BMJ Case Reports 2012; doi:10.1136/bcr.03.2012.5993
  • Rare disease

Life-threatening ANCA-positive vasculitis associated with rickettsial infection

  1. Paul Ellis Marik2
  1. 1Department of Medicine, Eastern Virginia Medical School, Norfolk, Virginia, USA
  2. 2Division of Pulmonary and Critical Care Medicine, Eastern Virginia Medical School, Norfolk, Virginia, USA
  1. Correspondence to Dr Paul Ellis Marik, marikpe{at}


We present a 47-year-old Caucasian fire fighter who developed multisystem organ failure in the setting of a positive antineutrophil cytoplasmic autoantibody (myeloperoxidase) as well as confirmed Rocky Mountain spotted fever by skin biopsy PCR. This case provided a diagnostic challenge, a rare association of a Rickettsia infection and autoimmune vasculitis as well as a unique management approach.


  • Competing interests None.

  • Patient consent Obtained.

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