Skip directly to site content Skip directly to page options Skip directly to A-Z link Skip directly to A-Z link Skip directly to A-Z link
Volume 26, Number 4—April 2020
Research Letter

Needlestick-Associated Rocky Mountain Spotted Fever, Brazil

Stefan Vilges de Oliveira, Álvaro A. Faccini-MartínezComments to Author , Talita Emile Ribeiro Adelino, Ana Íris de Lima Duré, Amalia R.M. Barbieri, and Marcelo B. Labruna
Author affiliations: Universidade Federal de Uberlândia, Uberlândia, Brazil (S.V. de Oliveira); Universidade Federal do Espírito Santo, Vitória, Brazil (Á.A. Faccini-Martínez); Fundação Ezequiel Dias, Belo Horizonte, Brazil (T.E. Ribeiro Adelino, A.Í. de Lima Duré); University of São Paulo, São Paulo, Brazil (A.R.M. Barbieri, M.B. Labruna)

Main Article

Table

Information about confirmed fatal case of needlestick-associated Rocky Mountain spotted fever and related source case in Minas Gerais state, Brazil, 2018*

Case-patient Age, y/sex Clinical signs and symptoms Exposure factors Date
 qPCR (gltA) Conventional heminested PCR (ompA)†
Symptom onset Serum collected Death
A, patient 74/M Fever, myalgia, dysuria, oliguria Environmental exposure to woods, rivers, waterfalls; report of insect bite Jul 20 Jul 22 Jul 24 + +
B, nurse 30/M Fever, maculopapular rash, acute respiratory distress syndrome, shock, oliguria No reported tick or insect bites or environmental exposures; accidental percutaneous needlestick injury associated with case-patient A on July 23 Jul 30 Aug 2 Aug 5 + +

*Clinical and epidemiological data were retrieved from official spotted fever–rickettsiosis case forms collected for each patient by the Ministry of Health, Brazil (4). gltA, rickettsial citrate synthase gene; ompA, rickettsial outer membrane protein A gene; qPCR, quantitative PCR; +, positive.
†All PCR amplicons were sequenced and confirmed a 100% identity with Rickettsia rickettsii.

Main Article

References
  1. Tarantola  A, Abiteboul  D, Rachline  A. Infection risks following accidental exposure to blood or body fluids in health care workers: a review of pathogens transmitted in published cases. Am J Infect Control. 2006;34:367–75. DOIPubMedGoogle Scholar
  2. Hidalgo  M, Faccini-Martínez  ÁA, Valbuena  G. [Tick-borne rickettsioses in the Americas: clinical and epidemiological advances, and diagnostic challenges] [in Spanish]. Biomedica. 2013;33(Suppl 1):161–78.PubMedGoogle Scholar
  3. de Oliveira  SV, Guimarães  JN, Reckziegel  GC, Neves  BM, Araújo-Vilges  KM, Fonseca  LX, et al. An update on the epidemiological situation of spotted fever in Brazil. J Venom Anim Toxins Incl Trop Dis. 2016;22:22. DOIPubMedGoogle Scholar
  4. Ministry of Health. Brazil. Official spotted fever/rickettsiosis case report [in Portuguese]. Brazil: The Ministry; 2018 [cited 2020 Feb 17]. http://portalsinan.saude.gov.br/images/documentos/Agravos/Febre%20Maculosa/Febre_Maculosa_v5.pdf
  5. Ministry of Health. Brazil. Exposure to biological materials [in Portuguese]. Brazil: The Ministry; 2006 [cited 2020 Feb 17]. http://bvsms.saude.gov.br/bvs/publicacoes/protocolo_expos_mat_biologicos.pdf
  6. Faccini-Martínez  ÁA, Muñoz-Leal  S, Acosta  ICL, de Oliveira  SV, de Lima Duré  AÍ, Cerutti  C, et al. Confirming Rickettsia rickettsii as the etiological agent of lethal spotted fever group rickettsiosis in human patients from Espírito Santo state, Brazil. Ticks Tick Borne Dis. 2018;9:496–9. DOIPubMedGoogle Scholar
  7. Johnson  JE III, Kadull  PJ. Rocky Mountain spotted fever acquired in a laboratory. N Engl J Med. 1967;277:842–7. DOIPubMedGoogle Scholar
  8. Sexton  DJ, Gallis  HA, McRae  JR, Cate  TR. Letter: Possible needle-associated Rocky Mountain spotted fever. N Engl J Med. 1975;292:645. DOIPubMedGoogle Scholar
  9. Kaplowitz  LG, Lange  JV, Fischer  JJ, Walker  DH. Correlation of rickettsial titers, circulating endotoxin, and clinical features in Rocky Mountain spotted fever. Arch Intern Med. 1983;143:1149–51. DOIPubMedGoogle Scholar

Main Article

Page created: March 17, 2020
Page updated: March 17, 2020
Page reviewed: March 17, 2020
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
file_external