{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T16:32:47Z","timestamp":1788021167158,"version":"build-2784847793"},"reference-count":23,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,2,7]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n<jats:p>Rocky Mountain spotted fever (RMSF) is a tick-borne infection caused by <jats:italic>Rickettsia rickettsii<\/jats:italic>. We present a series of two cases of pregnant patients who showed up at the emergency room of a hospital in Nuevo Le\u00f3n, Mexico. Both patients lived in environments where <jats:italic>R. rickettsii<\/jats:italic> is endemic and they presented with several days of symptoms, including fever. Both patients developed a rash and had stillbirths during their hospital stay. Treatment with doxycycline was delayed, with fatal results in both patients. Diagnosis of RMSF was confirmed via polymerase chain reaction assay postmortem. The need to link epidemiological clues with clinical data is critical in the diagnosis and early treatment of RMSF to prevent maternal deaths.<\/jats:p>","DOI":"10.4269\/ajtmh.23-0419","type":"journal-article","created":{"date-parts":[[2024,1,8]],"date-time":"2024-01-08T16:36:19Z","timestamp":1704731779000},"page":"320-322","source":"Crossref","is-referenced-by-count":6,"title":["Case Report: Fatal Rickettsiosis in Pregnancy"],"prefix":"10.4269","volume":"110","author":[{"given":"Eduardo","family":"Ponce N\u00e1jera","sequence":"first","affiliation":[{"name":"Hospital Regional Materno Infantil del Estado de Nuevo Le\u00f3n, Nuevo Le\u00f3n, Mexico;"},{"name":"Escuela de Medicina y Ciencias de la Salud Tecnol\u00f3gico de Monterrey, Nuevo Le\u00f3n, Mexico;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valeria","family":"Lozano Lazcano","sequence":"additional","affiliation":[{"name":"Hospital Regional Materno Infantil del Estado de Nuevo Le\u00f3n, Nuevo Le\u00f3n, Mexico;"},{"name":"Escuela de Medicina y Ciencias de la Salud Tecnol\u00f3gico de Monterrey, Nuevo Le\u00f3n, Mexico;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C\u00e9sar","family":"Ploneda Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"Hospital Metropolitano \u201cDr. Bernardo Sep\u00falveda\u2019\u2019 del Estado de Nuevo Le\u00f3n, Nuevo Le\u00f3n, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcela","family":"Montoya Hinojosa","sequence":"additional","affiliation":[{"name":"Hospital Regional Materno Infantil del Estado de Nuevo Le\u00f3n, Nuevo Le\u00f3n, Mexico;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diego","family":"Gonz\u00e1lez Oropeza","sequence":"additional","affiliation":[{"name":"Hospital Regional Materno Infantil del Estado de Nuevo Le\u00f3n, Nuevo Le\u00f3n, Mexico;"},{"name":"Escuela de Medicina y Ciencias de la Salud Tecnol\u00f3gico de Monterrey, Nuevo Le\u00f3n, Mexico;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Obstetric Catastrophes: A Clinical Guide","year":"2021"},{"key":"b2","series-title":"Semin Diagn Pathol","first-page":"146","article-title":"Emerging and re-emerging rickettsial infections","volume":"36","author":"Adem","year":"2019"},{"key":"b3","series-title":"Am J Trop Med Hyg","first-page":"190","article-title":"Epidemiology and clinical features of Rocky Mountain spotted fever from enhanced surveillance, Sonora, Mexico: 2015\u20132018","volume":"104","author":"\u00c1lvarez-L\u00f3pez","year":"2021"},{"key":"b4","year":"2022"},{"key":"b5","series-title":"Annu Rev Pathol","first-page":"127","article-title":"Pathogenesis of rickettsial diseases: pathogenic and immune mechanisms of an endotheliotropic infection","volume":"14","author":"Sahni","year":"2019"},{"key":"b6","series-title":"Acta Trop","first-page":"105887","article-title":"Current tools for the diagnosis and detection of spotted fever group Rickettsia.","volume":"218","author":"Husin","year":"2021"},{"key":"b7","series-title":"Infect Dis Clin North Am","first-page":"213","article-title":"The rickettsioses","volume":"33","author":"Blanton","year":"2019"},{"key":"b8","series-title":"Gac Med Mex","first-page":"61","article-title":"Caracter\u00edsticas cl\u00ednicas de los pacientes con fiebre manchada de las Monta\u00f1as Rocosas, infecci\u00f3n por dengue y chikungunya","volume":"157","author":"Delgado-De la Mora","year":"2021"},{"key":"b9","series-title":"J Vector Borne Dis","first-page":"114","article-title":"Clinical characteristics of Rocky Mountain spotted fever in the United States: a literature review","volume":"57","author":"Jay","year":"2020"},{"key":"b10","series-title":"Am J Trop Med Hyg","first-page":"795","article-title":"Rocky Mountain spotted fever and pregnancy: four cases from Sonora, Mexico","volume":"97","author":"Licona-Enriquez","year":"2017"},{"key":"b11","series-title":"Obstet Gynecol Surv","first-page":"37","article-title":"Rocky Mountain spotted fever and pregnancy: a case report and review of the literature","volume":"56","author":"Stallings","year":"2001"},{"key":"b12","series-title":"Eur J Obstet Gynecol Reprod Biol","first-page":"214","article-title":"Mediterranean spotted fever during pregnancy: case presentation and literature review","volume":"107","author":"Bentov","year":"2003"},{"key":"b13","series-title":"Microbiol Spectr","first-page":"e0081421","article-title":"Spotted fever group Rickettsia trigger species-specific alterations in macrophage proteome signatures with different impacts in host innate inflammatory responses","volume":"9","author":"Curto","year":"2021"},{"key":"b14","series-title":"Asian J Infect Dis","first-page":"1","article-title":"Spotted fever rickettsial infection in pregnancy causing acute hepatitis, fatal postpartum hemorrhage and possible vertical transmission","volume":"7","author":"Ratnayake","year":"2021"},{"key":"b15","series-title":"MMWR Recomm Rep","first-page":"1","article-title":"Diagnosis and management of tick-borne rickettsial diseases: Rocky Mountain spotted fever and other spotted fever group rickettsioses, ehrlichioses, and anaplasmosis \u2013 United States","volume":"65","author":"Biggs","year":"2016"},{"key":"b16","series-title":"J Infect Dis","first-page":"1469","article-title":"Hidden mortality attributable to Rocky Mountain spotted fever: immunohistochemical detection of fatal, serologically unconfirmed disease","volume":"179","author":"Paddock","year":"1999"},{"key":"b17","series-title":"Acta Med Costarric","first-page":"13","article-title":"Perspectives on the laboratory diagnosis of rickettsial diseases in the 21st century","volume":"55","author":"Paddock","year":"2013"},{"key":"b18","author":"Dumler","year":"2012"},{"key":"b19","series-title":"Ticks Tick Borne Dis","first-page":"101855","article-title":"Rickettsiosis subcommittee report to the tick-borne disease working group","volume":"13","author":"Walker","year":"2022"},{"key":"b20","series-title":"Paediatr Perinat Epidemiol","first-page":"18","article-title":"Antibiotics potentially used in response to bioterrorism and the risk of major congenital malformations","volume":"23","author":"Cooper","year":"2009"},{"key":"b21","series-title":"Expert Opin Drug Saf","first-page":"367","article-title":"Revisiting doxycycline in pregnancy and early childhood: time to rebuild its reputation?","volume":"15","author":"Cross","year":"2016"},{"key":"b22","series-title":"Obstet Gynecol","first-page":"524","article-title":"Teratogenic study of doxycycline","volume":"89","author":"Czeizel","year":"1997"},{"key":"b23","year":"2022"}],"container-title":["The American Journal of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/110\/2\/article-p320.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/110\/2\/article-p320.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/110\/2\/article-p320.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,18]],"date-time":"2025-04-18T12:51:25Z","timestamp":1744980685000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/110\/2\/article-p320.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2,7]]},"references-count":23,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.23-0419","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2,7]]}}}