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Rocky mountain spotted fever
• Rocky Mountain spotted fever (RMSF), also known as
blue disease,is the most lethal.
• Rocky Mountain spotted fever (RMSF) is a tick-borne
disease caused by the organism Rickettsia rickettsii.
• most common rickettsial infection and the second most
commonly reported tick-borne disease (after Lyme
disease) in the United States.
• The disease most often affects children and teenagers
younger than 15 years, especially those who spend time
outdoors or have pets that might carry the ticks.
• Rocky Mountain spotted fever (RMSF) is a bacterial
infection. It’s spread by the bite of an infected tick.
• It was first identified in the Rocky
• Rocky Mountain spotted fever is
most commonly found in the
southeastern part of the United
• It also occurs in parts of Canada,
Mexico, Central America and
• The mortality rate is 2% to 4%,
but increases to 25% in patients
in whom diagnosis and treatment
are delayed after day 5 of illness.
• Causative agent - Rickettsia
• spread- Rocky Mountain spotted fever
cannot be spread from person to
• If an infected tick attaches itself to your
skin and feeds on your blood for six to
10 hours, you may pick up the infection.
• seasonal occurrence (April to October)
wood tick- Dermacentor andersoni in
Rocky Mountain states and the dog tick-
Sign and symptoms
• initial symptoms
• Children infected with RMSF
first have symptoms common
to many other infectious
diseases symptoms appears in
3 to12 days including
• flu-like symptoms
• muscle pain,
• severe headaches,
• vomiting, nausea,
• loss of appetite
• Confusion or other
Sign and symptoms
• later symptoms -
• non itchy rash develop on wrist
and ankle during 2nd and 3rd
day of fever,then it spread
within hours to the torso and
palms of the hands and soles
of the feet.
• rash is red, spotted, and raised
(macular or maculopapular)
• abdominal pain
• joint pain
• Gangrene with
oedema of the
hands in a
• Rocky mountain
spotted fever. A
eruption is noted
on the arm in
this fatal case.
• ask about child’s symptoms and health history.
• ask about any recent risk of a tick bite.
• physical examination (The physical exam will include checking the rash
and tick bite)
• Other tests such as skin biopsy and blood tests. These are done to
confirm the diagnosis.
• classic triad- fever, rash, history of tick bite
• lab test-
• increased level of liver enzymes (elevated transaminases).
• imunofluorescent antibody assay
• Some people who are infected with Rocky Mountain spotted fever don't
ever develop a rash, which makes diagnosis much more difficult.
• It will also depend on how severe the condition is.
• Antibiotic-. Doxycycline 4.4mg/kg (twice a day)
• Adverse effect of Doxycycline -dental yellow stainig of permanent
teeth(should not use below age of 12)
• Other treatments may include:
• Making child getting plenty of rest
• Giving him or her lots of fluids
• Giving over-the- counter medicine for fever and discomfort Dont
give ibuprofen and Aspirine to a child younger than 6 months old,It
may cause GI bleeding.liver disease and Reye syndrome
• there is no vaccine to prevent
• Treat clothing and gear with
permethrin. Permethrin can be
used to treat boots, clothing
and camping gear and remain
protective through several
• Long-sleeved shirts tucked
• Socks and closed-toe shoes
• Long pants with legs tucked