​Dermatology - Rocky Mountain Spotted Fever

​Dermatology - Rocky Mountain Spotted Fever
Rickettsia infection  is transmitted through the bite of an infected tick. Merely 60% of patients possess knowledge regarding a previous tick bite. The transmission is most prevalent during the spring season in the Southeastern region of the United States.

The individual is experiencing a sudden and severe feverish illness characterized by chills, intense shaking, loss of appetite, feelings of sickness, vomiting, general discomfort, irritability, severe headache, and muscle pain. The sickness can imitate the symptoms of acute abdomen, acute cholecystitis, and acute appendicitis.
Abnormalities
At the beginning of the course, there is a rash consisting of little pink spots measuring 2-6 mm in diameter. These spots can be temporarily made to disappear by applying pressure. Within 1-3 days, the rash progresses to become raised red bumps. 

Typically, the rash initiates on the wrists, forearms, and ankles, and subsequently appears on the palms and soles. The rash expands towards the center of the body, reaching the arms, thighs, trunk, and face during a period of 6 to 18 hours. Over the following 2 to 4 days, the rash becomes hemorrhagic and does not fade when pressed, accompanied by swelling in the affected area. Palms and soles may develop a hemorrhagic rash.
Acral extremities experience necrosis as a result of persistent hypotension. There exists a variety that lacks a rash and is linked to a greater mortality risk due to a delay in diagnosis.

In the early stages of Rocky Mountain spotted fever (RMSF), clinical and epidemiologic factors are more significant than a laboratory diagnosis. It is crucial to examine RMSF in individuals who are experiencing fever and fall into the categories of children, adolescents, or males over 60 years old, particularly if they have been exposed to ticks in locations where the disease is prevalent. The diagnosis was initially made based on clinical observations and later validated.
During the initial three days of illness, only 3% of individuals with RMSF exhibit the triad of rash, fever, and a documented tick bite history.

Administer doxycycline.