A fatal case of Brazilian spotted fever in a non-endemic area in Brazil: the importance of having health professionals who understand the disease and its areas of transmission

Oliveira, Stefan Vilges de; Caldas, Eduardo Pacheco de; Colombo, Silvia; Labruna, Marcelo Bahia; Santos, Fabiana Cristina Pereira dos; Angerami, Rodrigo Nogueira

doi:10.1590/0037-8682-0088-2016

Cited by 18 publications

(19 citation statements)

References 11 publications

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“…The clinical presentations of both patients were similar to other recent cases in Panama, with sequential events being a sudden decrease in platelet counts, an increase in liver enzymes, and an abrupt deterioration of health during the fourth or fifth day after the onset of symptoms [3,10,11]. Oral amoxicillin, ampicillin, and clindamycin in both cases were ineffective, confirming the need to use doxycycline as early as possible [3,12,18,20]. Both autopsies revealed severe damage to the organs, characterised by oedema and haemorrhage, which are common in cases of RMSF.…”

Section: Discussionsupporting

confidence: 78%

Descriptions of two new cases of Rocky Mountain spotted fever in Panama, and coincident infection with Rickettsia rickettsii in Rhipicephalus sanguineus s.l. in an urban locality of Panama City, Panama

et al. 2018

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The clinical and pathologic characterisation of two fatal cases of tick-borne rickettsiosis in rural (El Valle) and urban (City of Panama) Panama are described. Clinical and autopsy findings were non-specific, but the molecular analysis was used to identify Rickettsia rickettsii in both cases. No ticks were collected in El Valle, while in the urban case, R. rickettsii was detected in Rhipicephalus sanguineus s.l., representing the first molecular finding in this tick in Panama and Central America.

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Section: Discussionsupporting

confidence: 78%

Descriptions of two new cases of Rocky Mountain spotted fever in Panama, and coincident infection with Rickettsia rickettsii in Rhipicephalus sanguineus s.l. in an urban locality of Panama City, Panama

et al. 2018

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“…The absence of initial clinical and epidemiological indicators, coupled with the rapid evolution of SF, has resulted in rickettsial deaths in several Brazilian States 3 , 5 , 6 . Rickettsia rickettsii shows the strongest pathological alterations associated with the most severe and lethal clinical conditions.…”

Section: Discussionmentioning

confidence: 99%

“…Spotted fever (SF) is an infectious, acute, febrile disease of varying severity, mainly transmitted by ticks 1 , 2 . It has a non-specific symptomatology, during which early clinical-epidemiological diagnosis is a great challenge 3 . The rash, considered the only clinical marker, is not always present, which delays diagnosis and hinders appropriate medical action 4 .…”

Section: Introductionmentioning

confidence: 99%

Fatal case of spotted fever in a patient from Northeastern Brazil

Oliveira

Costa

Ferreira

et al. 2018

Rev. Inst. Med. trop. S. Paulo

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Spotted fevers are diseases caused by bacterial agents belonging to the spotted-fever (SF) group of the genus Rickettsia. The first documented case of SF in Pernambuco State, Northeast Brazil, was reported here. Also, it is the first case described of fatal SF in Northeast region of Brazil. The patient was a resident of Arcoverde municipality and the probable site of infection lies in Sertania municipality, both in Pernambuco State, a semi-arid region of Brazil. The patient had not visited other areas where SF is endemic. The patient showed clinical manifestations and epidemiological exposure compatible with SF, and the infection was confirmed by molecular biology techniques.

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“…It is caused by R. rickettsii . Its case‐fatality rate surpasses 50% (Angerami et al., , , ; Oliveira et al., ).…”

Section: Introductionmentioning

confidence: 99%

“…It is caused by R. rickettsii. Its case-fatality rate surpasses 50% (Angerami et al, 2006(Angerami et al, , 2009b(Angerami et al, , 2012Oliveira et al, 2016b).…”

Section: Introductionmentioning

confidence: 99%

Predictive Factors for Fatal Tick‐Borne Spotted Fever in Brazil

Oliveira

Willemann²,

Angerami

et al. 2017

Zoonoses and Public Health

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In Brazil, two pathogenic Rickettsia species have been identified causing tick-borne spotted fever (SF). The aetiological agent Rickettsia rickettsii causes serious illness, particularly in the south-eastern region of the country. Moreover, the Rickettsia sp. strain Atlantic Rainforest cause milder clinical manifestations in south-eastern, south and north-east regions. This study has sought to analyse predictive factors for fatal SF. A case-control study was performed using disease notification records in Brazil. The cases included were individuals with laboratory confirmation and fatal progression of SF, while the controls included individuals with SF who were cured. A total of 386 cases and 415 controls were identified (1 : 1.1), and the cases and controls were similar in age. The factors identified as being protective against death were reported presence of ticks (odds ratio [OR], 0.60; 95% confidence interval [CI], 0.41-0.88), residing in urban areas (OR, 0.47, 95% CI, 0.31-0.74) and presenting lymphadenopathy (OR, 0.43; 95% CI, 0.23-0.82). Males exhibited a greater chance of death (OR, 1.57; 95% CI, 1.13-2.18), as did patients who were hospitalized (OR, 10.82; 95% CI, 6.38-18.35) and who presented hypotension or shock (OR, 10.80; 95% CI, 7.33-15.93), seizures (OR, 11.24; 95% CI, 6.49-19.45) and coma (OR of 15.16; 95% CI, 8.51-27.02). The study demonstrates the severity profile of the SF cases, defined either as the frequency of hospitalization (even in cases that were cured) or as the increased frequency of the clinical complications typically found in critical patients. Opportune clinical diagnosis, a careful evaluation of the epidemiological aspects of the disease and adequate care for patients are determining factors for reducing SF fatality rates.

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A fatal case of Brazilian spotted fever in a non-endemic area in Brazil: the importance of having health professionals who understand the disease and its areas of transmission

Cited by 18 publications

References 11 publications

Descriptions of two new cases of Rocky Mountain spotted fever in Panama, and coincident infection with Rickettsia rickettsii in Rhipicephalus sanguineus s.l. in an urban locality of Panama City, Panama

Descriptions of two new cases of Rocky Mountain spotted fever in Panama, and coincident infection with Rickettsia rickettsii in Rhipicephalus sanguineus s.l. in an urban locality of Panama City, Panama

Fatal case of spotted fever in a patient from Northeastern Brazil

Predictive Factors for Fatal Tick‐Borne Spotted Fever in Brazil

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