• Jesús Delgado-de la Mora, Jesús D Licona-Enríquez, Diego I Álvarez-López, Diana E Aguilar-León, and Gerardo Álvarez-Hernández.
• Anatomic Pathology Department, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Secretaría de Salud, Mexico City.
• Gac Med Mex. 2021 Jan 1; 157 (1): 58-63.

IntroductionClinical distinction between arbovirus infections and those caused by rickettsia is crucial to initiate appropriate medical treatment.ObjectiveTo compare the differences between Rocky Mountain spotted fever (RMSF) and other vector-borne diseases (dengue and chikungunya) with similar clinical presentation, and to identify data that could aid rapid diagnosis of these diseases.MethodsWe evaluated sociodemographic, clinical and laboratory data of 399 patients from five hospitals and clinics of Sonora, Mexico, between 2004 and 2016, with laboratory-confirmed diagnosis of RMSF, dengue, or chikungunya.ResultsThe RMSF group had the highest lethality (49/63 deaths, 77.8 %), followed by the chikungunya group (3/161, 1.9 %) and the dengue group (3/161, 1.9 %). Clinical differences included the presence of rash, edema, and pruritus; in addition, differences in multiple biomarkers such as platelets, hemoglobin, indirect bilirubin, and serum sodium levels were documented.ConclusionRash on the palms and soles, edema and absence of pruritus, together with high levels of direct bilirubin and severe thrombocytopenia could be useful indicators to differentiate patients at RMSF advanced stages from those with dengue and chikungunya.Copyright: © 2020 Permanyer.

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