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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

Table 2

Laboratory findings at admission for fatal and nonfatal cases in study of predictors of fatal outcomes among pediatric patients hospitalized for Rocky Mountain spotted fever, Sonora, Mexico, 2004–2024*

Indicator No. cases Median (interquartile range)
 p value†
Fatal Nonfatal Total
Hemoglobin, g/dL 497 11.3 (10.3–12.8) 11.5 (10.3–12.5) 11.4 (10.3–12.5) 0.75
Hematocrit, % 494 34.1 (30.4–37.5) 33.7 (30.4–36.9) 33.8 (30.4–37.0) 0.92
Blood leukocytes, × 103 cells/μL 498 17 (10–26) 8 (6–13) 9 (6–15) <0.001
Absolute lymphocyte count, × 103 cells/μL 475 1.8 (0.8–3.3) 1.1 (0.8–2.0) 1.2 (0.8–2.1) 0.007
Absolute neutrophil count, × 103 cells/μL 477 11.1 (8.1–18.8) 5.9 (4.0–9.0) 6.7 (4.3–10.5) <0.001
Neutrophil-to-lymphocyte ratio 471 8 (4–15) 5 (3–9) 5 (3–9) <0.001
Platelets, × 103 cells/μL 497 17 (10–25) 60 (27–120) 46 (20–103) <0.001
Serum procalcitonin, ng/mL 337 20 (8–44) 4 (1–11) 6 (2–18) <0.001
Prothrombin time, sec 488 18.0 (15.8–20.7) 15.1 (13.9–16.2) 15.5 (14.1–17.1) <0.001
Partial thromboplastin time, sec 486 47 (41–56) 39 (32–43) 40 (33–45) <0.001
Aspartate aminotransferase, U/L 488 253 (171–398) 115 (61–165) 132 (70–205) <0.001
Alanine aminotransferase, U/L 487 83 (65–115) 55 (34–82) 61 (37–90) <0.001
Lactate dehydrogenase, U/L 384 1,479 (1,055–1,928) 752 (549–998) 839 (574–1224) <0.001
Serum sodium level, mq/L 492 130 (126–135) 132 (129–136) 132 (129–136) 0.003
Serum creatinine, mg/dL 451 1.5 (0.8–2.6) 0.5 (0.4–0.6) 0.6 (0.4–0.9) <0.001
Serum albumin, g/dL 416 2.8 (2.4–3.1) 3.2 (2.8–3.9) 3.1 (2.7–3.8) <0.001
Serum total protein, mg/dL 417 5.0 (4.3–5.8) 5.8 (5.0–6.4) 5.6 (4.9–6.3) <0.001

*Bold font indicates statistical significance (p<0.001). †Based on Kruskall-Wallis analysis of variance or Fisher exact test; statistical significance determined by Bonferroni correction.

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.

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