A 34-yr-old man returns from a journey to West USA with fevers and a rash affecting his hands and feet. He says he was admitted to hospital and has a medical note from the hospital informing you that he was admitted for several days with high fevers and a tachycardia of 105 bpm but that his BP did not drop at any time. After several days of illness, he developed desquamation of his hands and feet. He received some treatment and is now better.
His GP sent some tests that revealed a normal FBC and U&Es. Syphilis serology is negative. What treatment did he most likely receive?
A. IV cefuroxime
B. IV benzylpenicillin
C. Oral doxycycline
D. Oral erythromycin
E. None
Answer:
C. Oral doxycycline
Discussion: This is Rocky Mountain spotted fever, a rickettsial infection caused by the organism
Rickettsia rickettsia which is spread by ticks. It occurs in the East, South and West US and also in
Central and South America. Treatment is with doxycycline. Chloramphenicol is also effective.
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