Retrospective Study of Rocky Mountain Spotted Fever in Children

Tull, B A Rechelle; Ahn, Christine S.; Daniel, Alyssa; Yosipovitch, Gil; Strowd, Lindsay C.

doi:10.1111/pde.13053

Cited by 8 publications

(6 citation statements)

References 17 publications

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“…13e15 The diagnosis is based on nonspecific clinical findings (fever, weakness, myalgia) and a specific petechial rash; it has a benign course in the majority of cases but sometimes can be severe and may reach mortality rates of 1.4 5.6%. 13,16,17 In the present study, we treated with Doxycycline 10 (14.5%) patients with PRF caused by a proven Rickettsial infection and 4 (5.8%) additional patients with a clinical picture appropriate for Rickettsial infection. Therefore, taking into consideration the high rates of Rickettsial infections reported in Israel and particularly in the southern area of the country and into the Bedouin population, we consider that Rickettsial infection should be highly suspected, in our geographic area, in the initial investigation of patients presenting with PRF and empiric treatment has to be administered to the patients with a high index of suspicion for this disease.…”

Section: Discussionmentioning

confidence: 78%

Purpuric rash and fever among hospitalized children aged 0–18 years: Comparison between clinical, laboratory, therapeutic and outcome features of patients with bacterial versus viral etiology

Gawie-Rotman

Hazan

Fruchtman

et al. 2019

Pediatrics & Neonatology

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Background: The evaluation of children with purpuric rash and fever (PRF) is controversial. Although many of them have viral infections, on occasion such patients may be infected with Neisseria meningitidis. We described all children aged 0e18 years with PRF in southern Israel during the period 2005 2016 and compared their microbiologic, laboratory, clinical and outcome characteristics in relation to various etiologies of this syndrome. Methods: Data were summarized from electronic patient and microbiology files. Viral diagnoses were made by serology and/or PCR. Results: Sixty-nine children with PRF were admitted; 30 (43.48%), 9 (13.04%) and 30 (43.48%) had a syndrome of bacterial, viral or non-established etiology, respectively. N. meningitidis infection was diagnosed in 16/69 (23.19%) patients and in 16/30 (53.33%) patients with bacterial etiology; 14/30 (46.67%) patients suffered from a non-invasive bacterial disease (9 with Rickettsial disease). Adenovirus and Influenza B (3 and 2 cases, respectively) represented the most frequent etiologic agents among patients with viral etiology. More patients with PRF of bacterial etiology were older, of Bedouin ethnicity, looked ill on admission, had higher Pediatrics and Neonatology (2019) 60, 556e563 rates of meningitis and were treated more frequently with antibiotics compared with patients with non-bacterial PRF. Fatality rates among patients with bacterial, viral and non-established etiology were 5/30 (16.7%), 0% and 2/39 (5.1%). Conclusions: Although PFR was uncommon, high rates of meningococcal infections were recorded in children with PRF, which was associated with high fatality rates. Rickettsial infections were frequent, emphasizing the need for a high index of suspicion for this disease in endemic geographic areas.

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Section: Discussionmentioning

confidence: 78%

Purpuric rash and fever among hospitalized children aged 0–18 years: Comparison between clinical, laboratory, therapeutic and outcome features of patients with bacterial versus viral etiology

Gawie-Rotman

Hazan

Fruchtman

et al. 2019

Pediatrics & Neonatology

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“…Because RMSF can be fatal if treatment is delayed beyond the first 5 days of illness, treatment should be started as soon as the diagnosis is entertained. 45 , 46 Doxycycline is the first-line treatment irrespective of a child's age, as advised by both the Centers for Disease Control and Prevention and the American Academy of Pediatrics. Recent studies indicate that short courses of doxycycline have negligible risk for tooth staining in young children.…”

Section: Rickettsial Diseases: Rocky Mountain Spotted Fevermentioning

confidence: 99%

Morbilliform Eruptions in the Hospitalized Child

Haber¹,

Cipriano

Oza³

2022

Dermatologic Clinics

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“…The decision to initiate treatment hinges on clinical suspicion and failure to promptly administer appropriate therapy during the first five days of illness is associated with elevated mortality rates [ 4 , 7 , 8 ]. Both the American Academy of Pediatrics and the Centers for Disease Control and Prevention concur that doxycycline is the primary treatment choice for RMSF across all age groups [ 9 , 10 ]. We present a 71-year-old male with a history of bladder cancer and other medical conditions who presents with fevers, weakness, and persistent hiccups.…”

Section: Introductionmentioning

confidence: 99%

Unconventional Rocky Mountain Spotted Fever Presentation From Kentucky: A Compelling Case Report and Literature Review

Hussain,

Gray,

Marlowe

et al. 2023

Cureus

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Rocky Mountain spotted fever (RMSF) is a potentially lethal tick-borne disease caused by Rickettsia rickettsii, known for its tropism for vascular endothelial cells. Its classic symptoms include fever, headaches, and a rash, but atypical presentations can challenge diagnosis. We present the case of a 71-year-old male with fever, weakness, and hiccups, evolving into confusion. Laboratory findings showed severe hyponatremia, leukocytosis, and abnormal blood parameters. Initial management addressed sepsis and hyponatremia, leading to symptom improvement. Later, a fever of 106.5°F prompted ICU transfer, broad-spectrum antibiotics, and testing for tick-borne diseases. The patient reported tick exposure and received prophylactic doxycycline. Follow-up confirmed the RMSF diagnosis based on serological testing and clinical symptoms. This case highlights the diagnostic challenges posed by atypical RMSF presentations and underscores the importance of early detection and treatment to prevent complications.

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Retrospective Study of Rocky Mountain Spotted Fever in Children

Cited by 8 publications

References 17 publications

Purpuric rash and fever among hospitalized children aged 0–18 years: Comparison between clinical, laboratory, therapeutic and outcome features of patients with bacterial versus viral etiology

Purpuric rash and fever among hospitalized children aged 0–18 years: Comparison between clinical, laboratory, therapeutic and outcome features of patients with bacterial versus viral etiology

Morbilliform Eruptions in the Hospitalized Child

Unconventional Rocky Mountain Spotted Fever Presentation From Kentucky: A Compelling Case Report and Literature Review

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