Rocky Mountain spotted fever complicated by gangrene: report of six cases and review.
Journal Article (Journal Article;Review)
Although mortality due to fulminant Rocky Mountain spotted fever (RMSF) is well appreciated, the ability of the disease to cause survivors to become permanently disabled is not as widely known. We report six cases of RMSF complicated by gangrene. Although four patients required multiple limb and/or digital amputations, only one death resulted. Our review of the English-language literature revealed 23 additional cases of RMSF complicated by gangrene. Pathophysiologically, gangrene is most likely related to small-vessel occlusion. Skin necrosis and gangrene in association with RMSF are the extreme end on a continuum from reversible to irreversible skin and tissue damage caused by Rickettsia rickettsii. Most patients with RMSF have a typical skin rash that resolves without sequelae. Some patients develop minute cicatrices marking the location of focal cutaneous necrosis; for other patients, digital ischemia occurs transiently or evolves to produce severe ischemic changes without gangrene that result in permanent impairment. At the far end of this clinical continuum are patients who develop gangrene requiring amputation.
Full Text
Duke Authors
Cited Authors
- Kirkland, KB; Marcom, PK; Sexton, DJ; Dumler, JS; Walker, DH
Published Date
- May 1993
Published In
- Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
Volume / Issue
- 16 / 5
Start / End Page
- 629 - 634
PubMed ID
- 8507753
Pubmed Central ID
- 8507753
International Standard Serial Number (ISSN)
- 1058-4838
Digital Object Identifier (DOI)
- 10.1093/clind/16.5.629
Language
- eng
Conference Location
- United States