Rocky Mountain spotted fever.

1. L. Akinbami, MD* 1. 2. *Pediatric Resident Children’s National Medical Center Washington, DC 1. Rocky Mountain Spotted Fever. Silber JL. Clin Dermatol . 1996;14:254-258 2. Lyme Disease, Rocky Mountain Spotted Fever, Ehrlichiosis: Emerging and Established Challenges for the Clinician. Jantausch BA. Ann Allergy . 1994;73:4-12 [OpenUrl][1][PubMed][2] 3. Treatment of Rocky Mountain Spotted Fever. Kamper C. J Pediatr Health Care . 1991;5:216-222 [OpenUrl][3][CrossRef][4][PubMed][5] 4. Therapeutic Delay and Mortality in Cases of Rocky Mountain Spotted Fever. Kirkland KB, Wilkinson WE, Sexton DJ. Clin Infect Dis . 1995;20:1118-1121 [OpenUrl][6][Abstract/FREE Full Text][7] 5. Rocky Mountain Spotted Fever. Weber DJ, Walker DH. Infect Dis Clin North Am . 1991;5:19-35 [OpenUrl][8][PubMed][9] Rocky Mountain spotted fever (RMSF) is a potentially fatal multisystem illness caused by Rickettsia rickettsii , a Gram-negative, obligate intracellular coccobacillus. A feeding tick inoculates the bacteria into the dermis from which they disseminate hematogenously and enter endothelial cells throughout the body. Intracellular replication leads to vasculitis and increased vascular permeability. The seasonal occurrence (April to October) of RMSF is associated with feeding activity of the vectors— the wood tick Dermacentor andersoni in Rocky Mountain states and the dog tick Dermacentor variabilis in the eastern two thirds of the United States. RMSF has been reported from every region of the continental United States, and the vector is found in both rural and urban areas. The incidence is highest in children ages 5 to 9 years. For all ages, risk factors include exposure to dogs, residence in wooded areas, and male gender. Clinical signs and symptoms of RMSF emerge after an average incubation of 1 week, which may range from 2 to 14 days, depending on the inoculum size. Patients present with fever, severe frontal headache, and myalgias, which make early RMSF difficult to distinguish from acute viral illnesses. Additional complaints … [1]: {openurl}?query=rft.jtitle%253DAnnals%2Bof%2Ballergy%26rft.stitle%253DAnn%2BAllergy%26rft.aulast%253DJantausch%26rft.auinit1%253DB.%2BA.%26rft.volume%253D73%26rft.issue%253D1%26rft.spage%253D4%26rft.epage%253D11%26rft.atitle%253DLyme%2Bdisease%252C%2BRocky%2BMountain%2Bspotted%2Bfever%252C%2Behrlichiosis%253A%2Bemerging%2Band%2Bestablished%2Bchallenges%2Bfor%2Bthe%2Bclinician.%26rft_id%253Dinfo%253Apmid%252F8030801%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [2]: /lookup/external-ref?access_num=8030801&link_type=MED&atom=%2Fpedsinreview%2F19%2F5%2F171.atom [3]: {openurl}?query=rft.jtitle%253DJournal%2Bof%2Bpediatric%2Bhealth%2Bcare%2B%253A%2B%2Bofficial%2Bpublication%2Bof%2BNational%2BAssociation%2Bof%2BPediatric%2BNurse%2BAssociates%2B%2526%2BPractitioners%26rft.stitle%253DJ%2BPediatr%2BHealth%2BCare%26rft.aulast%253DKamper%26rft.auinit1%253DC.%26rft.volume%253D5%26rft.issue%253D4%26rft.spage%253D216%26rft.epage%253D222%26rft.atitle%253DTreatment%2Bof%2BRocky%2BMountain%2Bspotted%2Bfever.%26rft_id%253Dinfo%253Adoi%252F10.1016%252F0891-5245%252891%252990067-Z%26rft_id%253Dinfo%253Apmid%252F1865296%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [4]: /lookup/external-ref?access_num=10.1016/0891-5245(91)90067-Z&link_type=DOI [5]: /lookup/external-ref?access_num=1865296&link_type=MED&atom=%2Fpedsinreview%2F19%2F5%2F171.atom [6]: {openurl}?query=rft.jtitle%253DClin%2BInfect%2BDis.%26rft_id%253Dinfo%253Adoi%252F10.1093%252Fclinids%252F20.5.1118%26rft_id%253Dinfo%253Apmid%252F7619985%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [7]: /lookup/ijlink?linkType=ABST&journalCode=cid&resid=20/5/1118&atom=%2Fpedsinreview%2F19%2F5%2F171.atom [8]: {openurl}?query=rft.jtitle%253DInfectious%2Bdisease%2Bclinics%2Bof%2BNorth%2BAmerica%26rft.stitle%253DInfect%2BDis%2BClin%2BNorth%2BAm%26rft.aulast%253DWeber%26rft.auinit1%253DD.%2BJ.%26rft.volume%253D5%26rft.issue%253D1%26rft.spage%253D19%26rft.epage%253D35%26rft.atitle%253DRocky%2BMountain%2Bspotted%2Bfever.%26rft_id%253Dinfo%253Apmid%252F1904897%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [9]: /lookup/external-ref?access_num=1904897&link_type=MED&atom=%2Fpedsinreview%2F19%2F5%2F171.atom