1981
DOI: 10.1016/s0190-9622(81)70059-8
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The occurrence of eschars in Rocky Mountain spotted fever

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Cited by 56 publications
(33 citation statements)
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“…Rickettsial vasculitis and occlusive luminal thrombosis are associated with dermal and epidermal coagulative necrosis, resulting in the formation of these eschars. 19 As such, they may represent a localized defensive reaction by the host against the penetration of the pathogenic bacterium. It is generally thought that the development of a localized defensive reaction is a good prognostic factor, and spotted fevers that generally induce multiple eschars in patients (for example, African tick bite fever) are milder than spotted fevers that are rarely accompanied by eschars (Rocky Mountain spotted fever).…”
Section: Discussionmentioning
confidence: 99%
“…Rickettsial vasculitis and occlusive luminal thrombosis are associated with dermal and epidermal coagulative necrosis, resulting in the formation of these eschars. 19 As such, they may represent a localized defensive reaction by the host against the penetration of the pathogenic bacterium. It is generally thought that the development of a localized defensive reaction is a good prognostic factor, and spotted fevers that generally induce multiple eschars in patients (for example, African tick bite fever) are milder than spotted fevers that are rarely accompanied by eschars (Rocky Mountain spotted fever).…”
Section: Discussionmentioning
confidence: 99%
“…Lack of rash or late-onset rash in RMSF has been associated with delays in diagnosis and increased mortality (6,18,74). Unlike some SFG rickettsioses, an inoculation eschar is rarely present with RMSF (100,101 features that have been observed in association with RMSF include abdominal pain that mimics acute appendicitis (102), cholecystitis (103), or gastroenteritis; diarrhea; conjunctival suffusion; periorbital and peripheral edema (more common in children); calf pain; acute transient hearing loss; hepatomegaly; and splenomegaly (6,104). Severe, late-stage manifestations of RMSF include meningoencephalitis, acute renal failure, ARDS, cutaneous necrosis, shock, arrhythmia, and seizure.…”
Section: Signs and Symptomsmentioning
confidence: 99%
“…mongolotimonae (245), but is generally an unusual clinical feature of most SFG rickettsial infections. Indeed, eschars are seldom described for patients with RMSF, and it has been suggested that rare observations of eschars in patients with supposed RMSF (76,354) could be caused by infection with R. parkeri rather than R. rickettsii (230). A 1994 report describing PCR-restriction fragment length polymorphism profiles of several SFG rickettsial stains isolated from patients presumably infected with R. rickettsii noted close similarity of one profile with that of R. parkeri (266).…”
Section: Vol 18 2005mentioning
confidence: 99%