Volume 87, Issue 2
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



This study reports the first urban human case of Rocky Mountain spotted fever caused by , in Costa Rica. An 8-year-old female who died at the National Children's Hospital 4 days after her admission, and an important and significant observation was the presence of an “eschar” (tache noire), which is typical in some rickettsial infections but not frequent in Rocky Mountain spotted fever cases.


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  1. Toledo RS, Tamekuni K, Filho MF, Haydu VB, Barbieri AR, Hiltel AC, Pacheco RC, Labruna MB, Dumler JS, Vidotto O, , 2011. Infection by spotted fever rickettsiae in people, dogs, horses and ticks in Londrina, Parana State, Brazil. Zoonoses Public Health 58: 416423.[Crossref]
  2. Parola P, Labruna MB, Raoult D, , 2009. Tick-borne rickettsioses in America: unanswered questions and emerging diseases. Curr Infect Dis Rep 11: 4050.[Crossref]
  3. Fuentes LG, , 1979. 1st case of Rocky Mountain fever in Costa Rico, Central America. Rev Latinoam Microbiol 21: 167172.
  4. Fuentes L, Calderón A, Hun L, , 1985. Isolation and identification of Rickettsia rickettsii from the rabbit tick (Haemaphysalis leporispalustris) in the Atlantic zone of Costa Rica. Am J Trop Med Hyg 34: 564567.
  5. Hun L, Cortes X, Taylor L, , 2009. Molecular characterization of Rickettsia rickettsii isolated from human clinical samples and from the rabbit tick Haemaphysalis leporispalustris collected at different geographic zones in Costa Rica. Am J Trop Med Hyg 79: 899902.
  6. Walker D, Ismail N, . 2008. Emerging and re-emerging rickettsioses: endothelial cell infection and early disease events. Nature Rev 6: 375386.
  7. Paddock CD, Sumner JW, Comer JA, Zaki SR, Goldsmith CS, Goddard J, McLellan SL, Tamminga CL, Ohl CA, , 2004. Rickettsia parkeri: a newly recognized cause of spotted fever rickettsiosis in the United State. Clin Infect Dis 38: 805811.[Crossref]
  8. García-García JC, Portillo A, Núñez MJ, Santibáñez S, Castro B, Oteo JA, , 2010. Case report: a patient from Argentina infected with Rickettsia massiliae . Am J Trop Med Hyg 82: 691692.[Crossref]
  9. Masters EJ, Olson GS, Weiner SJ, Paddock CD, , 2003. Rocky Mountain spotted fever: a clinician's dilemma. Arch Intern Med 163: 769774.[Crossref]
  10. Dantas-Torres F, , 2007. Rocky Mountain spotted fever. Lancet Infect Dis 7: 724732.[Crossref]
  11. Lacz NL, Schwartz RA, Kapila R, , 2006. Rocky Mountain spotted fever. J Eur Acad Dermatol Venereol 20: 411417.[Crossref]
  12. Labruna MB, Whitworth T, Horta MC, Bouyer DH, Mcbride JW, Pinter A, Popov V, Gennari SM, Walker DH, , 2004. Rickettsia species infecting Amblyomma cooperi ticks from an area in the state of Sao Paulo, Brazil, where Brazilian spotted fever is endemic. J Clin Microbiol 42: 9098.[Crossref]
  13. Horta MC, Labruna MB, Sangioni LA, Vianna MC, Gennari SM, Galvão MA, Mafra CL, Vidotto O, Schumaker TT, Walker DH, , 2004. Prevalence of antibodies to spotted fever group rickettsiae in humans and domestic animals in a Brazilian spotted fever-endemic area in the state of São Paulo, Brazil: serologic evidence for infection by Rickettsia rickettsii and another spotted fever group Rickettsia . Am J Trop Med Hyg 71: 9397.
  14. Roux V, Fournier PE, Raoult D, , 1996. Differentiation of spotted fever group rickettsiae by sequencing and analysis of restriction fragment length polymorphism of PCR-amplified DNA of the gene encoding the protein rOmpA . J Clin Microbiol 34: 20582065.
  15. Freitas MC, Grycajuk M, Molento MB, Bonacin J, Labruna MB, Pacheco Rde C, Moraes-Filho J, Deconto I, Biondo AW, , 2010. Brazilian spotted fever in cart horses in a non-endemic area in southern Brazil. Rev Bras Parasitol Vet 19: 130131.[Crossref]
  16. Lamas C, Favacho A, Rozental T, Bóia MN, Kirsten AH, Guterres A, Barreira J, de Lemos ER, , 2008. Characterization of Rickettsia rickettsii in a case of fatal Brazilian spotted fever in the city of Rio de Janeiro, Brazil. Braz J Infect Dis 12: 149151.[Crossref]
  17. Álvarez-Hernández G, , 2010. Rocky Mountain spotted fever: a forgotten epidemic. Salud Publica Mex 52: 13.[Crossref]
  18. Labruna M, , 2009. Ecology of Rickettsia in South America. Ann N Y Acad Sci 1166: 156166.[Crossref]
  19. Parola P, Labruna MB, Raoult D, , 2009. Tick-borne rickettsioses in America: unanswered questions and emerging diseases. Curr Infect Dis Rep 11: 4050.[Crossref]
  20. Sangioni LA, Horta MC, Vianna MC, Gennari SM, Soares RM, Galvão MA, Schumaker TT, Ferreira F, Vidotto O, Labruna MB, , 2005. Rickettsial infections in animals and Brazilian spotted fever endemicity. Emerg Infect Dis 11: 265270.[Crossref]
  21. Paddock DC, Finley RW, Wright CS, Robinson HN, Schrodt BJ, Lane CC, Okechukwu E, Blass MA, Tamminga CL, Ohl CA, McLellan SL, Goddard G, Holman RC, Openshaw JJ, Sumner JW, Zaki SR, Eremeeva ME, , 2008. Rickettsia parkeri rickettsiosis and its clinical distinction from Rocky Mountain spotted fever. Clin Infect Dis 47: 11881196.[Crossref]

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  • Received : 07 Mar 2012
  • Accepted : 17 Apr 2012

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