eMedicine Specialties > Ophthalmology > Infectious Disease

Rocky Mountain Spotted Fever: Follow-up

Author: Byron L Lam, MD, Professor, Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami School of Medicine
Contributor Information and Disclosures

Updated: Oct 30, 2009

Follow-up

Further Inpatient Care

  • Most patients with RMSF are treated on an inpatient basis.
  • The frequency of long-term ocular sequelae is low, and, in most cases, good binocular visual acuity is preserved.

Further Outpatient Care

  • As needed

Inpatient & Outpatient Medications

  • As needed

Deterrence/Prevention

  • Minimize exposure to ticks

Complications

  • Sequelae of encephalitis
  • Pulmonary damage
  • Retinal and optic nerve ischemia

Prognosis

  • Prognosis usually is excellent if the patient was treated early in disease.

Patient Education

  • People in endemic areas should avoid tick exposure by wearing well-covered clothing and by using tick repellants. A thorough body inspection should be performed after activity in a known or high-risk tick area.
  • For excellent patient education resources, visit eMedicine's Bites and Stings Center. Also, see eMedicine's patient education article Ticks.

Miscellaneous

Medicolegal Pitfalls

  • To prevent delay in diagnosis and treatment, consider RMSF in any febrile patient in an endemic area.
 


More on Rocky Mountain Spotted Fever

Overview: Rocky Mountain Spotted Fever
Differential Diagnoses & Workup: Rocky Mountain Spotted Fever
Treatment & Medication: Rocky Mountain Spotted Fever
Follow-up: Rocky Mountain Spotted Fever
References
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References

  1. Chen LF, Sexton DJ. What's new in Rocky Mountain spotted fever?. Infect Dis Clin North Am. Sep 2008;22(3):415-32, vii-viii. [Medline].

  2. Parola P, Labruna MB, Raoult D. Tick-Borne Rickettsioses in America: Unanswered Questions and Emerging Diseases. Curr Infect Dis Rep. Jan 2009;11(1):40-50. [Medline].

  3. Labruna MB, Kamakura O, Moraes-Filho J, Horta MC, Pacheco RC. Rocky Mountain spotted fever in dogs, Brazil. Emerg Infect Dis. Mar 2009;15(3):458-60. [Medline].

  4. Adjemian JZ, Krebs J, Mandel E, McQuiston J. Spatial clustering by disease severity among reported Rocky Mountain spotted fever cases in the United States, 2001-2005. Am J Trop Med Hyg. Jan 2009;80(1):72-7. [Medline].

  5. Chapman AS, Bakken JS, Folk SM, et al. Diagnosis and management of tickborne rickettsial diseases: Rocky Mountain spotted fever, ehrlichioses, and anaplasmosis--United States: a practical guide for physicians and other health-care and public health professionals. MMWR Recomm Rep. Mar 31 2006;55:1-27. [Medline]. [Full Text].

  6. Chapman AS, Murphy SM, Demma LJ, et al. Rocky Mountain spotted fever in the United States, 1997-2002. Vector Borne Zoonotic Dis. Summer 2006;6(2):170-8. [Medline].

  7. Cherubini TD, Spaeth GL. Anterior nongranulomatous uveitis associated with Rocky Mountain spotted fever. First report of a case. Arch Ophthalmol. Mar 1969;81(3):363-5. [Medline].

  8. Duffey RJ, Hammer ME. The ocular manifestations of Rocky Mountain spotted fever. Ann Ophthalmol. Aug 1987;19(8):301-3, 306. [Medline].

  9. Eremeeva ME, Dasch GA, Silverman DJ. Evaluation of a PCR assay for quantitation of Rickettsia rickettsii and closely related spotted fever group rickettsiae. J Clin Microbiol. Dec 2003;41(12):5466-72. [Medline].

  10. Kamper C. Treatment of Rocky Mountain spotted fever. J Pediatr Health Care. Jul-Aug 1991;5(4):216-22. [Medline].

  11. Kirk JL, Fine DP, Sexton DJ, Muchmore HG. Rocky Mountain spotted fever. A clinical review based on 48 confirmed cases, 1943-1986. Medicine (Baltimore). Jan 1990;69(1):35-45. [Medline].

  12. Kirkland KB, Wilkinson WE, Sexton DJ. Therapeutic delay and mortality in cases of Rocky Mountain spotted fever. Clin Infect Dis. May 1995;20(5):1118-21. [Medline].

  13. Marshall GS, Stout GG, Jacobs RF, et al. Antibodies reactive to Rickettsia rickettsii among children living in the southeast and south central regions of the United States. Arch Pediatr Adolesc Med. May 2003;157(5):443-8. [Medline].

  14. McNabb SJ, Jajosky RA, Hall-Baker PA, et al. Summary of notifiable diseases--United States, 2006. MMWR Morb Mortal Wkly Rep. Mar 21 2008;55(53):1-92. [Medline].

  15. Miller NR. Rickettsiae and rickettsial diseases. In: Miller NR, Newman NJ, eds. Walsh and Hoyt's Clinical Neuro-Ophthalmology. 5th ed. Baltimore: Williams and Wilkins; 1998:4739-4748.

  16. Presley GD. Fundus changes in Rocky Mountain spotted fever. Am J Ophthalmol. Feb 1969;67(2):263-7. [Medline].

  17. Raab EL, Leopold IH, Hodes HL. Retinopathy in Rocky Mountain spotted fever. Am J Ophthalmol. Jul 1969;68(1):42-6. [Medline].

  18. Smith TW, Burton TC. The retinal manifestations of Rocky Mountain spotted fever. Am J Ophthalmol. Aug 1977;84(2):259-62. [Medline].

  19. Spach DH, Liles WC, Campbell GL, Quick RE, Anderson DE Jr, Fritsche TR. Tick-borne diseases in the United States. N Engl J Med. Sep 23 1993;329(13):936-47. [Medline].

  20. Stenos J, Graves SR, Unsworth NB. A highly sensitive and specific real-time PCR assay for the detection of spotted fever and typhus group Rickettsiae. Am J Trop Med Hyg. Dec 2005;73(6):1083-5. [Medline].

  21. Vaphiades MS. Rocky Mountain Spotted Fever as a cause of macular star figure. J Neuroophthalmol. Dec 2003;23(4):276-8. [Medline].

  22. Weber DJ, Walker DH. Rocky Mountain spotted fever. Infect Dis Clin North Am. Mar 1991;5(1):19-35. [Medline].

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Further Reading

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Keywords

Rocky Mountain spotted fever, RMSF, rickettsial disease, ticks, wood ticks, dog ticks,

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Contributor Information and Disclosures

Author

Byron L Lam, MD, Professor, Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami School of Medicine
Byron L Lam, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Ophthalmology, American Medical Association, and Phi Beta Kappa
Disclosure: Nothing to disclose.

Medical Editor

John D Sheppard Jr, MD, MMSc, Professor of Ophthalmology, Microbiology and Molecular Biology, Clinical Director, Thomas R Lee Center for Ocular Pharmacology, Program Director, Ophthalmology Residency Training, Eastern Virginia Medical School; President, Virginia Eye Consultants
John D Sheppard Jr, MD, MMSc is a member of the following medical societies: American Academy of Ophthalmology, American Society for Microbiology, American Society of Cataract and Refractive Surgery, American Uveitis Society, and Association for Research in Vision and Ophthalmology
Disclosure: Nothing to disclose.

Pharmacy Editor

Simon K Law, MD, PharmD, Assistant Professor of Ophthalmology, Jules Stein Eye Institute; Chief of Section of Ophthalmology Surgical Services, Department of Veterans Affairs Healthcare Center, West Los Angeles
Simon K Law, MD, PharmD is a member of the following medical societies: American Academy of Ophthalmology, American Glaucoma Society, and Association for Research in Vision and Ophthalmology
Disclosure: Nothing to disclose.

Managing Editor

R Christopher Walton, MD, Professor, Director of Uveitis and Ocular Inflammatory Disease Service, Department of Ophthalmology, Assistant Dean for Graduate Medical Education, University of Tennessee College of Medicine; Consulting Staff, Regional Medical Center, Memphis Veterans Affairs Medical Center, St Jude Children's Research Hospital
R Christopher Walton, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Healthcare Executives, American Uveitis Society, Association for Research in Vision and Ophthalmology, and Retina Society
Disclosure: Nothing to disclose.

CME Editor

Lance L Brown, OD, MD, Ophthalmologist, Affiliated With Freeman Hospital and St John's Hospital, Regional Eye Center, Joplin, Missouri
Disclosure: Nothing to disclose.

Chief Editor

Hampton Roy Sr, MD, Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences
Hampton Roy Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, and Pan-American Association of Ophthalmology
Disclosure: Nothing to disclose.

 
 
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