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Rocky Mountain Spotted Fever

Definition


Disease: Rocky Mountain Spotted Fever Rocky Mountain Spotted Fever
Category: Dermatological diseases
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Disease Definition:

A potentially serious bacterial infection transmitted to humans by tick bites is called Rocky Mountain spotted fever. The disease was first identified in the Rocky Mountain region. When an infected tick attaches to the skin and feeds on one's blood, Rocky Mountain spotted fever occurs. The infection has the potential to spread to the bloodstream and other areas of the body.

This disease doesn't spread directly from one person to another. A case of Rocky Mountain spotted fever is usually fairly mild when treated promptly. The disease can be serious in a small number of people, even fatal, especially in older adults. Prompt treatment is important because Rocky Mountain spotted fever can progress rapidly.

Work Group:


Prepared by: Scientific Section

Symptoms, Causes

Symptoms:

The initial signs and symptoms of Rocky Mountain spotted fever are often nonspecific and can mimic those of other illnesses. They may include:

  • Loss of appetite.
  • Fatigue.
  • Abdominal pain.
  • Severe headache.
  • High fever — body temperature reaching 38.9 C (102 F) or greater.
  • Chills.
  • Sensitivity to light (photophobia).
  • Nausea and vomiting.


The signs and symptoms mentioned below can develop later on:

  • Restlessness.
  • Delirium.
  • Red-spotted or blotchy rash on the wrists or ankles.
  • Diarrhea.
  • Widespread aches and pains.


The illness could incubate for up to 14 days after the tick bite, but many people experience symptoms within the first week after being bitten by an infected tick.

THE CHARACTERISTIC RED RASH:  
A red, blotchy rash develops on the wrists and ankles in most cases of Rocky Mountain spotted fever, which then spreads to the palms of the hands and soles of the feet. This usually occurs between days three and five of infection. Usually, the rash spreads up the arms and legs to the torso.

A rash never develops in a few infected people. A rash might not be readily apparent if the skin is darkly pigmented. However, a milder form of illness isn’t indicated by the absence of a rash, which may make the condition more difficult to diagnose.

If a person becomes sick after a tick bite or develops a rash, he/she should see a doctor. Rocky Mountain spotted fever and other infectious diseases carried by ticks can progress rapidly and may be life-threatening. The patient may take the tick along with him/her to the doctor's office for laboratory testing in case it is possible.

Causes:

An infection with the organism Rickettsia rickettsii is the cause of Rocky Mountain spotted fever. When a person comes in contact with an infected tick in one of the following circumstances, the bacterium infects him/her:

  • Broken skin: After contact with the bacteria through broken skin, such as a cut or scrape on the hands or fingers, Rocky Mountain spotted fever can occur. The disease-causing bacteria circulate in the fluids of a tick’s body. An infection can occur if the fluid comes in contact with an area of broken skin when a person squeezes or crushes a tick as he/she removes it from one's self, another person or a pet. If a person touches his/her eye after coming into contact with an infected tick, it's also possible to develop an infection.
  • Tick bites: tick bites are the most common cause of the spread of Rocky Mountain spotted fever to humans. Ticks can attach themselves to the skin and feed on the blood. They are often found in the genital area, around the ankles and in the hair, but they can lodge anywhere on the body. Ticks can cause a small, hard, itchy lump surrounded by a red ring or halo once embedded in the skin. Someone’s chance of acquiring the infection will be greater the longer an infected tick stays attached to the skin.


The culprit ticks:
A family of ticks known as Ixodidaeor hard ticks is what typically carries the bacterium that causes Rocky Mountain spotted fever. These ticks live in the tall grasses and low bushes of wooded areas. In the late spring and early summer is when they’re more abundant.

Rocky Mountain spotted fever is transmitted by the wood tick (Dermacentor andersoni), the American dog tick (Dermacentor variabilis) or other ticks such as the cayenne tick (Amblyomma cajennense) and the brown dog tick (Rhipicephalus sanguineus).

When ticks are most active and during warm weather when people tend to spend more time outdoors is when Rocky Mountain spotted fever usually occurs.

The risk of contracting Rocky Mountain spotted fever depends on:

  • How much time one spends in grassy or wooded areas.
  • How well one is protected from tick bites.


Taking precautions against exposure to ticks and making sure to check one's self and the dog for ticks after being outside is important.

Complications

Complications:

Medications can successfully treat Rocky Mountain spotted fever if it is detected in its early stages. The infection could spread from the site of the bite via the bloodstream if it is left untreated, and may potentially cause infection in other areas of the body. The central and peripheral nervous system, kidneys, lungs, heart and joints may be involved in the serious complications that Rocky Mountain spotted fever may cause, these complications may include:

  • Shock.
  • Problems with blood clotting.
  • An infection of the membranes and fluid surrounding the brain and spinal cord (meningitis).
  • Heart, lung or kidney failure.
  • Gangrene and possible amputation of fingers, toes, arms or legs.
  • Brain damage.


Usually because treatment is delayed or is never sought, Rocky Mountain spotted fever may cause death in a small percentage of cases.

Treatments:

The treatment of Rocky Mountain spotted fever involves:

  • Taking antibiotic medication, such as doxycycline, for seven to 10 days, and at least three days after your fever and other symptoms subside, to eliminate the infection.
  • Carefully removing the tick from the skin.

It's better to begin the treatment as soon as possible as the disease may cause serious illness and it can progress rapidly. If treated within five days of developing symptoms, people who develop Rocky Mountain spotted fever are much more likely to survive. And for this reason, if the doctor suspects that Rocky Mountain spotted fever is the cause of the patient's symptoms, he/she will probably have the patient begin antibiotic therapy before receiving conclusive test results.

The most effective treatment for Rocky Mountain spotted fever is doxycycline; however, it's not a good choice if the patient is pregnant. And as alternative, chloramphenicol is prescribed.

HOW TO REMOVE A TICK SAFELY:  
A tick should be carefully removed when found crawling on the skin. It shouldn't be crushed between the fingers. It should be flushed, burnt or buried. And afterward hands must be washed.

The following steps should be followed if a tick has already bitten a person and is holding on to his/her skin:

  • That area of the skin should be washed thoroughly and an antiseptic should be applied to the bite area after the tick has been removed.
  • The tick should be removed by gently grasping it near its head or mouth, preferably with tweezers.
  • The tick should be pulled carefully and steadily; it shouldn’t be crushed or squeezed.
  • The tick should be sealed in a plastic bag and stored in the freezer. This way, the tick could be tested for specific bacteria in case the person becomes sick from the bite. Within two weeks, if no signs and symptoms appear, the person could get rid of the bag by flushing, burning or burying it.
  • The tweezers should be disinfected with antibiotic soap and water or with alcohol.
  • The hands should be washed thoroughly.

Prognosis:

Not available

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