Rocky Mountain Spotted Fever

A mother brought her 9 year old son into their doctor’s office. Her son had been experiencing a fever and general malaise for the last three days. She suspected he might be getting the flu. Their doctor diagnosed him with a general virus and sent him home to be treated symptomatically. Later that evening the boy complained of a persistent headache, muscle aches, fatigue, stomach aches, including diarrhea. The boy was rushed to the emergency room. Upon examination the physician noticed a rash spreading down his arms and on his torso. She explained to the physician that her son’s symptoms had become worse. His flu like symptoms had left him lethargic and now he had rash that seemed to be spreading.

Upon examination the boy was awake and responsive, but tired. His skin showed a rash that looked like measles. It seems to be spreading over his extremities and torso, including his palm and the soles of his feet. The mother mentioned that the family had taken a camping trip a week ago and perhaps the boy came in contact with a plant. The boy showed no signs of head trauma or difficulty breathing and his vitals were relatively stable. The doctor notices a small scabbing lesion on his upper arms by his elbow and questions the patient. The boy claims to have seen a bug on his arm and had to pluck it off but not before he thinks it bit him.

Labs were drawn and meningeal fluid was also extracted in order to rule out meningitis. Meningeal fluids look normal. The labs show normal white blood cell count but his platelets counts are low which can be an indication of a viral infection. Since the boy was probably bitten by a bug (tick) and his platelets were low. Blood serologies were ordered to identify the presence of antibodies. Rickettsia rickettsii is suspected. He starts the boy on IV antibodies of doxycycline.

Tests confirm the bacterium Rickettsia rickettssii. The boy is treated in the hospital due to how many days the child had been exposed to the bacterium. The boy probably came in contact with the bacterium after being bitten by a tick while on the family’s camping trip. Given the fact that the boy did not say anything until after he became symptomatic and his