• Infection with Rickettsia rickcttsii (Gram © obligate intracellular bacterium)
• Transmitted by Dermacentor variabilis, Dermacentor andersoni
• Coastal mid-Adantic, New England, midwest, northwest, southeast. Canada, Mexico.
Central America, and in parts of South America
• Peak incidence spring and early summer
• Rash (2-3 d after onset): starts on ankles and wrists trunk, palms & soles
• Myalgias, N/V, occasionally abdominal pain
• Usually a clinical diagnosis
• During acute illness can dx by examining skin bx for rickettsiae (Se 70%)
• 7-10 d after onset of sx. serology (indirect fluorescent antibody test) turns $ Treatment
• Doxycydine 100 mg PO bid
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