Rickettsial Diseases

First Things First

  • Decision to start treatment is based on epidemiologic and clinical findings.
  • Do not wait for diagnostic test results to come back before initiating treatment, or else you might wait days, thereby losing precious time and delaying potentially life-saving treatment.
  • The most virulent of the bugs are R. rickettsii, which causes Rocky Mountain spotted fever, and R. prowazekii, which causes epidemic typhus.
  • Before antibiotic era, mortality was 25%.
  • Current mortality is 3-5%, attributable to incorrect diagnosis or delayed antibiotic treatment.
  • Survey the skin to look for the tick bite.
  • The classic trio is:
    • Fever
    • Rash
    • Tick bite
  • Rocky Mountain spotted fever is a misnomer. Cases have been reported in every state except Alaska, Hawaii, Maine, and Vermont.

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Last updated: April 30, 2010