begins with non-specific symptoms such as fever and headache, vomiting, diarrhea, and sometimes rash.
The disease may be confused clinically with RMSF
but differs by rarity of the prominent rash and often referred to as spotless RMSF
CDC recommends starting doxycycline treatment as soon as a doctor suspects RMSF
or other rickettsial infection.
A recent study reported that the fatality rate for patients with RMSF
in a region of the Sao Paulo metropolitan area (transmission by A.
parkeri cases published, whereas eschars, such as the one seen in this case, are uncommonly described in association with RMSF
Because reliable clinical tests specific for different SFG rickettsiae are not readily available, several different rickettsioses may be serologically cross-reactive, leading to misdiagnosis of RMSF
Clinical signs (fever, depression, petechial hemorrhages, thrombocytopenia) in dogs with overt RMSF
infection or CME are often similar (5).
Such variations have also been noted for RMSF
is associated with a mortality rate of 7%, even with treatment (5), and R.
is endemic in much of the Western Hemisphere, including Central and South America.
We recently confirmed RMSF
as the cause of death for 2 patients by PCR (2,3), sequencing, immunohistochemical tests (4), and culture (5) (Table 1).
rickettsii antigen is the only antigen used in serologic analysis for routine diagnosis of RMSF