Wednesday, November 28, 2012

Rocky Mountain Spotted Fever

Rocky Mountain Spotted Fever is a rickettsial disease caused by Rickettsia rickettsii, and the natural history of RMSF goes like this:  1-2 weeks after being bitten by a tick from the Ixodid ticks, primary among them are the wood ticks (Dermacentor andersoni) and dog tick (D. variabilis), the victim develops constitutional symptoms (fever, chills, malaise) and a centripetal rash that begins on the distal extremities and marches inward toward the trunk.  This time lapse from the onset of the rash to the truncal manifestations can be as short as 6 hours.  Over the next couple of days, the rash becomes petichial and hemorrhagic, and if the patient isn't treated by day 5, the fatality rate rapidly climbs.  Problem is, in up to 20% of cases, there is no rash.  The usual cause of death is acute renal failure. If treated in time with a tetracycline derivative or chloramphenicol, the death rate is nil. 

About four years ago, I  had the pleasure of having a different rickettsial disease, R. conorii being the causative organism (bonus: which disease did I have and where did I get it?) and I thought someone was jackhammering the inside of my skull for about a week, in spite of starting Doxy as soon as I figured it out.  Not fun.  

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