Fiebre maculosa de las Montañas Rocosas en niños y adolescentes mexicanos: Cuadro clínico y factores de mortalidad

Objective: Characterize clinical manifestations and predictors of mortality in children hospitalized for spotted fever. Materials and methods: Cross-sectional study in 210 subjects with a diagnosis of Rocky Mountain spotted fever (RMSF) in a pediatric hospital in Sonora, from January 1st, 2004 to June 30th, 2015. Data were analyzed using descriptive statistics and multivariate logistic regression. Results: An upward trend was observed in RMSF morbidity and mortality. Fatality rate was 30%. Three predictors were associated with risk of death: delay ≥ 5 days at the start of doxycycline (OR^a = 2.95, 95% CI 1.10-7.95), acute renal failure ((OR^a = 8.79, 95% CI 3.46-22.33) and severe sepsis (ORa = 3.71, 95% CI 1.44-9.58). Conclusions: RMSF causes high mortality in children, which can be avoided with timely initiation of doxycycline. Acute renal failure and severe sepsis are two independent predictors of death in children with RMSF.