: Alfredo
authors.initials: A
authors.lastname: Seijo
authors.affiliation: Servicio de Zoonosis, Hospital de Enfermedades Infecciosas F. J. Muñiz, Buenos Aires, Argentina.
authors.forename: Sergio
authors.initials: S
authors.lastname: Giamperetti
authors.affiliation: Cátedra de Anatomía Patológica, Hospital ángel C. Padilla, Universidad Nacional de Tucumán, Argentina.
authors.forename: Sonia M
authors.initials: SM
authors.lastname: Ortiz Mayor
authors.affiliation: Dirección de Epidemiología, Ministerio de Salud de Tucumán, Argentina.
authors.forename: María B
authors.initials: MB
authors.lastname: González
authors.affiliation: Dirección de Epidemiología, Ministerio de Salud de Tucumán, Argentina.
authors.forename: Eugenia S
authors.initials: ES
authors.lastname: Ortega
authors.affiliation: Cátedra de Anatomía Patológica, Hospital ángel C. Padilla, Universidad Nacional de Tucumán, Argentina.
authors.forename: Rossana C
authors.initials: RC
authors.lastname: González
mesh_terms: D000818:Animals; D001118:Argentina; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D026863:Ixodidae / Q000382:microbiology; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000382:microbiology; D012284:Rickettsia rickettsii / Q000302:isolation & purification*; D012373:Rocky Mountain Spotted Fever / Q000150:complications / Q000382:microbiology*
keywords: Amblyomma spp.; Parque Nacional El Rey; Rickettsia rickettsii; spotted fever; ticks; travel medicine