title: The great imitator: Rocky Mountain spotted fever occurring after hospitalization for unrelated illnesses.
abstract: We describe two patients who had Rocky Mountain spotted fever after they were admitted to the hospital for emergency and elective surgical procedures. We initially thought one patient had a hospital-acquired infection; the correct diagnosis was deduced from epidemiologic clues elicited by consultants. These two cases were also unusual in that one patient had a recurrent rash after an abbreviated course of low-dose doxycycline therapy and the other patient had transient and self-limiting postinfectious polyneuropathy. These cases illustrate that community-acquired infection with Rickettsia rickettsii can occur simultaneously with other disease processes and sometimes mimic a nosocomial infection.
authors.affiliation: Department of Medicine, Duke University Medical Center, Durham, NC 27710, USA.
authors.forename: M A
authors.initials: MA
authors.lastname: Eloubeidi
authors.forename: C S
authors.initials: CS
authors.lastname: Burton
authors.forename: D J
authors.initials: DJ
authors.lastname: Sexton
mesh_terms: D000673:Amputation, Traumatic / Q000601:surgery; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use; D017714:Community-Acquired Infections / Q000175:diagnosis; D001026:Coronary Artery Bypass; D003428:Cross Infection / Q000175:diagnosis*; D003937:Diagnosis, Differential; D004318:Doxycycline / Q000008:administration & dosage / Q000627:therapeutic use; D017558:Elective Surgical Procedures; D004630:Emergencies; D005260:Female; D019085:Fluorescent Antibody Technique, Direct; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D008297:Male; D008409:Mastication / Q000502:physiology; D008875:Middle Aged; D010292:Paresthesia / Q000382:microbiology; D010523:Peripheral Nervous System Diseases / Q000382:microbiology; D012008:Recurrence; D012017:Referral and Consultation; D012092:Replantation; D012373:Rocky Mountain Spotted Fever / Q000175:diagnosis* / Q000188:drug therapy; D013651:Taste Disorders / Q000382:microbiology; D013933:Thumb / Q000293:injuries; D018366:Vasculitis, Leukocytoclastic, Cutaneous / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents; D004318:Doxycycline