Thursday - May 01, 2014
A confirmed fatal case of RMSF acquired in Illinois occurred last year. Tetracycline is the drug of choice in adults and children. Empiric treatment should be initiated as soon as RMSF is suspected to prevent serious complications or death. RMSF is transmitted by the dog tick; dog ticks are present in all areas of Illinois.
--Signs and symptoms of RMSF include fever, malaise, headache, myalgias, loss of appetite, nausea, and vomiting, and a rash. However, all of these diagnostic clues are rarely identified on the initial patient encounter, leading to delays in appropriate therapy. Rash occurs in about 90% of RMSF cases; the typical rash first appears as spots on the wrists and ankles and then spreads to the trunk and also sometimes the palms and soles. The rash often appears two to five days after onset of fever. Some patients, especially children, may also have abdominal pain that may be severe. As with other tick- borne illnesses, some patients do not report a history of a tick bite, since the inoculation site is generally painless and often obscured by hair or a skin fold. Eighty-five percent of patients report being in a tick habitat and 63 percent reported a known tick bite.
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