Clinical manifestations of Rickettsia rickettsii in a familial outbreak in Panama

We report an isolated outbreak of Rickettsia rickettsii in the Nga center dot be-Bugle ' indigenous region, located 750 m (tropical wet) above sea level, in a jungle and mountainous area of Western Panama. Seven members of a family were infected simultaneously, resulting in four deaths. Family outbreaks have been previously described and are responsible for 4-8% of the cases described [1-4]. The simultaneous onset of symptoms in the affected popu-lation group is extremely unusual [1,5], but it should not dissuade the clinician from considering the possibility of Rickettsia rickettsii infection.

Automated summary

We report an isolated outbreak of Rickettsia rickettsii in a jungle and mountainous area of Western Panama, where seven members of a family were simultaneously infected, resulting in four deaths. Previous studies have described family outbreaks as responsible for 4-8% of the cases, and the simultaneous onset of symptoms in the affected population group is extremely unusual, but should not be disregarded by clinicians in considering Rickettsia rickettsii infection.