Transient Acquired Immunodeficiency During Rickettsial Disease

To the Editor. —Abnormalities in lymphocyte subpopulations have been reported in patients with acquired immune deficiency syndrome (AIDS) 1-3 and in patients with infections due to viruses and intracellular pathogens. 4-8 We have recently had the opportunity of studying a case of boutonneuse fever during which a transient reduction of helper-suppressor (OKT4-OKT8) ratio was observed (Figure). Report of a Case. —A previously healthy 57-year-old heterosexual male patient was admitted to the hospital with high fever, severe headache, prostration, generalized myalgia, and disseminated macular exanthem that later became petechial. No initial lesion (tache noire) was seen. The diagnosis was established by the appearance of agglutinins to Proteus OX-2 and the specific complement-fixing antibodies (Rickettsia conorii) (Figure). A transient increase of antibodies for Epstein-Barr virus and cytomegalovirus was observed. This finding may be perhaps due to reactivation of latent infections.