Case report: Co-infection of Rickettsia rickettsii and Streptococcus pyogenes: is fatal Rocky Mountain spotted fever underdiagnosed?

doi:10.4269/ajtmh.14-0437

Case Reports

. 2014 Dec;91(6):1154-5.

doi: 10.4269/ajtmh.14-0437. Epub 2014 Oct 20.

Case report: Co-infection of Rickettsia rickettsii and Streptococcus pyogenes: is fatal Rocky Mountain spotted fever underdiagnosed?

Affiliations

¹ Epidemic Intelligence Service, Center for Surveillance, Epidemiology and Laboratory Services, Rickettsial Zoonoses Branch, National Center for Emerging and Zoonotic Infectious Diseases, Streptococcus Laboratory, National Center for Immunization and Respiratory Diseases, HIV Prevention Branch, Division of Global HIV/AIDS, Center for Global Health, Border Health Services Branch, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Office of Infectious Diseases Services, Arizona Department of Health Services, Phoenix, Arizona; Maricopa County Department of Public Health, Phoenix, Arizona vih5@cdc.gov.
² Epidemic Intelligence Service, Center for Surveillance, Epidemiology and Laboratory Services, Rickettsial Zoonoses Branch, National Center for Emerging and Zoonotic Infectious Diseases, Streptococcus Laboratory, National Center for Immunization and Respiratory Diseases, HIV Prevention Branch, Division of Global HIV/AIDS, Center for Global Health, Border Health Services Branch, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Office of Infectious Diseases Services, Arizona Department of Health Services, Phoenix, Arizona; Maricopa County Department of Public Health, Phoenix, Arizona.

PMID: 25331804
PMCID: PMC4257638
DOI: 10.4269/ajtmh.14-0437

Case Reports

Case report: Co-infection of Rickettsia rickettsii and Streptococcus pyogenes: is fatal Rocky Mountain spotted fever underdiagnosed?

Gregory A Raczniak et al. Am J Trop Med Hyg. 2014 Dec.

. 2014 Dec;91(6):1154-5.

doi: 10.4269/ajtmh.14-0437. Epub 2014 Oct 20.

Affiliations

¹ Epidemic Intelligence Service, Center for Surveillance, Epidemiology and Laboratory Services, Rickettsial Zoonoses Branch, National Center for Emerging and Zoonotic Infectious Diseases, Streptococcus Laboratory, National Center for Immunization and Respiratory Diseases, HIV Prevention Branch, Division of Global HIV/AIDS, Center for Global Health, Border Health Services Branch, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Office of Infectious Diseases Services, Arizona Department of Health Services, Phoenix, Arizona; Maricopa County Department of Public Health, Phoenix, Arizona vih5@cdc.gov.
² Epidemic Intelligence Service, Center for Surveillance, Epidemiology and Laboratory Services, Rickettsial Zoonoses Branch, National Center for Emerging and Zoonotic Infectious Diseases, Streptococcus Laboratory, National Center for Immunization and Respiratory Diseases, HIV Prevention Branch, Division of Global HIV/AIDS, Center for Global Health, Border Health Services Branch, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Office of Infectious Diseases Services, Arizona Department of Health Services, Phoenix, Arizona; Maricopa County Department of Public Health, Phoenix, Arizona.

PMID: 25331804
PMCID: PMC4257638
DOI: 10.4269/ajtmh.14-0437

Abstract

Rocky Mountain spotted fever, a tick-borne disease caused by Rickettsia rickettsii, is challenging to diagnose and rapidly fatal if not treated. We describe a decedent who was co-infected with group A β-hemolytic streptococcus and R. rickettsii. Fatal cases of Rocky Mountain spotted fever may be underreported because they present as difficult to diagnose co-infections.

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References

1. Kirkland KB, Wilkinson WE, Sexton DJ. Therapeutic delay and mortality in cases of Rocky Mountain spotted fever. Clin Infect Dis. 1995;20:1118–1121. - PubMed
1. Kaplan JE, Schonberger LB. The sensitivity of various serologic tests in the diagnosis of Rocky Mountain spotted fever. Am J Trop Med Hyg. 1986;35:840–844. - PubMed
1. Dahlgren FS, Holman RC, Paddock CD, Callinan LS, McQuiston JH. Fatal Rocky Mountain spotted fever in the United States, 1999–2007. Am J Trop Med Hyg. 2012;86:713–719. - PMC - PubMed
1. Fine D, Mosher D, Yamada T, Burke D, Kenyon R. Coagulation and complement studies in Rocky Mountain spotted fever. Arch Intern Med. 1978;138:735–738. - PubMed
1. Middleton DB. Rocky Mountain spotted fever: gastrointestinal and laboratory manifestations. South Med J. 1978;71:629–632. - PubMed

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[1] Kirkland KB, Wilkinson WE, Sexton DJ. Therapeutic delay and mortality in cases of Rocky Mountain spotted fever. Clin Infect Dis. 1995;20:1118–1121. - PubMed

[2] Kirkland KB, Wilkinson WE, Sexton DJ. Therapeutic delay and mortality in cases of Rocky Mountain spotted fever. Clin Infect Dis. 1995;20:1118–1121. - PubMed

[3] Kaplan JE, Schonberger LB. The sensitivity of various serologic tests in the diagnosis of Rocky Mountain spotted fever. Am J Trop Med Hyg. 1986;35:840–844. - PubMed

[4] Kaplan JE, Schonberger LB. The sensitivity of various serologic tests in the diagnosis of Rocky Mountain spotted fever. Am J Trop Med Hyg. 1986;35:840–844. - PubMed

[5] Dahlgren FS, Holman RC, Paddock CD, Callinan LS, McQuiston JH. Fatal Rocky Mountain spotted fever in the United States, 1999–2007. Am J Trop Med Hyg. 2012;86:713–719. - PMC - PubMed

[6] Dahlgren FS, Holman RC, Paddock CD, Callinan LS, McQuiston JH. Fatal Rocky Mountain spotted fever in the United States, 1999–2007. Am J Trop Med Hyg. 2012;86:713–719. - PMC - PubMed

[7] Fine D, Mosher D, Yamada T, Burke D, Kenyon R. Coagulation and complement studies in Rocky Mountain spotted fever. Arch Intern Med. 1978;138:735–738. - PubMed

[8] Fine D, Mosher D, Yamada T, Burke D, Kenyon R. Coagulation and complement studies in Rocky Mountain spotted fever. Arch Intern Med. 1978;138:735–738. - PubMed

[9] Middleton DB. Rocky Mountain spotted fever: gastrointestinal and laboratory manifestations. South Med J. 1978;71:629–632. - PubMed

[10] Middleton DB. Rocky Mountain spotted fever: gastrointestinal and laboratory manifestations. South Med J. 1978;71:629–632. - PubMed

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Case report: Co-infection of Rickettsia rickettsii and Streptococcus pyogenes: is fatal Rocky Mountain spotted fever underdiagnosed?

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Case report: Co-infection of Rickettsia rickettsii and Streptococcus pyogenes: is fatal Rocky Mountain spotted fever underdiagnosed?

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