PERSISTENCE OF RICKETTSIAE IN THE PARTIALLY VIABLE GANGRENOUS MARGINSOF AMPUTATED EXTREMITIES 5 TO 7 WEEKS AFTER ONSET OF ROCKY-MOUNTAIN-SPOTTED-FEVER

A case of Rocky Mountain spotted fever complicated by gangrene of the extremities required amputation and showed persistent rickettsial infe ction in the margins of the gangrene at 5 and 7 weeks after onset of i llness. Rickettsial organisms were demonstrated by immunoperoxidase st aining in the viable endothelial cells in the ischemic margins of the gangrenous tissue. We conclude that the cellular, humoral, and pharmac ologic components that lead to eradication of the rickettsiae were not delivered to the ischemic margins at effective antirickettsial concen trations.