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Rocky Mountain Spotted Fever

Eugene Y. Wang, MD, Lloyd Runser, MD, MPH, FAAFP and Christopher A. Zagar, MD Reviewed 06/2018
 


BASICS

Rocky Mountain spotted fever (RMSF) is one of the spotted fever rickettsioses (SFR) and is associated with the highest rates of severe and fatal outcomes of all reportable rickettsial diseases ...

DIAGNOSIS

Delay of empirical therapy increases risk of long-term sequelae and mortality. 

HISTORY

Consider RMSF in acute febrile illness and rash, particularly with a history of potential tick exposure ...

TREATMENT

MEDICATION

First Line

Doxycycline is the treatment of choice in both adults and children (1,2,4)[A],(3)[B]. 
  • Untreated rickettsial infections have a high rate of morbidity and mortality. Other ...

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 rickettsioses, ehrlichiose...

CODES

ICD10

A77.0 Spotted fever due to Rickettsia rickettsii 

ICD9

082.0 Spotted fevers 

SNOMED

  • 186772009 Rocky Mountain spotted fever (disorder)

  • 240616003 Eastern Rocky Mountain spotted fever

  • 240615004 West...

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 in suspected cases....

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