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Boletín médico del Hospital Infantil de México
versión impresa ISSN 1665-1146
Resumen
LOPEZ-CASTILLO, Delmy C. et al. Rocky mountain spotted fever: five years of active surveillance experience in a second level pediatric hospital in northeastern Mexico. Bol. Med. Hosp. Infant. Mex. [online]. 2018, vol.75, n.5, pp.303-308. ISSN 1665-1146. https://doi.org/10.24875/bmhim.m18000034.
Background:
Rocky Mountain Spotted Fever (RMSF) is caused by Rickettsia rickettsii. In Coahuila, Comarca Lagunera is considered an endemic zone; no cases have been reported in the southern zone of the state, specifically in the city of Saltillo.
Methods:
Prospective study, cases report. Children evaluated in the Hospital del Niño Dr. Federico Gómez Santos from September 2012 to September 2017, with clinically and laboratory (by polymerase chain reaction, PCR) confirmed diagnosis of FMMR were included. The epidemiological antecedents, clinical characteristics and patient’s evolution are presented.
Results:
14 patients were confirmed. The male: female ratio was 1.8: 1, the average age of the patients was 7.6 years (18 months to 13 years). 42.8% reported contact with dogs and 57.1% confirmed contact with ticks. In all cases, there was fever and purpuric rash; around 70% manifested myalgias and arthralgias; 28% presented digestive tract bleeding and 11% had severe neurological alterations. 64.2% of the cases received adequate treatment with doxycycline. Eight patients died with a case fatality rate of 57.1%.
Conclusions:
The southern zone of Coahuila should be considered an endemic area for FMMR. The delay in diagnosis and treatment favor a greater lethality.
Palabras llave : Rocky mountain spotted fever; Rickettsia rickettsii; Purpuric exanthema; Ticks.