Atypical fulminant Rickettsia rickettsii infection (Brazilian spotted fever) presenting as septic shock and adult respiratory distress syndrome.
Atypical fulminant Rickettsia rickettsii infection (Brazilian spotted fever) presenting as septic shock and adult respiratory distress syndrome.
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非典型暴发性立克次体感染（巴西斑疹热）表现为感染性休克和成人呼吸窘迫综合征。
DOI：
10.1590/s1413-86702002000200006
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发表时间：
2002
期刊：
影响因子：
--
通讯作者：
L. M. de Carvalho Valle
中科院分区：
文献类型：
--
作者：
P. S. Gonçalves da Costa;Marcos Emilio Brigatte;E. R. Pereira de Almeida;L. M. de Carvalho Valle
由立克次体引起的巴西斑疹热在巴西特别是东南部各州的报告越来越多。这种疾病的严重和暴发性形式并不罕见，但大多数报告的致命病例都显示出一些典型的临床线索，这些线索使主治医生做出正确的诊断。我们报告一例非典型暴发性巴西斑疹热的可能病例，表现为与成人呼吸窘迫综合征（ARDS）相关的全面败血性休克和迟发性非特征性皮疹，IgM抗体增加4倍以上，但抗立克次体IgG抗体滴度没有增加。巴西从业者应意识到巴西斑点热作为暴发性原发性脓毒症伴ARDS的原因的可能性;改进的实验室方法对于此类病例的快速诊断是必要的。
Brazilian spotted fever, caused by Rickettsia rickettsii, has been increasingly reported in Brazil especially in the southeastern states. The severe and fulminant forms of the disease are not unusual but most of the reported fatal cases have shown some typical clinical clue, which leads the attending physician to a correct diagnosis. We report a probable case of atypical fulminant Brazilian spotted fever that presented full-blown septic shock associated with Adult Respiratory Distress Syndrome (ARDS) and delayed uncharacteristic rash with an over four-fold increase in reciprocal IgM, but not IgG titer against Rickettsia rickettsii. Brazilian practitioners should be aware of the possibility of Brazilian spotted fever as a cause of fulminant primary sepsis with ARDS; improved laboratory methods are necessary for the rapid diagnosis of such cases.