Rocky Mountain Spotted Fever: The Importance of Proper Diagnosis and Treatment

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Introduction

Laboratory tests used to confirm the presence of Rickettsia rickettsii may take several days to a week to get results; therefore, antibiotic therapy should begin at the first suspicion of a R. rickettsial infection. Treatment should begin within the first five days of a suspected infection to achieve the patient’s most favorable prognosis. Otherwise, death or a lifetime of health complications may result from delayed medical treatment.

Treatment

Rickettsia rickettsii bacteria can be eradicated with a broad-spectrum antibiotic. For the ideal outcome, treatment should begin within the first 5 days on infection and continue for 7-14 days, depending on the severity of the infection and the age of the patient. The minimum treatment should last is 3 days after fever subsides. This usually occurs within 24-72 hours after dosing begins. (Todar, 2008). Hospitalization is necessary for persons who have difficult complications such as organ damage or who will are unable to follow the treatment regimen at home.
Doxycycline is the clinical antibiotic of choice for treating RMSF in adults and children of all ages (Centers for Disease Control and Prevention, 2013). Because doxycycline binds with calcium ions, there is debate concerning doxycycline causing permanent tooth discoloration in children when administered to pregnant women and children who have yet to develop crown formation on secondary teeth. This debate arose during the 1960s when doxycycline was used more commonly in children. According to the Morbidity and Mortality Weekly Report (MMWR) on Diagnosis and Management of Tickborne Rickettsial Diseases published by the Centers for Disease Control and Prevention (CDC), several recent studies have shown the occurrence of permanent tooth discoloration is low in children with restricted exposure to doxycycline. The American Academy of Pediatrics (AAP) has determined the effectiveness of doxycycline in treating RMSF is more substantial than the slight risk of tooth discoloration in children (American Academy of Pediatrics, 2013). Pregnant women should still avoid using doxycycline because it could cause bone and teeth defects in the child and toxicity in the mother.
Chloramphenicol is the alternative drug of choice to treat persons who are hypersensitive to doxycycline or who are pregnant. The use of chloramphenicol must be monitored closely due to its possible adverse reactions such as aplastic anemia and can only be administered intravenously in the United States (Chapman, 2006). Use of other antibiotics can exacerbate symptoms and is not recommended.

Prognosis

Persons who receive proper medication and comply with the drug regimen within...

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