GEORGE T. HARRELL, M.D.
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To the editor: Acute febrile cerebrovasculitis as reported by Wenzel and colleagues (1) and in a subsequent letter (2) poses a therapeutic dilemma to the clinician. No etiologic agent was recovered, and serologic data were confusing. Epidemiologic evidence suggested a possible rickettsial origin because the cases occurred in an area endemic for Rocky Mountain spotted fever, often of severe form.
My colleagues and I in Winston-Salem, North Carolina, studied a sizeable series of patients with rickettsial spotted fever beginning in 1941, before chemotherapy was available. We were among the first to use antibiotics in the disease. The patients were studied
HARRELL GT. Acute Febrile Cerebrovasculitis. Ann Intern Med. ;106:479–480. doi: 10.7326/0003-4819-106-3-479_2
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Published: Ann Intern Med. 1987;106(3):479-480.
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