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Rocky Mountain Spotted Fever

Christopher A. Zagar, FAAFP, MD and Kimberly M Chekan, MPH, DO Reviewed 06/2022
 


BASICS

Rocky Mountain spotted fever (RMSF) is the most common spotted fever rickettsiosis (SFR) in North America. It is associated with the highest rates of severe and fatal outcomes of all reportable...

DIAGNOSIS

  • Maintain high incidence of suspicion for Rickettsial infections when patients present with "influenza-like" symptoms during summer months regardless of a known history of tick exposure  (2)[...

TREATMENT

MEDICATION

First Line

Doxycycline is the treatment of choice in both adults and children (1)[A],(2)[C],(3)[C]. 
  • Untreated rickettsial infections have a high rate of morbidity and mortality (20...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Patients with mild disease may be treated as outpatients if close follow-up is available.

  • Hospitalize patients with moderate to severe disease.

  • Infection does not c...

REFERENCES

1
Biggs  HM, Behravesh  CB, Bradley  KK, et al. Diagnosis and management of tickborne rickettsial diseases: Rocky Mountain spotted fever and other spotted fever group...

ADDITIONAL READING

Blanton LS. The Rickettsioses: A Practical Update. Infect Dis Clin North Am. 2019 Mar;33(1):213-229.   

CODES

ICD10

A77.0 Spotted fever due to Rickettsia rickettsii 

SNOMED

  • 186772009 Rocky Mountain spotted fever (disorder)

  • 240616003 Eastern Rocky Mountain spotted fever

  • 240615004 Western Rocky Mountain spotte...

CLINICAL PEARLS

  • Diagnosis of RMSF requires a high index of clinical suspicion.

  • Tick bites are often unnoticed, and some patients may never develop a rash.

  • Begin treatment immediately without waiting for...

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