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Volume 32, Number 2—February 2026

Research

Predictors of Fatal Outcomes among Pediatric Patients Hospitalized for Rocky Mountain Spotted Fever, Sonora, Mexico, 2004–20241

Stephanie Bellman, Kaci D. McCoy, Diana Enriquez, Pamela Romo, JongIn Hwang, Kathleen Weimer, Sarah M. Gunter, José Luis Alomía-Zegarra, Kristy O. Murray2Comments to Author , and Gerardo Álvarez-Hernández2
Author affiliation: Emory University School of Medicine, Atlanta, Georgia, USA (S. Bellman, K.D. McCoy, J. Hwang, K. Weimer, K.O. Murray); Children’s Healthcare of Atlanta, Atlanta (S. Bellman, K.D. McCoy, J. Hwang, K. Weimer, K.O. Murray); University of Sonora, Hermosillo, Mexico (D. Enriquez, P. Romo, G. Álvarez-Hernández); Baylor College of Medicine and Texas Children’s Hospital, Houston, Texas, USA (S.M. Gunter); Secretaría de Salud Pública del Estado de Sonora, Hermosillo (J.L. Alomía-Zegarra); Hospital Infantil del Estado de Sonora, Hermosillo (G. Álvarez-Hernández)

Main Article

Figure 3

Clinical progress of children in in study of predictors of fatal outcomes among pediatric patients hospitalized for Rocky Mountain spotted fever, Sonora, Mexico, 2004–2024. A) Maculopapular rash on the palm of an 8-year-old child, observed on day 3 after symptom onset. B) Edema with petechia on the dorsum of the hand of a 6-year-old child, observed on day 5 after symptom onset. C) Ecchymotic patches on the foot and ankle of a 7-year-old child, observed on day 7 after symptom onset. D) Necrosis of the left lower limb in another 7-year-old child, observed on day 24 of disease progression.

Figure 3. Clinical progress of children in in study of predictors of fatal outcomes among pediatric patients hospitalized for Rocky Mountain spotted fever, Sonora, Mexico, 2004–2024. A) Maculopapular rash on the palm of an 8-year-old child, observed on day 3 after symptom onset. B) Edema with petechia on the dorsum of the hand of a 6-year-old child, observed on day 5 after symptom onset. C) Ecchymotic patches on the foot and ankle of a 7-year-old child, observed on day 7 after symptom onset. D) Necrosis of the left lower limb in another 7-year-old child, observed on day 24 of disease progression.

Main Article

1Preliminary results from this study were presented at the Southeastern Pediatric Research Conference; June 6, 2025; Atlanta, Georgia, USA; and at the American Society of Tropical Medicine and Hygiene Conference; November 10, 2025; Toronto, Ontario, Canada.

2These senior authors contributed equally to this article.

Page created: January 20, 2026
Page updated: February 05, 2026
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