Date of this Version
I read with interest the article by Paddock et al. , who described the detection of occult mortality due to Rocky Mountain spotted fever (RMSF) by demonstrating Rickettsia rickettsii antigens or DNA in blood and tissues. In Mediterranean countries, including Israel, spotted fever is caused by members of the R. conorii complex, which are antigenically related to R. rickettsii. ...
To the Editor -- We appreciate the comments by Yagupsky, which underscore several of the salient features of spotted fever- group rickettsial infections that we emphasized in our report . For patients, diagnosticians, and clinicians faced with the potentially tragic consequences of Rocky Mountain spotted fever or severe Mediterranean spotted fever (MSF), these points merit repeating. First, the nonspecific signs and symptoms early in the course of rickettsial infections mimic many other infectious and noninfectious syndromes. Second, the diagnostic challenges posed by these diseases are compounded by the lack of rapid and widely available confirmatory tests early in the course of the illnesses. Finally, spotted fevers have the potential to kill otherwise healthy persons in ^ week after onset of symptoms, emphasizing the need for early administration of appropriate therapy.