Atypical presentation of Rocky Mountain Noticed Fever

Atypical presentation of Rocky Mountain Noticed Fever

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Rocky Mountain noticed fever (RMSF) is a probably lethal tick-borne illness which might progress quickly. An early analysis is crucial, since administering remedy inside the first 5 days of sickness can considerably scale back illness severity and probability of fatality, in response to Hussain et al.

Rocky Mountain noticed fever was initially recognized within the Rocky Mountain area. Nevertheless, RMSF circumstances are actually reported all through the nation, with greater incidence within the southeastern and south-central areas.

Of their article, “Unconventional Rocky Mountain Spotted Fever Presentation From Kentucky: A Compelling Case Report and Literature Review,” Hussain and colleagues describe the case of a 71-year-old man who was admitted to the hospital with a fever, generalized weak point with myalgia, persistent hiccups, confusion and agitation.¹

A bodily examination revealed the affected person exhibited tachycardia, tachypnea, elevated blood strain, and a excessive fever of 103.3°F. Take a look at outcomes confirmed extreme hyponatremia (an electrolyte abnormality), leukocytosis, and irregular blood parameters.

Preliminary remedy for sepsis

The person’s signs improved after he was handled with IV ceftriaxone for sepsis as a result of a urinary tract an infection or pneumonia.

Nevertheless, the affected person later developed a 106.5°F fever and was admitted to the ICU.

“Upon additional history-taking to find out the supply of a fever of unknown origin, the affected person revealed a possible publicity to ticks and a cat suspected of getting lice one week prior.”

He was subsequently examined for Bartonella, Borrelia burgdorferi, and Rickettsia (the bacterium which causes Rocky Mountain noticed fever).

As a precaution, the affected person was handled empirically with doxycycline for a attainable tick-borne sickness and launched from the hospital.

Though preliminary testing was inconclusive for a tick-borne sickness, follow-up testing was optimistic for Rickettsia.

“This case report underscores the diagnostic challenges posed by atypical shows of RMSF and emphasizes the crucial significance of early detection and remedy to forestall extreme problems.”

Rocky Mountain noticed fever – key factors:

  • RMSF sometimes manifests with imprecise signs together with fever, headache, rash, muscle ache, and nausea.
  • Take a look at outcomes are sometimes inside regular ranges within the early levels of illness. Based on the authors, “it might take a number of weeks to acquire confirmatory diagnostic outcomes.”
  • “Atypical manifestations of RMSF, equivalent to generalized neurologic complaints, myocarditis, or visible disturbances, will not be nicely characterised within the literature. Healthcare suppliers ought to take into account RMSF within the differential analysis of sufferers with these manifestations.”


  1. Hussain A, Grey C, Marlowe S, et al. (November 09, 2023) Unconventional Rocky Mountain Noticed Fever Presentation From Kentucky: A Compelling Case Report and Literature Evaluation. Cureus 15(11): e48558. doi:10.7759/cureus.48558

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