PDF(Pubmed)
Abstract：
Rocky Mountain spotted fever (RMSF) is a potentially lethal tick-borne disease caused by Rickettsia rickettsii, known for its tropism for vascular endothelial cells. Its classic symptoms include fever, headaches, and a rash, but atypical presentations can challenge diagnosis. We present the case of a 71-year-old male with fever, weakness, and hiccups, evolving into confusion. Laboratory findings showed severe hyponatremia, leukocytosis, and abnormal blood parameters. Initial management addressed sepsis and hyponatremia, leading to symptom improvement. Later, a fever of 106.5°F prompted ICU transfer, broad-spectrum antibiotics, and testing for tick-borne diseases. The patient reported tick exposure and received prophylactic doxycycline. Follow-up confirmed the RMSF diagnosis based on serological testing and clinical symptoms. This case highlights the diagnostic challenges posed by atypical RMSF presentations and underscores the importance of early detection and treatment to prevent complications.
摘要：
落基山斑疹热（RMSF）是由立克次体立克次体引起的潜在致命的蜱传疾病，以其对血管内皮细胞的嗜性而闻名。它的典型症状包括发烧，头痛,还有皮疹,但是非典型的表现可能会挑战诊断。我们介绍一名71岁男性发烧的病例，弱点,打嗝，演变成混乱。实验室检查结果显示严重低钠血症,白细胞增多,和异常的血液参数。最初的治疗是针对脓毒症和低钠血症，导致症状改善。稍后，106.5°F的发烧促使ICU转移，广谱抗生素,并检测蜱传疾病。患者报告蜱暴露并接受预防性多西环素。根据血清学检测和临床症状，随访证实了RMSF的诊断。此病例突出了非典型RMSF演示文稿带来的诊断挑战，并强调了早期发现和治疗以预防并发症的重要性。
