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Five Cases of Atypical Rickettsial Infections

dc.contributor.authorSalva, I
dc.contributor.authorGouveia, C
dc.contributor.authorSousa, R
dc.contributor.authorBrito, MJ
dc.date.accessioned2013-02-07T15:00:27Z
dc.date.available2013-02-07T15:00:27Z
dc.date.issued2011
dc.description.abstractBackground: Rickettsia conorii is the most frequent species of RickettsiaI causing disease in Portugal. In general the disease manifests itself by fever, exanthema, headaches and the presence of an eschar. However atypical forms can be present and physicians should be aware. Aims: Analyse the atypical presentation of rickettsiosis. Material and Methods: Children admitted at the CHLC Hospital from 2000 to 2010 with atypical presentation of rickettsiosis. Clinical diagnosis was confirmed by serology and molecular techniques (PCR). Results: Five cases of children with a median age of 2 years, 1 of which female, were admitted between June and August. The diagnoses were: myositis (1), synovitis (1), cholecystitis (1), orchiepididymitis (1) and meningitis (1). Myositis developped with functional disability, CPK 9600 U/L, lower limbs’ edema, hypoalbuminemia (1,6 g/dL) and arterial hypertension. Synovitis developped with functional disability, synovial fluid increase and CRP 16,2 mg/dL. The child with cholecystitis had abdominal pain, intraabdominal fluid increase, leukopenia (1900/μL), thrombocytopenia (75000/μL) and CRP 15,3 mg/dL. Orchiepididymitis developped with testicle’s inflammatory signs, leukopenia (2900/μL), thrombocytopenia (90000/μL) and CRP 14,45 mg/dL. The patient with meningitis, who had pleocytosis (320 cells/μL), hyperproteinorrachia (284 mg/dL), hypoglicorrachia (36 mg/dL), presented only with fever and headaches. The tache noire and the classical triad were present in 3/5 cases. The clinical course was favourable in all cases. Antibodies against Rickettsia of spotted fever group were detected in 3/5 cases. In one patient Rickettsia conorii Malish strain was identified by PCR and sequencing. Conclusions: Rickettsial infection may present itself unusually. In a country of high prevalence, especially during summer months and in the presence of an inoculation eschar, it is of the uttermost importance to study the atypical presentations for a possible rickettsial infection.por
dc.identifier.citationIN: The 29th Annual Meeting of the European Society for Paediatrics Infectious Diseases (ESPID); 2011, 7 a 11 Junho.The Hague.por
dc.identifier.urihttp://hdl.handle.net/10400.17/1034
dc.language.isoengpor
dc.publisherUnidade de Infecciologia Pediátrica, Hospital Dona Estefânia, Centro Hospitalar de Lisboa Central, EPEpor
dc.subjectPneumonia Rickettsialpor
dc.subjectAnticorpospor
dc.subjectCriançapor
dc.subjectCaso Clínicopor
dc.subjectHDE INF PED
dc.titleFive Cases of Atypical Rickettsial Infectionspor
dc.typeother
dspace.entity.typePublication
rcaap.rightsopenAccesspor
rcaap.typeotherpor

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