Rocky Mountain spotted fever (RMSF) is a multisystem disease caused by a bacterium that is transmitted to humans by tick bites. In the Eastern United States, the dog tick is the bug responsible for transmission. In the Western United States, it is the wood tick.
Function
About a week following the bite of a tick, a patient develops fever, generalized aches, headache, nausea and vomiting. The disease also produces a characteristic rash, which typically appears first on the palms and soles of feet, or around the wrists and ankles, and then moves towards the trunk.
Effects
Other complications of the illness are a drop in the serum sodium concentration, a decrease in the platelet count, and severe illness involving the brain, kidneys, liver, heart and lungs. Despite the availability of treatment, Rocky Mountain spotted fever causes death in about 3 to 5 percent of cases, according to the Centers for Disease Control and Prevention. Survivors often have long-term complications, including paralysis of the legs, and amputation of digits.
Identification
The diagnosis of Rocky Mountain fever is often made clinically, but there are blood tests that confirm the diagnosis. These tests usually take several days, so if the patient has the history and symptoms consistent with the disease, it is important to begin therapy while waiting for test results.
Treatment
The treatment of choice for RMSF is the antibiotic doxycycline for seven to 10 days. Once antibiotic therapy begins, patients start improving within 24 to 72 hours. Doxycycline causes dental staining in children less than 8 years of age. The benefits of treatment far outweigh the staining effect of the antibiotic in this age group. Doxycycline belongs to a class of antibiotics that cannot be used in pregnant women, since it can cause bone problems in the unborn child. Pregnant women with Rocky Mountain spotted fever receive an antibiotic called chloramphenicol. This antibiotic can have significant side effects, including a decrease in the platelet count and anemia, so patients receiving it must be monitored closely.
Prevention/Solution
It is important to make sure a tick is still not attached to the skin. If a tick is found, it must be removed to prevent continuing transmission of the bacteria. The best way to remove a tick is to grab it with a pair of tweezers as close as possible to the skin and pull it up slowly and steadily.
References
- Centers for Disease Control and Prevention: Rocky Mountain Spotted Fever
- Red Book Atlas of Pediatric Infectious Diseases; Carol J. Baker, MD; 2007
- CDC: Current Trends in Rocky Mountain Spotted Fever
