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Case Reports
. 2021 Apr 12;13(4):e14438.
doi: 10.7759/cureus.14438.

Rocky Mountain Spotted Fever Masquerading as Gastroenteritis: A Common but Overlooked Clinical Presentation

David S Braun  1 , Ian Greenberg  2 , Mangesh Pagadala  2
Affiliations
Case Reports

Rocky Mountain Spotted Fever Masquerading as Gastroenteritis: A Common but Overlooked Clinical Presentation

David S Braun et al. Cureus. .

Abstract

Rocky Mountain spotted fever (RMSF) is a tick-borne illness caused by Rickettsia rickettsii. The classic triad of fever, rash, and a recent tick bite is rarely present at diagnosis. Less known, but more common initial presentations include gastrointestinal symptoms such as anorexia, nausea, vomiting, and abdominal pain. In endemic areas, a persistent fever with gastrointestinal symptoms should prompt screening and early initiation of antibiotics to prevent the development of fulminant RMSF and its associated high mortality. This case aims to educate about the gastrointestinal and hepatic manifestations of this diagnostic enigma.

Keywords: abnormal liver function test; enteritis; fever; gastroenteritis; rocky mountain spotted fever.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Abdominal computed tomography scan with diffuse inflammation causing the appearance of hepatomegaly and splenomegaly (A), appendicitis and colitis (B).
Figure 2
Figure 2. Liver biopsy in RMSF revealing a nonspecific reactive hepatitis with peri-portal inflammation and surrounding bile ductular inflammation and proliferation.
RMSF - Rocky Mountain spotted fever
See this image and copyright information in PMC

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References

    1. Rocky Mountain spotted fever: clinical, laboratory, and epidemiological features of 262 cases. Helmick CG, Bernard KW, D'Angelo LJ. J Infect Dis. 1984;150:480–488. - PubMed
    1. Rocky Mountain spotted fever mimicking acute cholecystitis. Walker DH, Lesesne HR, Varma VA, et al. https://pubmed.ncbi.nlm.nih.gov/4074033/ Arch Intern Med. 1985;145:2194–2196. - PubMed
    1. Rocky Mountain spotted fever. A clinical review based on 48 confirmed cases, 1943-1986. Kirk JL, Fine DP, Sexton DJ, et al. https://pubmed.ncbi.nlm.nih.gov/2299975/ Medicine (Baltimore) 1990;69:35–45. - PubMed
    1. Elevated transaminases presenting as a spotless Rocky Mountain spotted fever. Brady EKB, Berger S, Pillai A. https://journals.lww.com/ajg/Fulltext/2016/10001/Elevated_Transaminases_... Am J Gastroenterol. 2016;111:961.
    1. Rocky mountain spotted fever. Thorner AR, Walker DH, Petri WA Jr. Clin Infect Dis. 1998;27:1353–1359. - PubMed

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