Rocky Mountain spotted fever

Rocky Mountain spotted fever

Chris Schach

Author Bio -

 Key Points
*Infectious condition which typically develops in children
*Caused by an infection with bacteria carried by ticks
*Consists of a red rash initially on the ankles and wrists which spreads to other areas and is accompanied by fever and a severe headache

Rocky Mountain spotted fever is an infectious condition which typically develops in children. The condition initially consists of the presence of fever and a severe headache, which are sometimes accompanied by muscle aches. Within 3-5 days of the onset of symptoms, a rash consisting of small, red flat spots appears on the wrists and ankles, which then spreads to the limbs and torso. During this time, the rash becomes popular, and may be accompanied by small purple or red macules and bruising. In approximately half of all cases, the rash becomes hemorrhagic. Rarely, the rash may be necrotic, typically in cases which affect the legs or genital area, and may require aggressive treatment to prevent the spread of tissue death. During resolution the rash becomes tender and may scale or flake off, though in severe cases resolution may be accompanied by sloughing of the skin. In addition to classic symptoms, internal organ involvement may occur in some cases, including infection of the GI tract, central nervous system and organs such as the heart, lungs, liver and kidneys.

Rocky Mountain spotted fever is caused by an infection with bacteria which are carried by ticks, rickettsia rickettsii. The bacterium is transferred via tick bite, and the condition most often occurs in North and South America.

Differential Diagnosis (Other conditions with similar appearance)
Bronchitis
Pneumonia
Gastroenteritis
Pneumonia, Viral
Hepatitis
Syphilis
Idiopathic Thrombocytopenic Purpura
Thrombocytopenic Purpura
Meningitis
Ehrlichiosis
Mononucleosis
Lyme disease
Kawasaki disease
Q Fever
Measles
Relapsing fever
Rubella
Tularemia
Toxic shock syndrome

Diagnosis
Key Points
*Diagnosis based on characteristic appearance of the affected area in conjunction with clinical examination of symptoms
*Laboratory tests and/or skin Biopsy will be performed to confirm diagnosis and rule out other conditions

Rocky Mountain spotted fever is typically diagnosed based on the characteristic appearance of the affected area in conjunction with a clinical examination of symptoms. Laboratory tests and/or skin biopsy may be performed to confirm the diagnosis and to rule out similar appearing conditions.

Treatment
*Severity of the condition is predicated on time of diagnosis
*Typically treated with tetracycline antibiotics
OTC Options: calamine lotion, topical and oral antihistamines, acetaminophen

Early diagnosis of Rocky Mountain spotted fever is a key factor in determining treatment and prognosis, as delayed diagnosis may result in the development of serious systemic complications. The condition is typically treated with tetracycline antibiotics, and treatment course should run until no fever is present for 2 to 3 days. If untreated, the condition can be fatal.

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