The great imitator: Rocky Mountain spotted fever occurring after hospitalization for unrelated illnesses.
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.
Eloubeidi
M A
MA
Department of Medicine, Duke University Medical Center, Durham, NC 27710, USA.
Burton
C S
CS
Sexton
D J
DJ
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
D000900:Anti-Bacterial Agents; D004318:Doxycycline