This challenging case of acute febrile illness and rapidly evolving petechial rash and digital gangrene in a traveller who returned from North India and highlights the need for a high index of suspicion for rickettsial infection in returned travellers.
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A pilgrim's progress: severe Rickettsia conorii infection complicated by gangrene
Puvesh Punj, Renjy Nelson, Sarah Gardiner, Michelle Lodge, Stephen R Graves and Morgyn S Warner
Med J Aust 2013; 198 (11): 629-631.
Puvesh Punj, MB BS, Surgical Resident1
Renjy Nelson, MB BS, FRACP, Infectious Diseases Physician1
Sarah Gardiner, BM BS, Surgical Registrar1
Michelle Lodge, MB BS, FRACS, Plastic and Reconstructive Surgeon1
Stephen R Graves, FASM, FRCPA, PhD, Medical Director2
Morgyn S Warner, MD, FRACP, FRCPA, Clinical Microbiologist and Infectious Diseases Physician1,3
Raoult D, Roux V. Rickettsioses as paradigms of new and emerging infectious diseases. Clin Microbiol Rev 1997; 10: 694-719.
McBride WJ, Hanson JP, Miller R, Wenck D. Severe spotted fever group rickettsiosis, Australia. Emerg Infect Dis 2007; 13: 1742-1744.
Murphy H, Renvoise A, Pandey P, et al. Rickettsia honei infection in human, Nepal, 2009. Emerg Infect Dis 2011; 17: 1865-1867.
Raoult D, Weiller PJ, Chagnon A, et al. Mediterranean spotted fever: clinical, laboratory and epidemiological features of 199 cases. Am J Trop Med Hyg 1986; 35: 845-850.
Cascio A, Dones P, Romano A, Titone L. Clinical and laboratory findings of boutonneuse fever in Sicilian children. Eur J Pediatr 1998; 157: 482-486.
Walker DH. Rickettsiae and rickettsial infections: the current state of knowledge. Clin Infect Dis 2007; 45 Suppl 1: S39-S44.
Lee N, Ip M, Wong B, et al. Risk factors associated with life-threatening rickettsial infections. Am J Trop Med Hyg 2008; 78: 973-978.
Cascio A, Colomba C, Di Rosa D, et al. Efficacy and safety of clarithromycin as treatment for Mediterranean spotted fever in children: a randomized controlled trial. Clin Infect Dis 2001; 33: 409-411.
Breitschwerdt EB, Davidson MG, Hegarty BC, et al. Prednisolone at anti-inflammatory or immunosuppressive dosages in conjunction with doxycycline does not potentiate the severity of Rickettsia rickettsii infection in dogs. Antimicrob Agents Chemother 1997; 41: 141-147.
Birch TF, Muller M. Severe Queensland tick typhus complicated by diabetes in south-eastern Queensland. Med J Aust 2009; 191: 290-291.
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