Portal de Periódicos da CAPES

Spotted Fever: Meningococcal Disease and Petechiae

2010; Elsevier BV; Volume: 123; Issue: 4 Linguagem: Inglês

10.1016/j.amjmed.2009.09.032

1555-7162

Sarah Forgie, Thomas J. Marrie,

Bacillus and Francisella bacterial research

Although there are descriptions of skin findings and invasive meningococcal disease dating back to the 16th century, Vieusseux was the first to describe a European outbreak of “spotted fever” that claimed 33 lives in Geneva. He dubbed the disease “Fièvre cérébrale maligne non contagieuse” (noncontagious malignant cerebral fever), which he hypothesized was spread by bad air. 1 Manchanda V. Gupta S. Bhalla P. Meningococcal disease: history, epidemiology, pathogenesis, clinical manifestations, diagnosis, antimicrobial susceptibility and prevention. Indian J Med Microbiol. 2006; 24: 7-19 Crossref PubMed Scopus (65) Google Scholar In 1806, Danielson and Mann 2 Danielson L. Mann E. The history of a singular and very mortal disease which lately made its appearance in Medfield. Med Agric Reg. 1806; 1: 65-69 Google Scholar described a presumed meningococcal outbreak of “malignant spotted fever” in North America, where 9 people died over a 1-month period. A bacterial cause was found in 1887 by the Austrian pathologist Anton Weichselbaum. He identified Neisseria meningitides (then Diplococcus intracellularis meningitides) in the cerebrospinal fluid of patients with “epidemic cerebrospinal meningitis.” 3 de Souza A.L. Seguro A.C. Two centuries of meningococcal infections: from Vieusseux to the cellular and molecular basis of disease. J Med Microbiol. 2008; 57: 1313-1321 Crossref PubMed Scopus (27) Google Scholar Thirty years later, Herrick 4 Herrick W.W. Extrameningeal meningococcus infections. Arch Intern Med. 1919; 23: 409-418 Crossref Scopus (22) Google Scholar , 5 Herrick W.W. Meningococcus infections including meningitis. Bull NY Acad Med. 1931; 7: 487-501 PubMed Google Scholar described the extrameningeal signs of meningococcal infections in soldiers: “Almost diagnostic is the hemorrhagic rash. Pathologically this consists of minute hemorrhages into the skin. Usually of pinhead size, these may reach a diameter of several inches or in fulminating cases amount to a diffuse purpura. Like other hemorrhagic rashes, they do not disappear on pressure. They continue bright for 2 or 3 days when they fade leaving a rusty stain. Most commonly they occur about the shoulder and pelvic girdle; in more severe cases, over the trunk, conjunctivae, mucosa, extremities, even the face. They come out very quickly and within 1 to 2 hours a patient previously without skin lesions may show an astounding number of these spots. From these the ancient term ‘spotted fever’ arises.”