Rocky mountain spotted fever

Question 1

Etiology

Answer 1

Rickettsia rickettsii

Question 2

Transmission

Answer 2

Bite of infected tick;only60% of patients are aware of prior tick bite.Most common in
springtime

Question 3

Clinical manifestation

Answer 3

Abrupt onset of symptoms.
Fever,chills,shaking rigor.
Anorexia, nausea, vomiting. Malaise, irritability. Severe headache. Myalgia.
Can mimic acute abdomen, acute cholecystitis, and acute appendicitis.
Tâche noire uncommon in RMSF.

Early exanthem: 2 to 6 mm, pink, blanchable macules In 1 to 3 days, evolves to deep red papules.
Characteristically, rash begins on wrists, forearms, and ankles and somewhat later on the palms and soles. Within 6 to 18 h, the rash spreads centripetally to the arms, thighs, trunk, and face.
Later exanthem: In 2 to 4 days, become hemorrhagic, no longer blanchable. Local edema. Petechiae may occur on the palms and soles. Necrosis occurs in acral extremities following prolonged hypotension. Pedal edema.
Spotless ever:≤10% of cases.Associated with higher mortalityrate because of the delay in diagnosis.

Question 4

Treatment

Answer 4

Doxycycline is DOC.

Chloramphenicol