Rapid Review: Rocky Mountain Spotted Fever

Reviewed February 2024

Rocky Mountain Spotted Fever (RMSF)

• History of recently being in the woods, hiking, or camping
• Abrupt onset of severe headache, photophobia, vomiting, diarrhea, and myalgia
• PE will show maculopapular eruption on palms and soles
• Most commonly caused by Rickettsia rickettsii
• Empiric treatment based on clinical presentation
• Diagnosis confirmed by serologic testing
• Treatment is ALWAYS doxycycline, even in children

Sample question:

A 19-year-old woman presents with 4 days of high fever, headache, and myalgias. She also developed a blanching erythematous rash with macules on her wrists and ankles that spread to her trunk. She reports no history of distant travel but was camping at a local state park in North Carolina, USA last weekend. Which of the following is the most appropriate treatment?