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Rocky Mountain Spotted Fever

more about Rocky Mountain Spotted Fever

RMSF or Tick Typhus

  • This is an infection caused by a microscopic organism known as Rickettsia rickettsii, which is transmitted by the bite of ticks.

  • Rash - starts as pale-pink or reddened skin areas (wrists, ankles, arms), which after 24 hours may spread to the trunk, face, and rest of the body (palms and soles). Spotty red (leakage of blood) rash may also occur. Rarely, if left untreated, sores or ulcers may appear on the tip of the nose, ear lobes, and fingertips.
  • Headache
  • Cough
  • Nausea
  • Muscle ache
  • Joint ache
  • Abdominal pain
  • Diarrhea
  • Confusion
  • Seizures

  • Bacteria R. rickettsii live inside the cells in the body of ticks from the Ixodidae (hard ticks) family and are transmitted to humans via the tick's bite.
  • On rare occasions, if the tick is crushed and its blood (and the bacteria) comes in contact with someone's open skin wound, it can also cause RMSF.
  • The cells lining the blood vessels -- known as endothelial cells -- are the main targets of the organism (R. rickettsii). Following invasion of these cells, vasculitis or blood vessel inflammation (irritation, swelling, damage) occurs, which is responsible for the majority of symptoms of RMSF.

  • History of camping, illnesses, medications, job, family history, allergies
  • Medical exam:
    1. Fever
    2. Rash
    3. Jaundice or a yellow discoloration of the skin and whites of the eyes
    4. Enlarged lymph nodes -- Pea-sized glands in the neck, armpits, and throughout the body
    5. Enlarged spleen -- located left upper part of abdomen
    6. Enlarged liver -- located on the right upper part of the abdomen
  • Blood tests:
    1. Serology and indirect immunofluorescence assay (IFA) measure levels of protective Proteins (antibodies) produced by the body to defend itself against Rickettsia.
    2. Antibodies detected are of Proteus Ox-19, CF (Complement fixation), and IFA
    3. If available and necessary, a skin biopsy can be done by taking a small piece of the area with the rash and staining (DFA or direct fluorescence antibody) it with fluorescence dye to look for evidence of rickettsial infection
    4. Low levels of Sodium (hyponatremia)
    5. Normal -- increased levels of white blood cells
    6. Anemia or low blood components may be present
    7. Lowered number of platelets -- cells that aid in blood clotting
  • Other tests:
    1. If Lung Infection is suspected -- chest X-Ray
    2. If infection of the spine and the brain (i.e., Meningitis) is suspected -- spinal tap is done to remove spinal fluid for laboratory studies

  • Out door activities
  • Camping in wooded areas
  • Nature walks
  • Contact with dogs
  • Children, young adults
  • Caucasians
  • Males more than females
  • Exposure to animals (wild or domestic)
  • Southeastern United States

  • Prevention by checking your child's skin (or your own) after spending time outdoors
  • Showering after outdoor activities
  • Apply insect repellents (e.g., DEET) to skin before camping in heavy tick infested areas
  • Wear light colored clothing so you can see the ticks
  • Walk on paths and stay away from plants, trees, and heavily shrubbed areas
  • If you find a tick, wear gloves and apply a drop of oil, alcohol, or gasoline to the tick before touching it. If near a health care facility (within 1-2 hours drive), let professionals remove the tick.
  • If symptoms are severe, inpatient treatments -- such as fluid, oxygen and blood transfusion -- may be needed.
  • Mild cases can be treated as outpatient
  • Antibiotics such as Vibramycin, Tetracycline, and other antibiotics are often given.
  • If pregnant, let your doctor know before any antibiotic treatment begins

  • Contact your doctor or nearest health care facility immediately.

  • Other infections:
    1. Rickettsial pox
    2. Viruses -- Measles, enterovirus, rubella
    3. Bacteria -- Staphylococcus, Meningococcemia
    4. Lyme Disease

more about Rocky Mountain Spotted Fever

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