A case of rocky mountain spotted fever without eschar as a cause of pyrexia with multiple organ failure

Authors

  • Subodh K. Mahto Department of Medicine, PGIMER, Dr. RML Hospital, New Delhi, India
  • Pulin K. Gupta Department of Medicine, PGIMER, Dr. RML Hospital, New Delhi, India
  • Sahil Sareen Department of Medicine, PGIMER, Dr. RML Hospital, New Delhi, India
  • Arjun M. Balakrishnaa Department of Medicine, Sucheta Kriplani Hospital, LHMC, New Delhi, India
  • Sumit K. Suman Department of Medicine, PGIMER, Dr. RML Hospital, New Delhi, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20174618

Keywords:

Eschar, RMSF, Rickettsia, Thrombocytopenia

Abstract

Rocky mountain spotted fever (RMSF) is a rickettsia disease frequently reported from North America and Europe and transmitted by tick bite. This disease is very rare in India and other parts of South East Asia. Fever with rash and thrombocytopenia are the hallmark clinical presentations of viral hemorrhagic fever but other diseases like malaria, typhoid, Leptospira and rickettsia diseases should also be considered in differential diagnosis. Knowledge of geographical distribution, evidence of exposure to the vector and a high degree of clinical suspicion of rickettsia diseases are very important for early differentiation from other diseases to prevent lethal complications and institute initial treatment. We report a rare case of rocky mountain spotted fever (RMSF) from New Delhi, which was confirmed by specific indirect immunofluorescence assay (IIF). 

References

Chaudhry D, Garg A, Singh I, Tandon C, Saini R. Rickettsial diseases in Haryana: not an uncommon entity. J Assoc Physicians India. 2009;57:334-7.

Mathai E, Rolain JM, Verghese GM, Abraham OC, Mathai D, Mathai M. Outbreak of scrub typhus in southern India during the cooler months. Ann NY Acad Sci. 2003;990:359-64.

Choi YH, Kim SJ, Lee JY, Pai HJ, Lee KY, Lee YS. Scrub typhus: radiological and clinical findings. Clin Radiol. 2000;55:140-4.

Menon RD, Padbidri VS, Gupta NP. Sero epidemiological survey of scrub typhus. J Hyg Epidemiol Microbiol Immunol. 1978;22:306-11.

Sharma A, Mahajan S, Gupta ML, Kanga A, Sharma V. Investigation of an outbreak of scrub typhus in Himalayan region of India. J Infect Dis. 2005;58:208-10.

Kamarasu K, Malathi M, Rajagopal V, Subramani K, Jagadeeshramasamy D, Mathai E. Serological evidence for wide distribution of spotted fevers and typhus fever in Tamil Nadu. Indian J Med Res. 2007;126:128-30.

Pavithran S, Mathai E, Moses PD. Scrub typhus. Indian Pediatrics. 2004;41:1254-7.

Hechemy KE, Stevens RW, Sasowski S, Michaelson EE, Casper EA, Philip RN. Discrepancies in Weil Felix tests and micro immunofluorescence test results in Rocky Mountain spotted fever. J Clin Microbiol Feb. 1979;9(2):292-3.

Poomalar GK, Rekha R. Scrub typhus in pregnancy. J Clin Diagnostic Res. 2014;8:1-3.

Downloads

Published

2017-09-28

How to Cite

Mahto, S. K., Gupta, P. K., Sareen, S., Balakrishnaa, A. M., & Suman, S. K. (2017). A case of rocky mountain spotted fever without eschar as a cause of pyrexia with multiple organ failure. International Journal of Research in Medical Sciences, 5(10), 4658–4660. https://doi.org/10.18203/2320-6012.ijrms20174618

Issue

Section

Case Reports