Kidney lesions in Rocky Mountain spotted fever: a light-, immunofluorescence-, and electron-microscopic study.

摘要: The essential pathologic lesion in Rocky Mountain spotted fever (RMSF) is a vasculitis that may involve the kidneys as well heart, brain, skin, and subcutaneous tissues. Histopathologic information concerning response of RMSF rather limited, however. In this study renal tissue from 17 children who died was examined by light, electron, immunofluorescence microscopy. A lymphocytic or mixed inflammation, both, involving vessels interstitium kidney found all patients. addition, 10 patients had histologic evidence acute tubular necrosis, another 3 glomerular lesions consisting focal segmental tuft necrosis increased cellularity secondary to neutophilic infiltration, both. Immunofluorescence- electron-microscopic studies failed demonstrate immune-complex deposition within glomeruli, finding suggests immunoglobulin classic immune complexes were not involved pathogenesis at time death. These findings suggest possibility be due direct action organism (Rickettsia rickettsii) on vessel wall.