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Rocky Mountain Spotted Fever, Pediatric

Carolyn A. Paris, MD, MPH and George A. (Tony) Woodward, MD, MBA Reviewed 10/2018
 


BASICS

DESCRIPTION

  • Life-threatening, small vessel vasculitis

  • Caused by infection with Rickettsia rickettsii, an obligate intracellular gram-negative coccobacillus, predominantly transmitted by three spe...

DIAGNOSIS

HISTORY

  • History: classic triad of fever (high, abrupt onset), headache, and rash seen in ~50% of cases

  • Abdominal pain common mainly in children

  • Symptoms usually appear 2 to 8 days after tick bi...

TREATMENT

GENERAL MEASURES

  • Treat empirically if clinical suspicion.

  • 3rd-generation cephalosporin indicated to treat potential meningococcemia until blood culture results final

  • Platelets as indicated for ...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Expect improvement in 24 to 36 hours and defervescence in 2 to 3 days with treatment, especially if initiated <5 days after onset of symptoms. 

PROGNOSIS

  • Related...

ADDITIONAL READING

  • Akgoz A, Mukundan S, Lee TC. Imaging of rickettsial, spirochetal, and parasitic infections. Neuroimaging Clin N Am.  2012;22(4):633–657. [View Abstract on OvidInsights]

  • Andersen...

CODES

ICD9

082.0 Spotted fevers 

ICD10

A77.0 Spotted fever due to Rickettsia rickettsii 

SNOMED

  • 186772009 Rocky Mountain spotted fever (disorder)

  • 240616003 Eastern Rocky Mountain spotted fever

  • 240615004 West...

FAQ

  • Q: In which patients should Rocky Mountain spotted fever be considered in the differential diagnosis?

  • A: Anyone with a fever during the spring and summer who has been in an endemic area, regardless...

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