Spotted Fever

What are the symptoms of spotted fever?

Initially, spotted fever presents with the same symptoms as all other Rickettsia infections:

• Fever
• Severe headache
• Rash
• A feeling of illness.
• In a later stage, the following symptoms may also develop:
  • Confusion
  • Coughing
  • Respiratory problems
  • Vomiting
  • Diarrhea

The specific symptoms of spotted fever may differ depending on the type of this Rickettsiosis. As an example, here are the symptoms of Rocky Mountain spotted fever:

• Fever
• Rash
• Headache
• Nausea
• Vomiting
• Abdominal pain
• Muscle pain
• Decreased appetite
• Eye inflammation

This spotted fever can be very severe and occurs primarily in North America. Most symptoms are similar to those of other Rickettsiosis infections. However, this infectious disease is a severe variant. Patients with Rocky Mountain spotted fever usually need to be hospitalized. Despite treatment, three to five percent of patients die. This disease can also be accompanied by the following complications:

• Encephalitis
• Pneumonia
• Heart failure
• Kidney failure
• Necrosis of fingers and/or toes.

How is spotted fever diagnosed?

The initial symptoms of spotted fever resemble those of the flu. To determine if there is more at play than a harmless viral infection like the flu, it's important to check whether the patient has been bitten by a vector of a Rickettsia bacterium, such as a tick, mite, or flea. Such a bite can be an indication of a Rickettsia infection, especially in areas where this infection is common. Unfortunately, most people do not remember a bite. When the patient develops a rash, it is also an indication of a Rickettsiosis. Further investigation should then show whether it is indeed a case of Rickettsiosis (like spotted fever), and if so, which bacterium it involves.

There is currently no laboratory test that can quickly and unambiguously identify a Rickettsia bacterium causing spotted fever in the blood. Patients cannot wait for long-term (blood) tests. Treatment cannot be postponed and will therefore have to be based on a suspected diagnosis of spotted fever.

In blood tests, antibodies against the R. rickettsii bacterium can be detected; this is the bacterium that causes Rocky Mountain spotted fever. This bacterium can also be demonstrated in microscopic skin examinations.

How is spotted fever treated?
A Rickettsia, like a spotted fever, is an obligate intracellular bacterium. This means that it hides in the cells of its host. This makes it difficult for our immune system to reach and combat the bacterium. For the same reason, not all antibiotics work against a spotted fever.

A Rickettsiosis is best treated early with one of the following three antibiotics:

• Tetracycline
• Doxycycline
• Chloramphenicol

These antibiotics can be taken orally. If the patient is too ill for oral administration, these medications can be given intravenously.

After treatment with one of these antibiotics, the patient will start to feel better quickly, and the fever will disappear within three days. The antibiotic course lasts for at least a week and longer if the fever persists afterward. The later the treatment is started, the slower the improvement occurs and the longer the fever lasts.

Failing to treat or starting treatment too late can be fatal for a patient with Rickettsiosis.