title: Rocky Mountain Spotted Fever in a patient treated with anti-TNF-alpha inhibitors.
abstract: Rocky Mountain Spotted Fever (RMSF) is a tick-bourne illness, which can be fatal if unrecognized. We discuss the case of a patient treated with an anti-TNF-alpha inhibitor for rheumatoid arthritis who later developed a generalized erythematous macular eruption accompanied by fever. The clinical findings were suggestive of RMSF, which was later confirmed with serology. Prompt treatment with doxyclycine is recommended for all patients with clinical suspicion of RMSF.
authors.affiliation: Center for Clinical Studies, Webster, TX, USA.
authors.forename: Rana M
authors.initials: RM
authors.lastname: Mays
authors.forename: Rachel A
authors.initials: RA
authors.lastname: Gordon
authors.forename: K Celeste
authors.initials: KC
authors.lastname: Durham
authors.forename: Whitney J
authors.initials: WJ
authors.lastname: LaPolla
authors.forename: Stephen K
authors.initials: SK
authors.lastname: Tyring
mesh_terms: D000068879:Adalimumab; D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D001733:Bites and Stings; D004318:Doxycycline / Q000627:therapeutic use*; D005334:Fever / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011565:Psoriasis / Q000188:drug therapy*; D012373:Rocky Mountain Spotted Fever / Q000175:diagnosis* / Q000188:drug therapy; D013987:Ticks; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
chemical_list: D000900:Anti-Bacterial Agents; D061067:Antibodies, Monoclonal, Humanized; D014409:Tumor Necrosis Factor-alpha; D000068879:Adalimumab; D004318:Doxycycline