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The Tick-Borne Infections in Children Study Group reviewed 92 patients from six hospitals in the southeastern and south-central US treated from 1990 to 2002 for Rocky Mountain spotted fever (RMSF) in order to identify clinical findings associated with death or neurologic deficits at the time of hospital discharge. Patients in the study met established criteria for confirmed or probable RMSF.1,2 Children (median age 5.8 years; range 3.7–9.1) presented to the hospitals a median of six days after the onset of symptoms, most commonly fever (98%), rash (97% [62% petechial]), nausea or vomiting (73%), and headache (61%). Less common symptoms included altered mental status (33%), photophobia (18%), seizures (17%), and coma (10%). Ninety percent of cases occurred between the months of April through August.
Only 49% of children with RMSF reported history …
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