Gangrene in cases of spotted fever: a report of three cases

Area of Science:

• Infectious Diseases
• Microbiology
• Dermatology

Background:

• Spotted fever rickettsiosis is a group of tick-borne diseases caused by Rickettsia species.
• Gangrene is a rare but severe complication of rickettsial infections.
• Rickettsia conorii subspecies indica is a suspected pathogen in South India.

Observation:

• Three cases of spotted fever with gangrene from South India are presented.
• Patients exhibited severe sepsis and multiorgan dysfunction syndrome (MODS), including acute kidney injury, liver dysfunction, delirium, and seizures.
• One patient succumbed to the illness, while two recovered.

Findings:

• This case series highlights the occurrence of gangrene in spotted fever rickettsiosis.
• Severe manifestations such as sepsis and MODS were noted alongside gangrene.
• The presumed causative agent was Rickettsia conorii subspecies indica.

Implications:

• Early diagnosis and prompt management of spotted fever rickettsiosis are critical, especially when gangrene is present.
• Awareness of gangrene as a potential complication can guide clinical suspicion and treatment.
• This underscores the need for timely intervention to improve patient prognosis in severe rickettsial infections.