Rocky Mountain Spotted Fever Still Difficult to Diagnose in Children

The classic history and triad of symptoms are absent in nearly half of young patients.

This retrospective review of 92 confirmed or probable pediatric (age, ≤18 years) cases of Rocky Mountain spotted fever (RMSF) from six institutions in the Southeast and South Central U.S. from 1990 to 2003 provides updated information on clinical characteristics of the disease in children.

Overall, 90% of cases were diagnosed between April and September (61% in May, June, and July). Only 58% of patients had the triad of fever, rash, and headache; 45% had the triad of fever, rash, and history of tick attachment. Fifty-nine percent had thrombocytopenia, and 18% had pneumonia. Although 86% of patients had been taken to a healthcare provider before hospital admission, only four patients were prescribed antirickettsial antibiotics. Median time fr…

Reviewing Author

Jill M. Baren, MD, MBE, FACEP, FAAP