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Gaceta médica de México

versión On-line ISSN 2696-1288versión impresa ISSN 0016-3813

Gac. Méd. Méx vol.157 no.5 Ciudad de México sep./oct. 2021  Epub 13-Dic-2021 

Cartas al editor

Rocky Mountain spotted fever, dengue and chikungunya, and other tropical vector borne infection

Rujittika Mungmunpuntipantip1 

Viroj Wiwanitkit2  3 

1Private Academic Consultant, Bangkok Thailand

2Department of Community Medicine, Dr. DY Patil University, Pune, India

3Department of Tropical Medicine, Hainan Medical University, Haikou, China

Dear Editor, we would like to share ideas on the publication “Clinical features of patients with Rocky Mountain spotted fever (RMSF), dengue and chikungunya infection1.” Mora et al. concluded that “Rash on the palms and soles, edema and absence of pruritus, together with high levels of direct bilirubin and severe thrombocytopenia could be useful indicators to differentiate patients at RMSF advanced stages from those with dengue and chikungunya1.” We agree that the finding might be useful in clinical practice. However, the diagnostic value of the proposed clinical characteristics has to be further verified. There are several tropical vectors borne disease and common clinical presentations might be seen. For example, a dengue case might present all mentioned clinical characteristics2. In addition, concurrent infection is possible and the proposed clinical characteristic might not be useful for diagnosis. For example, coinfection between RMSF and dengue is possible and is difficult for diagnosis and can lead to fatality3.


1. Mora JD, Licona-Enríquez JD, Álvarez-López DI, Aguilar-León DE, Álvarez-Hernández G. Clinical features of patients with Rocky Mountain spotted fever, dengue and chikungunya infection. Gac Med Mex. 2021;157:58-63. [ Links ]

2. Wiwanitkit V. Dengue fever:diagnosis and treatment. Expert Rev Anti Infect Ther. 2010;8:841-5. [ Links ]

3. Licona-Enríquez JD, de la Mora JD, Hernández GA. Fatal case of co-infected of rickettiosis and dengue virus in Mexico. Rev Med Inst Mex Seguro Soc. 2018;56:320-2. [ Links ]

FundingThe authors declare no funding was received for this study.

Received: June 17, 2021; Accepted: June 24, 2021

* Correspondence: Rujittika Mungmunpuntipantip E-mail:

Conflicts of interest

The authors declare no conflicts of interest

Creative Commons License Academia Nacional de Medicina de México. Published by Permanyer. This is an open access article under the CC BY-NC-ND license