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Infección central con Rickettsia felis complicada con accidente cerebrovascular: una serie de casos y una revisión
Jiongfei Jin1,2, Fei Dong3, Er Xu4
1Department of Infectious Diseases, The Second Affiliated Hospital of the College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310002, China.
IDCases
|August 21, 2025
Resumen
Rickettsia felis, un patógeno transmitido por pulgas, puede causar complicaciones neurológicas graves como el accidente cerebrovascular. El diagnóstico temprano utilizando métodos avanzados como el NGS es crucial para mejores resultados en pacientes febriles.
Área de la Ciencia:
- Enfermedades infecciosas
- Neurología
- Medicina vascular
Sus antecedentes:
- Rickettsia felis es un patógeno emergente transmitido por pulgas que presenta síntomas similares a otros rickettsial infecciones.
- Las complicaciones del sistema nervioso central (SNC), incluida la meningoencefalitis, son secuelas raras pero documentadas de la infección por R. felis.
Objetivo del estudio:
- Para reportar tres casos de Rickettsia felis infecciones del sistema nervioso central complicadas por un derrame cerebral.
- Para resaltar los hallazgos clínicos y del líquido cefalorraquídeo en estos casos.
- Para enfatizar la importancia de considerar R. felis en el diagnóstico diferencial del accidente cerebrovascular en pacientes con fiebre.
Principales métodos:
- Presentación de la serie de casos de tres pacientes con infecciones centrales por R. felis y accidente cerebrovascular.
- Análisis del líquido cefalorraquídeo, incluidos los niveles de proteínas y el recuento de células con diferencial.
- Discusión de los desafíos de diagnóstico y el papel de la secuenciación de próxima generación (NGS).
Principales resultados:
- Dos pacientes presentaron infartos cerebrales, y uno experimentó una hemorragia subaracnoidea.
- El análisis del líquido cefalorraquídeo reveló un aumento de proteínas y de células nucleadas, predominantemente linfocitos, en todos los casos.
- Rickettsia felis fue identificado como el agente causal, lo que requirió la consideración de diagnósticos avanzados.
Conclusiones:
- Rickettsia felis debe considerarse en el diagnóstico diferencial de accidente cerebrovascular, especialmente en pacientes con fiebre.
- Las técnicas de diagnóstico avanzadas como el NGS son vitales para identificar patógenos raros como el R. felis.
- El diagnóstico y el tratamiento oportunos de las infecciones por R. felis son fundamentales para mejorar el pronóstico del paciente y prevenir secuelas neurológicas graves.
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