Abstract
Background
Rocky Mountain spotted fever (RMSF) is an acute, serious tick borne illness caused
by Rickettsia rickettsi. Frequently, RMSF is manifested by headache, a typical rash and fever but atypical
disease is common, making diagnosis difficult. Inflammatory arthritis as a manifestation
is rare. The purpose of this study is to describe a patient with serologically proven
RMSF who presented in an atypical manner with inflammatory arthritis of the small
joints of the hands and to review the previously reported patients with rickettsial
infection and inflammatory arthritis.
Methods
An 18-year-old woman presented with a rash that began on the distal extremities and
spread centrally, along with hand pain and swelling. She had tenderness and swelling
of the metacarpophlangeal joints on examination in addition to an erythematosus macular
rash and occasional fever.
Results
Acute and convalescent serology demonstrated R rickettsi infection. She was successfully treated with doxycycline. Conclusions: Inflammatory arthritis is a rare manifestation of RMSF or other rickettsial infection
with 8 previously reported patients, only 1 of whom had RMSF. Physician must have
a high index of suspicion for RMSF because of atypical presentations.
Key Indexing Terms
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Article info
Publication history
Accepted:
April 5,
2013
Received:
December 15,
2012
Footnotes
The authors have no financial or other conflicts of interest to disclose.
Identification
Copyright
© 2013 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.
