Spotted fever rickettsioses causing myocarditis and ARDS
ARDS and myocarditis are rare complications of Rickettsia conorii infections and only a few cases are reported to date. Published in the journal BMC Infectious Diseases, the authors describe a patient with rapidly progressing ARDS and myocarditis secondary to spotted fever caused by Rickettsia conorii.

A 53 years old manual worker presented with fever for 5 days and a skin rash. He was in circulatory failure on admission and developed severe hypoxaemia with gross changes in chest radiograph by next day requiring assisted ventilation. He had myocarditis causing left ventricular failure and acute respiratory distress syndrome.

He was confirmed to have spotted fever rickettsial infection with rising titre of indirect immunofluorescence antibodies to Ricketssia conorii and made a complete recovery with appropriate antibiotic therapy and supportive care.

Lessons to learn:-
- Rickettsial infections can present with diverse manifestations.

- Even the patients with severe organ involvements such as myocarditis and ARDS can be completely cured if timely identified and treated.

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