Skin of a man who died from cardiac insufficiency has an eruption in form of spots and specks. There are also bedsores in the area of sacrum and spinous vertebral processes. Microscopical examination of CNS, skin, adrenal glands revealed in the vessels of microcirculatory bed and in small arteries destructive-proliferative endothrombovasculitis with Popov's granulomas; interstitial myocarditis. What diagnosis corresponds with the described picture?

Answer options

1. Enteric fever
2. Spotted fever
3. Nodular periarteritis
4. HIV
5. Q fever

Explanation

Spotted fever is a type of tick-borne disease that presents on the skin. They are all caused by bacteria of the genus Rickettsia. A typhus is a group of similar diseases also caused by Rickettsia bacteria, but spotted fevers and typhus are different clinical entities. The typical lesion caused by rickettsia is endothrombovasculitis. Damage to the vessels of the skin results in the characteristic rash and edema and hemorrhages caused by the increased capillary permeability. In Rickettsioses, there is also the formation of typhus nodules in the small vessels which results in a proliferative destructive thrombovasculitis with the formation of perivascular granulomas (Popov's granuloma) consisting of macrophages, lymphocytes, and plasma cells.