KIDNEY LESIONS IN ROCKY-MOUNTAIN SPOTTED-FEVER - LIGHT-MICROSCOPIC, IMMUNOFLUORESCENCE-MICROSCOPIC, AND ELECTRON-MICROSCOPIC STUDY

  • 1 January 1979
    • journal article
    • research article
    • Vol. 97  (2) , 381-+
Abstract
The essential pathologic lesion in Rocky Mountain spotted fever (RMSF) is a vasculitis that may involve kidneys, heart, brain, skin and subcutaneous tissues. Histopathologic information concerning the response of kidneys in RMSF is limited. Renal tissue from 17 children who died of RMSF was examined by light, electron and immunofluorescence microscopy. A lymphocytic or mixed inflammation or both, involving vessels and interstitium of the kidney, was found in all patients; 10 had histologic evidence of acute tubular necrosis. Another 3 had glomerular lesions consisting of focal segmental tuft necrosis or increased cellularity secondary to neutrophilic infiltration or both. Immunofluorescence- and EM studies failed to demonstrate immune-complex deposition within glomeruli. Immunoglobulin and classic immune complexes were not involved in pathogenesis of renal lesions at the time of death. Pathogenesis of the renal lesion in RMSF may be due to a direct action of the organism (Rickettsia rickettsii) on the vessel wall.