(See "Initial therapy and prognosis of bacterial meningitis in adults" and "Bacterial meningitis in children older than one month: Treatment and prognosis".) Thus, patients should receive empiric antibiotic therapy for both conditions if their symptoms are consistent with invasive meningococcal disease and RMSF. As an example, the early signs and symptoms of invasive meningococcal infection and RMSF are often difficult to distinguish.
#JACKSON LAB TICK BORNE DISEASE DOXY SKIN#
Clinicians should not wait for the skin rash to develop before initiating treatment. Most patients will require empiric therapy for RMSF based upon clinical judgment and the epidemiologic setting since RMSF can rarely be confirmed or disproved in its early phase. (See 'Importance of early therapy' below and 'Choice of antibiotic' below.) It is particularly important that empiric therapy not be delayed if RMSF is suspected in patients who are severely ill (eg, severe headache or abdominal pain) and/or those who present with possible complications associated with RMSF (eg, seizures, hypotension, noncardiogenic pulmonary edema, jaundice). Patients suspected to have RMSF - Antimicrobial therapy should be initiated as soon as possible in all patients who are suspected to have RMSF. (See "Clinical manifestations and diagnosis of Rocky Mountain spotted fever", section on 'Epidemiology' and "Clinical manifestations and diagnosis of Rocky Mountain spotted fever", section on 'Vectors'.) Have a known tick bite or an exposure to outdoor areas where ticks are common.(See "Clinical manifestations and diagnosis of Rocky Mountain spotted fever", section on 'Clinical manifestations' and "Clinical manifestations and diagnosis of Rocky Mountain spotted fever", section on 'Laboratory findings'.) Present in the spring and summer months with fever and at least one of the following: headache, rash, constitutional symptoms, RMSF-associated laboratory abnormalities (thrombocytopenia, elevated liver functions tests, etc).When to suspect RMSF - A diagnosis of RMSF should be suspected in patients who are from an endemic area (or have visited one within the past 14 days) if they: Early therapy for RMSF is critical since a delay in treatment has been associated with an increased risk of mortality. (See "Biology of Rickettsia rickettsii infection" and "Clinical manifestations and diagnosis of Rocky Mountain spotted fever".)ĪPPROACH - We recommend empiric therapy with doxycycline for patients with suspected RMSF, even if the symptoms are mild. rickettsii, and the epidemiology, clinical manifestations, and diagnosis of RMSF are discussed separately. The treatment of RMSF will be reviewed here.
Mortality from RMSF has declined markedly, from 2.2 percent in 2000 to 0.3 percent in 2007 and has been essentially unchanged since that time. The etiologic agent, Rickettsia rickettsii, is a gram-negative, obligate intracellular bacterium that causes a wide spectrum of clinical disease ranging from mild to fulminant infection. RMSF occurs throughout the United States, Canada, Mexico, Central America, and in parts of South America. INTRODUCTION - Rocky Mountain spotted fever (RMSF) is a potentially lethal, but usually curable, tick-borne disease.
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