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1: Arch Intern Med. 2003 Apr 14;163(7):769-74.Click here to read Links
Comment in:
Arch Intern Med. 2004 Jan 26;164(2):221-2.

Rocky Mountain spotted fever: a clinician's dilemma.

Masters EJ, Olson GS, Weiner SJ, Paddock CD.

Department of Pediatrics, St Francis Medical Center and Southeast Missouri Hospital, Cape Girardeau, MO, USA. EMAST7456@AOL.com

Rocky Mountain spotted fever is still the most lethal tick-vectored illness in the United States. We examine the dilemmas facing the clinician who is evaluating the patient with possible Rocky Mountain spotted fever, with particular attention to the following 8 pitfalls in diagnosis and treatment: (1) waiting for a petechial rash to develop before diagnosis; (2) misdiagnosing as gastroenteritis; (3) discounting a diagnosis when there is no history of a tick bite; (4) using an inappropriate geographic exclusion; (5) using an inappropriate seasonal exclusion; (6) failing to treat on clinical suspicion; (7) failing to elicit an appropriate history; and (8) failing to treat with doxycycline. Early diagnosis and proper treatment save lives.

PMID: 12695267 [PubMed - indexed for MEDLINE]

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