Researchers reviewed 19 cases of meningoencephalitis associated with spotted fever rickettsioses. Fever was present in all cases. Rash was present in 100% of pediatric patients but in only 50% of adult patients. Cerebrospinal fluide pleocytosis was present in 88% of patients. Ninety percent of patients required ICU admission, and only 46% of patients recovered completely.
Pediatric patients present to the emergency department (ED) with a variety of issues ranging from benign upper respiratory infections to life-threatening anaphylaxis. Many emergent conditions may mimic the common and nonthreatening ailments of normal childhood. Emergency physicians must be able to recognize and treat uncommon but emergent illnesses quickly and accurately. In addition, providers must be aware of those illnesses that look serious but warrant only supportive care. This article will focus on the assessment, evaluation, differential, and treatment of uncommon but can’t-miss diagnoses that clinicians should consider in the emergency setting.
Two patients with Crimean-Congo hemorrhagic fever acquired in Spain are reported. The index patient acquired infection from a tick bite, and the second patient was a nurse who cared for the index patient. The first patient died in the hospital with multi-system organ failure and was diagnosed at autopsy. The second patient recovered with supportive care and was treated with ribavirin, but it was unclear whether the use of ribavirin was helpful.