Submit
   
Case Report
 
Atypical presentation of rocky mountain spotted fever in a young adult: A case report
Nneka Iroka1, Mohammed Hossain2, John Middleton3
1MD, PGY-II, Department of Internal Medicine, Raritan Bay Medical Center, Perth Amboy, New Jersey, United States.
2MD, PGY-III, Department of Internal Medicine, Raritan Bay Medical Center, Perth Amboy, New Jersey, United States.
3MD, Attending Physician, Department of Infectious Disease, Raritan Bay Medical Center, Perth Amboy, New Jersey, United States.

doi:10.5348/ijcri-201546-CR-10507

Address correspondence to:
Nneka Iroka
MD, 530 New Brunswick Avenue, Perth Amboy
New Jersey 08861
USA
Phone: 214-779-7221

Access full text article on other devices

  Access PDF of article on other devices

[HTML Full Text]   [PDF Full Text] [Print This Article]
[Similar article in Pumed] [Similar article in Google Scholar]


How to cite this article
Iroka N, Hossain M, Middleton J. Atypical presentation of Rocky Mountain spotted fever in a young adult: A case report. Int J Case Rep Images 2015;6(5):286–289.


Abstract
Introduction: Rocky Mountain spotted fever (RMSF) is a tick-borne disease that can be potentially lethal if left untreated. Its causative agent Rickettsia rickettsii is a gram negative intracellular bacterium that is known to have a tropism for vascular endothelial cells. Classic symptoms of RMSF include fever; which is almost always present, headaches and rash. However, all of these diagnostic clues may not be present which can lead to delay in diagnosis and appropriate antibiotic therapy leading to poor outcomes in certain cases. RMSF rarely may involve the myocardium but solely presenting with cardiac signs and symptoms without any of the typical features-fever, rash or headaches at any point is even rarer and may pose a diagnostic challenge.
Case Report: We report a case of an atypical presentation of Rocky Mountain spotted fever in a healthy 20-year- old male. This report describes a case of a serologically proven RMSF infection in a patient who presented with chest pain, electrocardiographic changes and elevated cardiac enzymes without any fever, rash or headaches.
Conclusion: Rocky Mountain spotted fever can present solely with cardiac manifestations such as chest pain, electrocardiographic changes and elevation of cardiac markers without any of the typical features of Rocky Mountain spotted fever including fever.

Keywords: Chest pain, Myocarditis, Rickettsia rickettsii, Rocky mountain spotted fever


[HTML Full Text]   [PDF Full Text]
Author Contributions
Nneka Iroka – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Mohammed Hossain – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
John Middleton – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of submission
The corresponding author is the guarantor of submission.
Source of support
None
Conflict of interest
Authors declare no conflict of interest.
Copyright
© 2015 Nneka Iroka et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.