Rocky Mountain spotted fever

Amerikanisches Felsengebirgsfieber, Zeckenbissfieber der neuen Welt.

Durch Rickettsia rickettsii vorkommende Rickettsiose.

• Weltweit verbreitet.
• Vor allem am amerikanischen Kontinent (insbes. während der Frühlings- oder Sommermonate).
• Meist sind Kindern zwischen 4.-10. J. betroffen.

• Erreger: Rickettsia rickettsii, Rickettsia rickettsii wird durch Zeckenstiche.

• Inkubationszeit: 2-14 Tage.
• Im Bereich der Inokulationsstelle zeigt sich eine, teils ulzerierte, ggf verkrustete Papel.
• Makulopapulöses Exanthem (initial an Hand- und Fußgelenken).
• Nasenbluten, Fieber, Splenohepatomegalie.
• Es kann zur Beteiligung von Niere, Leber und ZNS kommen.

• Reiseanamnese.
• Klinik.
• Läusebefall.
• BB, Leber- und Nierenwerte, Elektrolyte.
• Ab der 2. Krankheitswoche Weil-Felix-Reaktion (Agglutinationstest).
• Ab der 3. Krankheitswoche Komplementbindungsreaktion. 
• Ab der 3. Krankheitswoche indirekter Immunfluoreszenztest.

Letalität: 5–25%.

1. Consequences of Delayed Diagnosis of Rocky Mountain Spotted Fever in Children—West Virginia, Michigan, Tennessee, and Oklahoma, May-July 2000. JAMA, 2000. 284(16): p. 2049.
2. Elghetany, M.T. and D.H. Walker, Hemostatic Changes in Rocky Mountain Spotted Fever and Mediterranean Spotted Fever. American Journal of Clinical Pathology, 1999. 112(2): p. 159-168.
3. Helmick, C.G., K.W. Bernard, and L.J. D'Angelo, Rocky Mountain Spotted Fever: Clinical, Laboratory, and Epidemiological Features of 262 Cases. Journal of Infectious Diseases, 1984. 150(4): p. 480-488.
4. Holman, Robert C., et al., Analysis of Risk Factors for Fatal Rocky Mountain Spotted Fever: Evidence for Superiority of Tetracyclines for Therapy. The Journal of Infectious Diseases, 2001. 184(11): p. 1437-1444.
5. Kaplan, J.E., J.E. McDade, and V.F. Newhouse, Suspected Rocky Mountain spotted fever in the winter--epidemic typhus? N Engl J Med, 1981. 305(27): p. 1648.
6. Paddock, Christopher D., et al., Rickettsia parkeriRickettsiosis and Its Clinical Distinction from Rocky Mountain Spotted Fever. Clinical Infectious Diseases, 2008. 47(9): p. 1188-1196.
7. Ricketts, H.T., A Micro-Organism which Apparently Has a Specific Relationship to Rocky Mountain Spotted Fever. JAMA, 1909. LII(6): p. 491.
8. Spolidorio, M.G., et al., Novel spotted fever group rickettsiosis, Brazil. Emerg Infect Dis, 2010. 16(3): p. 521-3.
9. Thorner, A.R., D.H. Walker, and J.W.A. Petri, Rocky Mountain Spotted Fever. Clinical Infectious Diseases, 1998. 27(6): p. 1353-1359.
10. Walker, D.H., Rickettsia rickettsii and Other Spotted Fever Group Rickettsiae (Rocky Mountain Spotted Fever and Other Spotted Fevers), in Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 2010, Elsevier BV. p. 2499-2507.