Rocky Mountain Spotted Fever (RMSF) (cont.)

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What is the treatment for Rocky Mountain spotted fever?

Antibiotics are the treatment for RMSF. Doxycycline is the antibiotic of choice in children and adults suspected of having RMSF. Antibiotic treatment is most effective if started within the first five days of symptom onset, so prompt treatment with antibiotics should be initiated in any individual suspected of having RMSF, even before confirmatory laboratory testing is obtained. The early initiation of antibiotics decreases the mortality rate of RMSF from 20% to about 5%. For individuals who are allergic to doxycycline, and in some pregnant patients, chloramphenicol is an alternative antibiotic that can be used. Although the disease responds well to treatment, it can become life-threatening if not treated promptly.

Though certain patients with mild symptoms suspected of having RMSF can be treated as outpatients with antibiotics and close follow-up, other patients with suspected RMSF will require admission to the hospital for close monitoring and further evaluation.

What is the prognosis of Rocky Mountain spotted fever?

If diagnosed early and treated promptly, RMSF has a very good prognosis. Most patients will fully recover without any long-term disabilities. However, a delay in diagnosis and treatment is contributory to the higher rates of complications and mortality seen with RMSF. In the United States, the mortality rate for RMSF is currently about 1%. In the preantibiotic era, the mortality rate was around 30%.

Is it possible to prevent Rocky Mountain spotted fever?

RMSF can be prevented by implementing the following precautionary measures that can help avoid tick bites:

  • Wear long pants and long sleeves when walking or working outside, especially in wooded areas.
  • Use DEET-containing insect repellents.
  • Check yourself, family members, and pets for ticks after you have been outside in a high-risk area.
  • If a tick is found, proper removal of the tick is important. Removal of the tick should be performed with tweezers while wearing gloves. The tick should not be crushed, and care should be taken to ensure that the whole tick is removed while gently pulling the tick out.
  • If possible, keep the tick so that identification of the tick species can be established if necessary.

REFERENCES:

Tintinalli, Judith E., et al. Tintinalli's Emergency Medicine: A Comprehensive Study Guide, 7th ed. New York: McGraw Hill Professional, 2010; 1071-1072.

United States. Centers for Disease Control and Prevention. "Rocky Mountain Spotted Fever." Nov. 21, 2013. <http://www.cdc.gov/rmsf/>.


Medically Reviewed by a Doctor on 5/15/2014

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