Resultados. Se apreció un incremento en la incidencia y mortalidad en los casos hospitalizados por FMMR, con una letalidad de 30%. Tres variables se asociaron con el riesgo de muerte: retraso ≥ 5 días en el inicio del uso de doxiciclina (RM a =2.95, IC95% 1.10-7.95), falla renal aguda (RM a =8.79, IC95% 3.46-22.33) y sepsis severa (RM a =3.71, IC95% 1.44-9.58). Conclusión. La FMMR provoca resultados fatales en niños, que puede evitarse con la administración oportuna de doxiciclina. La falla renal aguda y la sepsis severa son dos predictores de muerte en niños con FMMR. Results. An upward trend was observed in RMSF morbidity and mortality. Fatality rate was 30%. Three predictors were associated with risk of death: delay ≥ 5 days at the start of doxycycline (OR a = 2.95, 95% CI 1.10-7.95), acute renal failure ((OR a = 8.79, 95% CI 3.46-22.33) and severe sepsis (OR a = 3.71, 95% CI 1.44-9.58). Conclusions. RMSF causes high mortality in children, which can be avoided with timely initiation of doxycycline. Acute renal failure and severe sepsis are two independent predictors of death in children with RMSF.
Inadequate medical knowledge may adversely affect how patients infected with Rickettsia rickettsii are diagnosed and treated. Educational programs that improve the risk perception and medical knowledge about RMSF should be targeted at physicians most likely to have initial contact with diseased patients.
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