title: Adult Onset Still's Disease and Rocky Mountain Spotted Fever.
abstract: Adult Still's Disease was first described in 1971 by Bywaters in fourteen adult female patients who presented with symptoms indistinguishable from that of classic childhood Still's Disease (Bywaters, 1971). George Still in 1896 first recognized this triad of quotidian (daily) fevers, evanescent rash, and arthritis in children with what later became known as juvenile inflammatory arthritis (Still, 1990). Adult Onset Still's Disease (AOSD) is an inflammatory condition of unknown etiology characterized by an evanescent rash, quotidian fevers, and arthralgias. Numerous infectious agents have been associated with its presentation. This case is to our knowledge the first presentation of AOSD in the setting of Rocky Mountain Spotted Fever. Although numerous infectious agents have been suggested, the etiology of this disorder remains elusive. Nevertheless, infection may in fact play a role in triggering the onset of symptoms in those with this disorder. Our case presentation is, to our knowledge, the first case of Adult Onset Still's Disease associated with Rocky Mountain spotted fever (RMSF).
authors.affiliation: Department of Internal Medicine, Mercer University School of Medicine, Macon, GA 31201-0001, USA.
authors.forename: Paul
authors.initials: P
authors.lastname: Persad
authors.forename: Rajendrakumar
authors.initials: R
authors.lastname: Patel
authors.forename: Niki
authors.initials: N
authors.lastname: Patel
references.citation: Semin Arthritis Rheum. 2006 Dec;36(3):144-52
references.pmid: 16949136
references.citation: West J Med. 1985 May;142(5):665-71
references.pmid: 4013282
references.citation: Joint Bone Spine. 2002 Jun;69(4):355-7
references.pmid: 12184429
references.citation: Ann Rheum Dis. 1971 Mar;30(2):121-33
references.pmid: 5315135
references.citation: Drugs. 2008;68(3):319-37
references.pmid: 18257609
references.citation: Medicine (Baltimore). 1991 Mar;70(2):118-36
references.pmid: 2005777
references.citation: Rev Rhum Engl Ed. 1995 Dec;62(11):748-57
references.pmid: 8869216
references.citation: Hepatogastroenterology. 2003 Jan-Feb;50(49):192-5
references.pmid: 12630021
references.citation: Ann Rheum Dis. 2006 May;65(5):564-72
references.pmid: 16219707
references.citation: Scand J Rheumatol. 2003;32(2):119-21
references.pmid: 12737332
references.citation: Ann Rheum Dis. 1988 Sep;47(9):764-7
references.pmid: 3178317
references.citation: Bull Rheum Dis. 2000;49(6):1-4
references.pmid: 11100625
references.citation: Int J Cardiol. 1990 Jun;27(3):377-80
references.pmid: 2351497
references.citation: Q J Med. 1986 Nov;61(235):1055-65
references.pmid: 3659248
references.citation: J Rheumatol. 1996 Jan;23(1):201-2
references.pmid: 8838544
references.citation: Scand J Rheumatol. 2002;31(3):181-3
references.pmid: 12195635
references.citation: Clin Orthop Relat Res. 1990 Oct;(259):4-10
references.pmid: 2208872
references.citation: Arthritis Rheum. 1987 Feb;30(2):186-94
references.pmid: 3827959
references.citation: J Rheumatol. 1992 Mar;19(3):424-30
references.pmid: 1578458
references.citation: Indian J Med Sci. 2009 May;63(5):207-21
references.pmid: 19584494
references.citation: Medicine (Baltimore). 2002 May;81(3):194-200
references.pmid: 11997716
references.citation: Arthritis Rheum. 1976 Mar-Apr;19(2):232-42
references.pmid: 1259802
references.citation: Clin Infect Dis. 2001 Mar 15;32(6):E105-6
references.pmid: 11247732
references.citation: Br J Dermatol. 2001 Jul;145(1):187-8
references.pmid: 11453943