Rocky mountain spotted fever and bed bugs

Question 1

Rocky Mountain Spotted fever Etiology and Bacteria

Answer 1

Etiology

• American Dog tick
• Rocky mountain wood tick

Bacteria
-Rickettsia rickettsii

Question 2

Region/time of year and Age most commonly affected (RMSF)

Answer 2

Region/time of year

• South-Atlantic
• April-September

Age

• 5-9yo (MC)
• > 60yo

Question 3

Clinical Features (RMSF)

Answer 3

• fever, nausea, vomiting, myalgia, anorexia, headache
• rash may or may not be present
• rash 90% people = macules –> papules/petechiae –> ecchymosis/ulcerations

Question 4

Most common areas for rash RMSF

Answer 4

• wrist/ankles –> palms/soles –>arms/legs –> trunk

- spares FACE

Question 5

Diagnosis RMSF

Answer 5

Labs (DONT DELAY TREATMENT FOR DEFINITIVE TESTING)

• CBC
• lytes
• LFTs
• Blood Cx

serology
-7-10 days after ssx start

Question 6

Treatment RMSF

Answer 6

Doxycycline

• kids: 2mg/kg/dose PO/IV q12h
• adults: 100 mg PO/IV q12h
• take for 5-14 days depending on severity

Question 7

Follow up/Complications RMSF

Answer 7

• Cutaneous necrosis
• tetracycline tooth staining,
• death <1.4%

Question 8

BED BUGS ETIOLOGY

Answer 8

• Cimex lectularius (temperature climates) = MC MN
• Cimex hemipterus (tropical climates)
• Leptocimex boueti (west africa)

Question 9

History/Diagnosis (bed bugs)

Answer 9

• travel Hx
• social Hx
• itchy, burning rash

Question 10

Clinical Presentation of Bed Bugs

Answer 10

• Tiny (1-5mm) erythematous papules
• rash over exposed areas during sleep
• RARE: urticaria, bullae

Question 11

Labs for Bed bugs

Answer 11

NONE

Question 12

Treatment for bed bugs

Answer 12

• self-limiting within 1-2wks
• anti-histamine
• anti-pruritic
• get rid of continuous source of infection (professional assistance to get rid of bugs, can wash, air dry in hot air or freeze to get rid of bugs)

Question 13

Follow up/Complications of Bed Bugs

Answer 13

• secondary infection

- recurrences if dont get rid of the source