RT Journal
A1 Oster CN
T1 EArly diagnosis of rocky mountain spotted fever
JF Archives of Internal Medicine
JO Archives of Internal Medicine
YR 1979
FD April 1
VO 139
IS 4
SP 400
OP 401
DO 10.1001/archinte.1979.03630410010008
UL http://dx.doi.org/10.1001/archinte.1979.03630410010008
AB Rocky Mountain spotted fever (RMSF) is a disease of increasing importance in the United States, especially in the Southeast. The annual reported incidence has increased from 298 to 1,153 in the last ten years.1 Two thirds of these cases occur in the states of North and South Carolina, Virginia, Maryland, Georgia, Tennessee, and Oklahoma,2 while only about 1% of the cases reported in 1977 occurred in the Rocky Mountain states.1 The average mortality has been 5% to 7% in recent years—a rate that has not improved since the introduction of effective treatment with the tetracycline antibiotics or chloramphenicol nearly three decades ago.Comparison of fatal and nonfatal cases has revealed that diagnosis and initiation of effective therapy were substantially delayed in fatal cases.3,4 The mean intervals between the onset of illness and both diagnosis of RMSF and the initiation of appropriate therapy were 6.7 and 6.8