<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0120-4157</journal-id>
<journal-title><![CDATA[Biomédica]]></journal-title>
<abbrev-journal-title><![CDATA[Biomed.]]></abbrev-journal-title>
<issn>0120-4157</issn>
<publisher>
<publisher-name><![CDATA[Instituto Nacional de Salud]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0120-41572021000200208</article-id>
<article-id pub-id-type="doi">10.7705/biomedica.5598</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Leptospirosis y rickettsiosis, reto diagnóstico para el síndrome febril en zonas endémicas]]></article-title>
<article-title xml:lang="en"><![CDATA[Leptospirosis and rickettsiosis, a diagnostic challenge for febrile syndrome in endemic areas]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ramírez-García]]></surname>
<given-names><![CDATA[René]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Quintero]]></surname>
<given-names><![CDATA[Juan Carlos]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Rosado]]></surname>
<given-names><![CDATA[Aixa Paola]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Arboleda]]></surname>
<given-names><![CDATA[Margarita]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[González]]></surname>
<given-names><![CDATA[Víctor Alejandro]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Agudelo-Flórez]]></surname>
<given-names><![CDATA[Piedad]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad CES  ]]></institution>
<addr-line><![CDATA[Medellín ]]></addr-line>
<country>Colombia</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Universidad de Antioquia Facultad de Ciencias Agrarias ]]></institution>
<addr-line><![CDATA[Medellín ]]></addr-line>
<country>Colombia</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Hospital Antonio Roldán Betancur IPS Universitaria ]]></institution>
<addr-line><![CDATA[Apartadó ]]></addr-line>
<country>Colombia</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,CES ICMT ]]></institution>
<addr-line><![CDATA[Apartadó ]]></addr-line>
<country>Colombia</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>06</month>
<year>2021</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>06</month>
<year>2021</year>
</pub-date>
<volume>41</volume>
<numero>2</numero>
<fpage>208</fpage>
<lpage>217</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_arttext&amp;pid=S0120-41572021000200208&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_abstract&amp;pid=S0120-41572021000200208&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_pdf&amp;pid=S0120-41572021000200208&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen Se presenta el caso de un hombre de 50 años de edad proveniente de la región de Urabá, Colombia, con una infección mixta por Rickettsia rickettsii y Leptospira interrogans serovar Copenhageni ST78, y pruebas negativas para malaria y dengue. El paciente presentó un síndrome febril que no mejoró con el tratamiento antibiótico sistémico y, finalmente, falleció en la unidad de cuidados intensivos. El diagnóstico post mortem se hizo mediante tipificación molecular de los dos agentes etiológicos. En la inspección del domicilio del paciente, se encontró un ejemplar de Rattus rattus infectado con L. interrogans del mismo serovar detectado en él. No se encontraron garrapatas en los animales domésticos que habitaban con el paciente. Se reporta una infección mixta con síntomas clínicos progresivos y fatales en un paciente con antecedentes laborales de riesgo en una zona endémica para enfermedades tropicales, lo que obliga a tener presente la posibilidad de infecciones simultáneas en personas procedentes de áreas endémicas que consulten reiteradamente por síndrome febril sin resolución y tengan riesgo laboral relacionado con actividades agrícolas.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract This is the case of a 50-year-old male from the region of Urabá, Colombia, with a mixed infection by Rickettsia rickettsii and Leptospira interrogans serovar Copenhageni ST78 and negative test for malaria and dengue fever. The patient presented with febrile syndrome and was unresponsive to systemic antibiotic treatment, who finally died in the intensive care unit. We established the postmortem diagnosis through molecular typification of the two etiological agents. In the inspection at the patient&#8217;s home, we found a Rattus rattus specimen infected with L. interrogans of the same serovar found in him. We found no ticks parasitizing the domestic animals cohabitating with the patient. This case of a mixed infection with progressive and fatal symptoms in a patient with occupational risk in a tropical disease endemic zone highlights the importance of considering the potential presentation of simultaneous etiologies in patients with multiple medical visits for unresolved febrile syndromes associated with risky exposure during agricultural activities.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Leptospirosis/diagnóstico]]></kwd>
<kwd lng="es"><![CDATA[infecciones por Rickettsiaceae/diagnóstico]]></kwd>
<kwd lng="es"><![CDATA[fiebre]]></kwd>
<kwd lng="es"><![CDATA[hemorragia]]></kwd>
<kwd lng="es"><![CDATA[zoonosis]]></kwd>
<kwd lng="en"><![CDATA[Leptospirosis/diagnosis]]></kwd>
<kwd lng="en"><![CDATA[Rickettsiaceae infections/diagnosis]]></kwd>
<kwd lng="en"><![CDATA[fever]]></kwd>
<kwd lng="en"><![CDATA[hemorrhage, zoonosis]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Karnad]]></surname>
<given-names><![CDATA[DR]]></given-names>
</name>
<name>
<surname><![CDATA[Richards]]></surname>
<given-names><![CDATA[GA]]></given-names>
</name>
<name>
<surname><![CDATA[Silva]]></surname>
<given-names><![CDATA[GS]]></given-names>
</name>
<name>
<surname><![CDATA[Amin]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Council of the World Federation of Societies of Intensive and Critical Care Medicine. Tropical diseases in the ICU: A syndromic approach to diagnosis and treatment]]></article-title>
<source><![CDATA[J Crit Care]]></source>
<year>2018</year>
<volume>46</volume>
<page-range>119-26</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Kothari]]></surname>
<given-names><![CDATA[VM]]></given-names>
</name>
<name>
<surname><![CDATA[Karnad]]></surname>
<given-names><![CDATA[DR]]></given-names>
</name>
<name>
<surname><![CDATA[Bichile]]></surname>
<given-names><![CDATA[LS]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Tropical infections in the ICU]]></article-title>
<source><![CDATA[J Assoc Physicians India]]></source>
<year>2006</year>
<volume>54</volume>
<page-range>291-8</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Montenegro]]></surname>
<given-names><![CDATA[DC]]></given-names>
</name>
<name>
<surname><![CDATA[Bitencourth]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[de Oliveira]]></surname>
<given-names><![CDATA[SV]]></given-names>
</name>
<name>
<surname><![CDATA[Borsoi]]></surname>
<given-names><![CDATA[AP]]></given-names>
</name>
<name>
<surname><![CDATA[Cardoso]]></surname>
<given-names><![CDATA[KM]]></given-names>
</name>
<name>
<surname><![CDATA[Sousa]]></surname>
<given-names><![CDATA[MS]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Spotted fever: Epidemiology and vector-rickettsia-host relationship in Rio de Janeiro State]]></article-title>
<source><![CDATA[Front Microbio]]></source>
<year>2017</year>
<volume>8</volume>
<page-range>505</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Vk]]></surname>
<given-names><![CDATA[Chin]]></given-names>
</name>
<name>
<surname><![CDATA[Lee]]></surname>
<given-names><![CDATA[TY]]></given-names>
</name>
<name>
<surname><![CDATA[Lim]]></surname>
<given-names><![CDATA[WF]]></given-names>
</name>
<name>
<surname><![CDATA[Wan Shahriman]]></surname>
<given-names><![CDATA[YW]]></given-names>
</name>
<name>
<surname><![CDATA[Syafinaz]]></surname>
<given-names><![CDATA[AN]]></given-names>
</name>
<name>
<surname><![CDATA[Zamberi]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Leptospirosis in human: Biomarkers in host immune responses]]></article-title>
<source><![CDATA[Microbiol Res]]></source>
<year>2018</year>
<volume>207</volume>
<page-range>108-15</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Mattar]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Tique]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Miranda]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Montes]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Garzón]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Undifferentiated tropical febrile illness in Córdoba, Colombia: Not everything is dengue]]></article-title>
<source><![CDATA[J Infect Public Health]]></source>
<year>2017</year>
<volume>10</volume>
<page-range>507-12</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Arroyave]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Londoño]]></surname>
<given-names><![CDATA[AF]]></given-names>
</name>
<name>
<surname><![CDATA[Quintero]]></surname>
<given-names><![CDATA[JC]]></given-names>
</name>
<name>
<surname><![CDATA[Agudelo-Flórez]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Arboleda]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Díaz]]></surname>
<given-names><![CDATA[FJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Etiología y caracterización epidemiológica del síndrome febril no palúdico en tres municipios del Urabá antioqueño, Colombia]]></article-title>
<source><![CDATA[Biomédica]]></source>
<year>2013</year>
<volume>33</volume>
<numero>^s1</numero>
<issue>^s1</issue>
<supplement>1</supplement>
<page-range>99-107</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Martínez-Caballero]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Moreno]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[González]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Martínez]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Adames]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Pachar]]></surname>
<given-names><![CDATA[JV]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Descriptions of two new cases of Rocky Mountain spotted fever in Panama, and coincident infection with Rickettsia rickettsii in Rhipicephalus sanguineus s.l. in an urban locality of Panama City, Panama]]></article-title>
<source><![CDATA[Epidemiol Infect]]></source>
<year>2018</year>
<volume>146</volume>
<page-range>875-8</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Wang]]></surname>
<given-names><![CDATA[H-K]]></given-names>
</name>
<name>
<surname><![CDATA[Lee]]></surname>
<given-names><![CDATA[M-H]]></given-names>
</name>
<name>
<surname><![CDATA[Chen]]></surname>
<given-names><![CDATA[Y-C]]></given-names>
</name>
<name>
<surname><![CDATA[Hsueh]]></surname>
<given-names><![CDATA[P-R]]></given-names>
</name>
<name>
<surname><![CDATA[Chang]]></surname>
<given-names><![CDATA[S-C]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Factors associated with severity and mortality in patients with confirmed leptospirosis at a regional hospital in northern Taiwan]]></article-title>
<source><![CDATA[J Microbiol Immunol Infect]]></source>
<year>2020</year>
<volume>53</volume>
<page-range>307-14</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Vikram]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Agarwala]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Bhargava]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Jain]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
<name>
<surname><![CDATA[Jagzape]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Wasnik]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Scrub typhus and leptospirosis in rural and urban settings of central India: A preliminary evaluation]]></article-title>
<source><![CDATA[Trop Doct]]></source>
<year>2020</year>
<volume>50</volume>
<page-range>111-5</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Quintero]]></surname>
<given-names><![CDATA[JC]]></given-names>
</name>
<name>
<surname><![CDATA[Paternina]]></surname>
<given-names><![CDATA[LE]]></given-names>
</name>
<name>
<surname><![CDATA[Uribe]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Muskus]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Hidalgo]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Gil]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Eco-epidemiological analysis of rickettsial seropositivity in rural areas of Colombia: A multilevel approach]]></article-title>
<source><![CDATA[PLoS Negl Trop Dis]]></source>
<year>2017</year>
<volume>11</volume>
</nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Peláez-Sanchez]]></surname>
<given-names><![CDATA[RG]]></given-names>
</name>
<name>
<surname><![CDATA[López]]></surname>
<given-names><![CDATA[JÁ]]></given-names>
</name>
<name>
<surname><![CDATA[Pereira]]></surname>
<given-names><![CDATA[MM]]></given-names>
</name>
<name>
<surname><![CDATA[Arboleda-Naranjo]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Agudelo-Flórez]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Genetic diversity of Leptospira in northwestern Colombia: First report of Leptospira santarosai as a recognized leptospirosis agent]]></article-title>
<source><![CDATA[Mem Inst Oswaldo Cruz]]></source>
<year>2016</year>
<volume>111</volume>
<page-range>737-44</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Boonsilp]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Thaipadungpanit]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Amornchai]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Wuthiekanun]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Bailey]]></surname>
<given-names><![CDATA[MS]]></given-names>
</name>
<name>
<surname><![CDATA[Holden]]></surname>
<given-names><![CDATA[MTG]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[A single multilocus sequence typing (MLST) scheme for seven pathogenic Leptospira species]]></article-title>
<source><![CDATA[PLoS Negl Trop Dis]]></source>
<year>2013</year>
<volume>7</volume>
</nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ahmed]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Devi]]></surname>
<given-names><![CDATA[SM]]></given-names>
</name>
<name>
<surname><![CDATA[Valverde M de los]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Vijayachari]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Machang&#8217;u]]></surname>
<given-names><![CDATA[RS]]></given-names>
</name>
<name>
<surname><![CDATA[Ellis]]></surname>
<given-names><![CDATA[WA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Multilocus sequence typing method for identification and genotypic classification of pathogenic Leptospira species]]></article-title>
<source><![CDATA[Ann Clin Microbiol Antimicrob]]></source>
<year>2006</year>
<volume>5</volume>
<page-range>28</page-range></nlm-citation>
</ref>
<ref id="B14">
<label>14</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Londoño]]></surname>
<given-names><![CDATA[AF]]></given-names>
</name>
<name>
<surname><![CDATA[Acevedo-Gutiérrez]]></surname>
<given-names><![CDATA[LY]]></given-names>
</name>
<name>
<surname><![CDATA[Marín]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Contreras]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Díaz]]></surname>
<given-names><![CDATA[FJ]]></given-names>
</name>
<name>
<surname><![CDATA[Valbuena]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Human prevalence of the spotted fever group (SFG) rickettsiae in endemic zones of Northwestern Colombia]]></article-title>
<source><![CDATA[Ticks Tick-Borne Dis]]></source>
<year>2017</year>
<volume>8</volume>
<page-range>477-82</page-range></nlm-citation>
</ref>
<ref id="B15">
<label>15</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ko]]></surname>
<given-names><![CDATA[AI]]></given-names>
</name>
<name>
<surname><![CDATA[Goarant]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Picardeau]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Leptospira: The dawn of the molecular genetics&#8217; era for an emerging zoonotic pathogen]]></article-title>
<source><![CDATA[Nat Rev Microbiol]]></source>
<year>2009</year>
<volume>7</volume>
<page-range>736-47</page-range></nlm-citation>
</ref>
<ref id="B16">
<label>16</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[De Brito]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Silva]]></surname>
<given-names><![CDATA[AMG da]]></given-names>
</name>
<name>
<surname><![CDATA[Abreu]]></surname>
<given-names><![CDATA[PAE]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Pathology and pathogenesis of human leptospirosis: A commented review]]></article-title>
<source><![CDATA[Rev Inst Med Trop Sao Paulo]]></source>
<year>2018</year>
<volume>60</volume>
</nlm-citation>
</ref>
<ref id="B17">
<label>17</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Parola]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Paddock]]></surname>
<given-names><![CDATA[CD]]></given-names>
</name>
<name>
<surname><![CDATA[Socolovschi]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Labruna]]></surname>
<given-names><![CDATA[MB]]></given-names>
</name>
<name>
<surname><![CDATA[Mediannikov]]></surname>
<given-names><![CDATA[O]]></given-names>
</name>
<name>
<surname><![CDATA[Kernif]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Update on tick-borne rickettsioses around the world: A geographic approach]]></article-title>
<source><![CDATA[Clin Microbiol Rev]]></source>
<year>2013</year>
<volume>26</volume>
<page-range>657-702</page-range></nlm-citation>
</ref>
<ref id="B18">
<label>18</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Quintero-Vélez]]></surname>
<given-names><![CDATA[JC]]></given-names>
</name>
<name>
<surname><![CDATA[Faccini-Martínez]]></surname>
<given-names><![CDATA[ÁA]]></given-names>
</name>
<name>
<surname><![CDATA[Rodas-González]]></surname>
<given-names><![CDATA[JD]]></given-names>
</name>
<name>
<surname><![CDATA[Díaz]]></surname>
<given-names><![CDATA[FJ]]></given-names>
</name>
<name>
<surname><![CDATA[Ramírez-García]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Somoyar-Ordosgoitia]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Fatal Rickettsia rickettsii infection in a child, Northwestern Colombia, 2017]]></article-title>
<source><![CDATA[Ticks Tick-Borne Dis]]></source>
<year>2019</year>
<volume>10</volume>
<page-range>995-6</page-range></nlm-citation>
</ref>
<ref id="B19">
<label>19</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Jaramillo]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Arboleda]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[García]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Agudelo-Flórez]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Coinfección brucelosis-leptospirosis, Urabá, Colombia. Reporte de caso]]></article-title>
<source><![CDATA[Infectio]]></source>
<year>2014</year>
<volume>18</volume>
<page-range>72-6</page-range></nlm-citation>
</ref>
<ref id="B20">
<label>20</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Prabhakar]]></surname>
<given-names><![CDATA[U]]></given-names>
</name>
<name>
<surname><![CDATA[Singh]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Atypical presentation of rickettsial spotted fever]]></article-title>
<source><![CDATA[J Ayub Med Coll Abbottabad]]></source>
<year>2017</year>
<volume>29</volume>
<page-range>692-3</page-range></nlm-citation>
</ref>
<ref id="B21">
<label>21</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Licona-Enriquez]]></surname>
<given-names><![CDATA[JD]]></given-names>
</name>
<name>
<surname><![CDATA[Delgado-de la Mora]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Paddock]]></surname>
<given-names><![CDATA[CD]]></given-names>
</name>
<name>
<surname><![CDATA[Ramírez-Rodríguez]]></surname>
<given-names><![CDATA[CA]]></given-names>
</name>
<name>
<surname><![CDATA[Candia-Plata]]></surname>
<given-names><![CDATA[MDC]]></given-names>
</name>
<name>
<surname><![CDATA[Hernández]]></surname>
<given-names><![CDATA[GÁ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Rocky mountain spotted fever and pregnancy: Four cases from Sonora, México]]></article-title>
<source><![CDATA[Am J Trop Med Hyg]]></source>
<year>2017</year>
<volume>97</volume>
<page-range>795-8</page-range></nlm-citation>
</ref>
<ref id="B22">
<label>22</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Cagliero]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Villanueva]]></surname>
<given-names><![CDATA[SYAM]]></given-names>
</name>
<name>
<surname><![CDATA[Matsui]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Leptospirosis pathophysiology: Into the storm of cytokines]]></article-title>
<source><![CDATA[Front Cell Infect Microbiol]]></source>
<year>2018</year>
<volume>8</volume>
<page-range>204</page-range></nlm-citation>
</ref>
<ref id="B23">
<label>23</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Bhavnani]]></surname>
<given-names><![CDATA[SK]]></given-names>
</name>
<name>
<surname><![CDATA[Drake]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Bellala]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Dang]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Peng]]></surname>
<given-names><![CDATA[B-H]]></given-names>
</name>
<name>
<surname><![CDATA[Oteo]]></surname>
<given-names><![CDATA[JA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[How cytokines co-occur across rickettsioses patients: From bipartite visual analytics to mechanistic inferences of a cytokine storm]]></article-title>
<source><![CDATA[AMIA Jt Summits Transl Sci Proc]]></source>
<year>2013</year>
<volume>18</volume>
<page-range>15-9</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
