<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0300-9041</journal-id>
<journal-title><![CDATA[Ginecología y obstetricia de México]]></journal-title>
<abbrev-journal-title><![CDATA[Ginecol. obstet. Méx.]]></abbrev-journal-title>
<issn>0300-9041</issn>
<publisher>
<publisher-name><![CDATA[Federación Mexicana de Colegios de Obstetricia y Ginecología A.C.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0300-90412020000700008</article-id>
<article-id pub-id-type="doi">10.24245/gom.v88i7.3859</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Rickettsiosis vs síndrome de HELLP. Informe de caso clínico]]></article-title>
<article-title xml:lang="en"><![CDATA[Rickettsiosis vs HELLP syndrome. A clinical report]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Moreno-Trujillo]]></surname>
<given-names><![CDATA[Misael]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Orendain-Jaime]]></surname>
<given-names><![CDATA[Erika Nallely]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Castro-Luque]]></surname>
<given-names><![CDATA[Eleobardo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Sotelo-Barajas]]></surname>
<given-names><![CDATA[Brianna]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Monay-Gallardo]]></surname>
<given-names><![CDATA[Gerardo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado Hospital General 5 de Diciembre ]]></institution>
<addr-line><![CDATA[Mexicali Baja California]]></addr-line>
<country>México</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,aff2  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>México</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado Hospital General 5 de Diciembre ]]></institution>
<addr-line><![CDATA[Mexicali Baja California]]></addr-line>
<country>México</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado Hospital General 5 de Diciembre ]]></institution>
<addr-line><![CDATA[Mexicali Baja California]]></addr-line>
<country>México</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>00</month>
<year>2020</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>00</month>
<year>2020</year>
</pub-date>
<volume>88</volume>
<numero>7</numero>
<fpage>477</fpage>
<lpage>483</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S0300-90412020000700008&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S0300-90412020000700008&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S0300-90412020000700008&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  ANTECEDENTES:  La rickettsiosis y su aparición como infección reemergente en México ha suscitado preocupación en las autoridades de salud ante su alto riesgo de mortalidad en embarazadas y niños.  CASO CLÍNICO:  Paciente de 19 años, con 37 semanas de embarazo, que ingresó a Urgencias por síndrome febril. Ante los hallazgos clínicos de sufrimiento fetal se finalizó el embarazo mediante cesárea. Posteriormente se sospechó síndrome de HELLP vs rickettsiosis debido a fiebre persistente, plaquetopenia e hipertransaminasemia. Esta última se confirmó al cuarto día de estancia hospitalaria, con desenlace fatal a pesar del tratamiento específico.  CONCLUSIONES:  El diagnóstico temprano de rickettsiosis es complejo: requiere un alto discernimiento clínico porque existe la posibilidad de enmascararse con las enfermedades posibles durante el embarazo. Por ello es de vital importancia puntualizar que en áreas endémicas debe considerarse la posibilidad de contagio en pacientes con cuadros febriles que no cuenten con un foco infeccioso específico y que tengan: cefalea, fiebre y plaquetopenia, y la posibilidad de exposición al agente.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  BACKGROUND:  Rickettsiosis in Mexico has grown concern into the national sanitary system in Mexico due its high mortality risk, being the pregnant woman and pediatric the most vulnerable groups.  CLINICAL CASE:  19 year-old pregnant woman with 37 weeks, referred by febrile syndrome. Caesarean procedure is performed due to premature rupture of membranes. In later days is suspected the diagnosis of HELLP syndrome vs Rickettsiosis in the fourth hospital day due to persistent fever and low platelets, confirming last mentioned. Patient presents fatal outcome even with specific treatment.  CONCLUSIONS:  Early diagnosis of rickettsiosis is difficult, requiring high clinical discernment as there is the possibility of masking with possible pathologies during pregnancy. In accordance with the above, it is vitally important to point out that in endemic areas the possibility of infection in those feverish conditions that do not have a specific infectious focus and that present with headache, fever and platelet disease, as well as the possibility of exposure to the agent should be considered.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Fiebre manchada de las montañas rocosas]]></kwd>
<kwd lng="es"><![CDATA[gestación]]></kwd>
<kwd lng="es"><![CDATA[diagnóstico]]></kwd>
<kwd lng="es"><![CDATA[doxiciclina]]></kwd>
<kwd lng="en"><![CDATA[Rocky Mountain spotted fever]]></kwd>
<kwd lng="en"><![CDATA[pregnancy]]></kwd>
<kwd lng="en"><![CDATA[diagnosis]]></kwd>
<kwd lng="en"><![CDATA[doxycycline]]></kwd>
</kwd-group>
</article-meta>
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