Rocky Mountain High: Could it be the result of a Fever?

One of my friends alerted me to the fact that Phoenix Coyote Shane Doan is recovering from Rocky Mountain Spotted Fever (RMSF), a dangerous tick-borne infection that often requires a competent clinician to diagnose and preemptively treat.

RMSF is caused by Rickettsia rickettsii and is spread to humans through the bite of one of three ticks: the American Dog Tick, the Rocky Mountain wood tick, or the brown dog tick. These ticks have a wide geographic spread. 

Despite its name, however, 4 states account for the majority of RMSF cases: North Carolina, Oklahoma, Arkansas, Tennessee, and Missouri. Interestingly, in Arizona--which may be relevant to Doan's case--there is a newly established foci of infection in the eastern part of the state which is tied to transmission via the brown dog tick and large populations of roaming dogs. 

The initial presentation of RMSF is what makes it so challenging as it can appear to be just an ordinary viral illness. If overlooked, individuals may develop more serious infections that can be debilitating or even fatal. The characteristic rash may not be present until later in the course of illness. In areas where RMSF is known to circulate, doxycycline is prescribed routinely for illnesses that fit wide criteria for possible RMSF in order to avoid any delays in treatment. 

So long as RMSF remains a clinical diagnosis, as the result of serological tests may take days to obtain, it serves as another example of the value of the astute clinician who is able to discriminate the hoofbeats of a zebra from a horse.