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Rocky Mountain spotted fever mimicking acute cholecystitis.
Arch Intern Med. 1985 Dec; 145(12):2194-6.AI

Abstract

Rocky Mountain spotted fever can present with predominantly abdominal symptoms including nausea, vomiting, diarrhea, and abdominal pain. Two elderly patients presented with an acute febrile illness and abdominal symptoms. Rash was not present initially. Workup disclosed cholelithiasis in one, and a thickened gallbladder wall surrounded by a sonolucent zone suggesting a pericholecystic abscess was found by ultrasonography in the other. Both patients underwent emergency laparotomy, with cholecystectomy in both and appendectomy in one. Both patients died several days postoperatively. Pathologic specimens reviewed later showed that multiple blood vessels of the gallbladder and the appendix were infected with Rickettsia rickettsii, and there was focal vascular thrombosis and hemorrhage. These documented direct rickettsial infections and lesions in the blood vessels of abdominal viscera suggest the basis for the abdominal symptoms in Rocky Mountain spotted fever.

Authors

No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

4074033

Citation

Walker, D H., et al. "Rocky Mountain Spotted Fever Mimicking Acute Cholecystitis." Archives of Internal Medicine, vol. 145, no. 12, 1985, pp. 2194-6.
Walker DH, Lesesne HR, Varma VA, et al. Rocky Mountain spotted fever mimicking acute cholecystitis. Arch Intern Med. 1985;145(12):2194-6.
Walker, D. H., Lesesne, H. R., Varma, V. A., & Thacker, W. C. (1985). Rocky Mountain spotted fever mimicking acute cholecystitis. Archives of Internal Medicine, 145(12), 2194-6.
Walker DH, et al. Rocky Mountain Spotted Fever Mimicking Acute Cholecystitis. Arch Intern Med. 1985;145(12):2194-6. PubMed PMID: 4074033.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Rocky Mountain spotted fever mimicking acute cholecystitis. AU - Walker,D H, AU - Lesesne,H R, AU - Varma,V A, AU - Thacker,W C, PY - 1985/12/1/pubmed PY - 1985/12/1/medline PY - 1985/12/1/entrez SP - 2194 EP - 6 JF - Archives of internal medicine JO - Arch Intern Med VL - 145 IS - 12 N2 - Rocky Mountain spotted fever can present with predominantly abdominal symptoms including nausea, vomiting, diarrhea, and abdominal pain. Two elderly patients presented with an acute febrile illness and abdominal symptoms. Rash was not present initially. Workup disclosed cholelithiasis in one, and a thickened gallbladder wall surrounded by a sonolucent zone suggesting a pericholecystic abscess was found by ultrasonography in the other. Both patients underwent emergency laparotomy, with cholecystectomy in both and appendectomy in one. Both patients died several days postoperatively. Pathologic specimens reviewed later showed that multiple blood vessels of the gallbladder and the appendix were infected with Rickettsia rickettsii, and there was focal vascular thrombosis and hemorrhage. These documented direct rickettsial infections and lesions in the blood vessels of abdominal viscera suggest the basis for the abdominal symptoms in Rocky Mountain spotted fever. SN - 0003-9926 UR - https://www.unboundmedicine.com/medline/citation/4074033/Rocky_Mountain_spotted_fever_mimicking_acute_cholecystitis_ L2 - https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/vol/145/pg/2194 DB - PRIME DP - Unbound Medicine ER -