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October 1952

RESIDUAL EFFECTS OF RICKETTSIAL DISEASE ON THE CENTRAL NERVOUS SYSTEMResults of Neurologic Examinations and Electroencephalograms Following Rocky Mountain Spotted Fever

Author Affiliations


From the Departments of Psychiatry and Neurology and Internal Medicine of the Bowman Gray School of Medicine of Wake Forest College and the North Carolina Baptist Hospital.

AMA Arch Intern Med. 1952;90(4):444-455. doi:10.1001/archinte.1952.00240100021003

ROCKY Mountain spotted fever is one of the severest of all infectious diseases. Essentially it is a specific generalized intracellular infection of small peripheral blood vessels. In untreated patients the rickettsias circulate in the blood during the first week and part of the second week after infection. The organisms first invade the nuclei of capillary endothelial cells, where they multiply in great numbers and destroy the cells. From there the lesion extends centripetally along the intima into slightly larger vessels (the arterioles), where smooth muscle cells of the media are also invaded and destroyed.1 This destruction of muscle cells is a distinctive feature of Rocky Mountain spotted fever (Fig. 1). With the death of cells necrosis occurs in the intima and media of the vessels, resulting in thrombosis and extravasation of blood. As a result of the thrombosis, microinfarcts are formed, chiefly in the skin, subcutaneous tissues, and central

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