Fatal spotted fever rickettsiosis in Argentina

Abstract

We present a fatal case of a 17-year-old male patient who was hospitalized for febrile seizures and generalized skin rash.

We describe the case of a 17-year-old male patient from the city of Salta, a northern city of Argentina, who was admitted for febrile syndrome of 6 days of evolution, followed by a generalized skin rash and multiple organ dysfunction [1] (Fig. 1, Fig. 2). The patient developed irreversible shock, dying 48 h after being admitted.

Fig. 1.

Patient with endotracheal intubation and mechanical ventilation, with confluent ecchymoses disseminated on face, trunk and extremities.

Fig. 2.

Generalized ecchymosis in a young patient with multiple organ dysfunction.

The diagnosis was established after the death of the patient, by Indirect Immunofluorescence with high titers against Rickettsia species, for immunoglobulin M and immunoglobulin G. Only a diagnosis of Rickettsia infection was made, not being able to speciate it since it was performed postmortem.

This case report highlights both an immediate and a long-term need for rickettsiae surveillance and dissemination of information about rickettsioses to health care workers in Argentina. In a similar manner, physicians in industrialized countries who care for ill travelers who have visited Argentina should consider rickettsial infections among the differential diagnoses of febrile disease [2]. Further studies of the epidemiology and ecology of Argentinean spotted fever group rickettsiae and rickettsioses are warranted [3].