Background: Rocky Mountain spotted fever (RMSF) is a well-described, potentially lethal, tick-borne zoonotic infection and has very effective therapy. However, the diagnosis might not be made early enough, often leading to worse outcomes.
Objective: Our aim was to discuss the diagnostic dilemmas facing the physician when evaluating patients with suspected RMSF.
Methods: We report a case of RMSF in a 6-year-old girl who presented to our hospital with a 7-day history of fever, headache, and a petechial rash. After blood cultures were obtained, the patient was treated empirically with doxycycline, vancomycin, and ceftriaxone. During the next 24 h, her clinical status worsened, with acute onset of altered mental status, posturing, and fixed and dilated pupils. A computed tomography scan of the brain demonstrated diffuse cerebral edema with evidence of tonsillar herniation. She died 24 h after admission. A serum specimen tested positive for immunoglobulin G to Rickettsia rickettsii at a titer of 128 dilutions, confirming recent infection.
Conclusions: We present this case to raise awareness of RMSF in patients who present with a nonspecific febrile illness in tick-endemic areas in the United States. Early diagnosis and treatment with doxycycline before day 5 of illness is essential and can prevent morbidity and mortality.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.jemermed.2012.11.038 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Moebius syndrome and hypopituitarism: a case of multiple pituitary hormone deficiency and revision of the literature.
J Pediatr Endocrinol Metab
January 2025
Pediatrics, Fondazione IRCCS San Gerardo Dei Tintori, Monza, Italy.
Objectives: Moebius syndrome (MS) is a rare congenital non-progressive rhombencephalic disorder mostly characterised by abducens and facial nerve palsy, but with a multifaceted clinical presentation. Isolated or multiple pituitary hormone deficiencies in the setting of MS have been occasionally reported, but the simultaneous involvement of three or more hypothalamic-pituitary axes has never been described. We hereby report the case of a girl with MS that showed a co-occurrence of GH-, TSH- and ACTH-deficiency.
View Article and Find Full Text PDFOral Manifestations in a Child With Distal Renal Tubular Acidosis, and Refractory Rickets.
Spec Care Dentist
January 2025
Department of Pediatric and Preventive Dentistry, Centre for Dental Education and Research, AIIMS, New Delhi, India.
Renal tubular acidosis (RTA) is a group of disorders in which there is an alteration in acid-base homeostasis because of the impairment of nephrons to excrete hydrogen ions or reabsorb bicarbonate ions, resulting in chronic metabolic acidosis. RTA is an important cause of rickets, particularly 'resistant rickets'. Dental manifestations frequently reported in patients with RTA include enamel hypoplasia and amelogenesis imperfecta, affecting permanent dentition.
View Article and Find Full Text PDFWhat I say is not what I do: Gender differences in the home mathematics environment.
Dev Psychol
January 2025
Department of Human Development and Family Science, Purdue University.
Consistent evidence shows that women are underrepresented across most Science, Technology, Engineering, and Mathematics fields. Research indicates that early attitudes and gendered beliefs about mathematics can predict later achievement and academic choices in Science, Technology, Engineering, and Mathematics and that children's attitudes are tied to parents' beliefs and interactions with their children surrounding math. To identify potential antecedents of gender differences, we examined whether there are differences between parents of sons and parents of daughters on factors in the home mathematics environment that influence early math experiences for young children.
View Article and Find Full Text PDFCase 3: Fatigue, Ankle Pain, and a Murmur in a 6-Year-Old Girl.
Pediatr Rev
January 2025
Department of Pediatrics, Baylor College of Medicine, Houston, TX.
Anesthetic management using desflurane and nitrous oxide in a child with non-ketotic hyperglycinemia: a case report.
JA Clin Rep
December 2024
Department of Anesthesiology, Niigata University Medical and Dental Hospital, 1-754 Asahimachi-Dori, Chuo-Ku, Niigata, 951-8520, Japan.
Background: Non-ketotic hyperglycinemia (NKH) is a rare autosomal recessive disorder caused by defects in the glycine cleavage system, leading to elevated glycine levels in the central nervous system. NKH manifests in various forms, with the neonatal type being the most severe and often associated with high mortality and significant neurological impairment. This case report highlights the successful uses of desflurane and nitrous oxide for anesthetic management in a patient with NKH.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!