Treatment of Rocky Mountain spotted fever
- Daniel J Sexton, MD
Daniel J Sexton, MD
- Editor-in-Chief — Infectious Diseases
- Section Editor — Bacterial Infections
- Professor of Medicine
- Duke University Medical Center
Rocky Mountain spotted fever (RMSF) is a potentially lethal, but usually curable, tick-borne disease. It occurs throughout the United States, Canada, Mexico, Central America, and in parts of South America. The etiologic agent, Rickettsia rickettsii, is a gram-negative, obligate intracellular bacterium that causes a wide spectrum of clinical disease from mild to fulminant infection. Mortality from RMSF declined markedly in the last decade from 2.2 percent in 2000 to 0.3 percent in 2007, and has been essentially unchanged since that time [1,2].
The treatment of RMSF will be reviewed here. The basic biology of R. rickettsii, and the epidemiology, clinical manifestations, and diagnosis of RMSF are discussed separately. (See "Biology of Rickettsia rickettsii infection" and "Clinical manifestations and diagnosis of Rocky Mountain spotted fever".)
A diagnosis of Rocky Mountain spotted fever (RMSF) should be considered in individuals who present with fever, headache, and constitutional symptoms in the spring and summer months if:
●They are from an endemic area (see "Clinical manifestations and diagnosis of Rocky Mountain spotted fever", section on 'Epidemiology')
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- Mild disease
- Severe disease
- IMPORTANCE OF EARLY THERAPY
- CHOICE OF ANTIBIOTIC
- Preferred agent
- - Non-pregnant adults
- - Children
- Alternative agent
- MONITORING FOR DRUG TOXICITY
- DURATION OF TREATMENT
- RESPONSE TO THERAPY
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS