Rapid Review: Rock Mountain Spotted Fever

Rocky Mountain spotted fever (RMSF)

  • Patient with a history of recently in the woods hiking or camping
  • Complaining of abrupt onset of severe headache, photophobia, vomiting, diarrhea, and myalgia
  • PE will show maculopapular eruption on the palms and soles
  • Diagnosis is made by skin biopsy
  • Most commonly caused by Rickettsia rickettsia
  • Treatment is ALWAYS doxycycline, even in children

Sample question:

A 19-year-old woman presents with four days of high fever, headache, myalgias. She also developed blanching erythematous rash with macules on her wrists and ankles that spread to her trunk. She denies history of distant travel but was camping last weekend at a local state park in North Carolina. Which of the following is the most appropriate treatment?

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