Spotting Rocky Mountain Spotted Fever in Children

Clinical and Laboratory Features, Hospital Course, and Outcome of Rocky Mountain Spotted Fever in Children

Buckingham SC, Marshall GS, Shutze GE, et al; Tick-borne Infections in Children Study Group J Pediatr. 2007;150:180-184, 184.e1

The goal of the authors was to provide a contemporary descriptive review of cases of Rocky Mountain spotted fever (RMSF) in children, given that there is a relative dearth of information about how the disease presents in children (relative to the published literature on adults with RMSF).

The cases were identified from 6 medical centers in the southeastern and southcentral United States during the period 1990-2002. The authors began the search for cases by looking for rickettsial disease diagnoses among ICD-9 discharge codes at the 6 medical centers. They also searched laboratory data at the centers, along with other sources, in an effort to identify all cases of RMSF. The authors then performed chart review of all cases to collect data on presentation, treatment required, etc.

There were 92 patients with RMSF identified at the 6 centers during the study period; 47% were male. Of the 92 subjects, approximately one third were confirmed cases and two thirds were suspected cases. The median age was 5.8 years, and only 49% reported a tick bite. Only one third reported having been in a wooded area. The median duration of symptoms before admission to hospital was 6 days, but 86% of the patients had made at least 1 healthcare visit before the admission. Four of the patients had received a prescription for