ad
This Article
Right arrow Images Only
Right arrow Full Version
Services
Right arrow E-mail this link to a friend
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow reprints & permissions
Right arrow Section 1
Section 2
Section 3
Section 4
Section 5
Appendices
Right arrow Earn CME - What's This?
Related Collections
Right arrowRelated Articles

The following text is from an archived Red Book® edition and may not reflect current recommendations or information. To view the current edition, click here.

The first 300 words of the full text of this section appear below.

Section 3. Summaries of Infectious Diseases

Rocky Mountain Spotted Fever

Clinical Manifestations
Etiology
Epidemiology
Diagnostic Tests
Treatment
Isolation of the Hospitalized Patient
Control Measures

Top
 Next
CLINICAL MANIFESTATIONS: Rocky Mountain spotted fever (RMSF) is a systemic, small-vessel vasculitis with a characteristic rash that usually occurs before the sixth day of illness. Fever, myalgia, severe headache, nausea, vomiting, and anorexia are major clinical features. Abdominal pain and diarrhea often are present and can obscure the diagnosis. The rash initially is erythematous and macular and later can become maculopapular and often petechial. Rash usually appears first on the wrists and ankles, often spreading within hours proximally to the trunk. The palms and soles typically are involved. Although early development of a rash is a useful diagnostic sign, rash fails to develop in up to 20% of cases. Thrombocytopenia of varying severity and hyponatremia develop in many cases. The white blood cell count typically is normal, but leukopenia and anemia can occur. The illness can last as long as 3 weeks and can be severe, with prominent central nervous system, cardiac, pulmonary, gastrointestinal tract, and renal involvement; disseminated intravascular coagulation; and shock leading to death. Significant long-term sequelae are common in patients with severe RMSF, including neurologic (paraparesis; hearing loss; peripheral neuropathy; bladder and bowel incontinence; and cerebellar, vestibular, and motor dysfunction) and nonneurologic effects (disability from limb amputation).


Top
 Previous
Next
ETIOLOGY: Rickettsia rickettsii is an obligate intracellular pathogen and a member of the spotted fever group of rickettsiae. The primary targets of infection in mammalian hosts are endothelial cells lining the small vessels of all major tissues and organs.


Top
 Previous
Next
EPIDEMIOLOGY: The disease is transmitted to humans by the bite of an Ixodes species tick. Many small wild animals and dogs have antibodies to R rickettsii, but their role as natural reservoirs is not clear. Ticks are . . . [Go to Full Text]


Related Articles

Prevention of Tickborne Infections
Red Book 2006 2006: 195-197. [Extract] [Full Text]

Rickettsial Diseases
Red Book 2006 2006: 567-569. [Extract] [Full Text]

Ehrlichia and Anaplasma Infections (Human Ehrlichioses)
Red Book 2006 2006: 281-284. [Extract] [Full Text]

Introduction
Red Book 2006 2006: 735. [Extract] [Full Text]

Tetracyclines
Red Book 2006 2006: 736-737. [Extract] [Full Text]