Rocky mountain spotted fever

Infection of vascular endothelial cells causes multiple abnormal organ manifestations 

African-American ethnicity Chronic alcohol abuse G6PD deficiency Male gender 

Calendar Year-round, peak April-September 

Bowel sounds - decreased/absent (ileus, adynamic) 

Cough - nonproductive Ears, hearing - loss (deafness) 

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The tetracyclines are a group of anti-infectives composed of natural and semisynthetic compounds. They are useful in select infections when die organism shows sensitivity (see Chap. 7) to the tetracyclines, such as in cholera, Rocky Mountain spotted fever, and typhus. 

These antibiotics are effective in die treatment of infections caused by a wide range of gram-negative and gram-positive microorganisms. The tetracyclines are used in infections caused by Rickettsiae (Rocky Mountain spotted fever, typhus fever, and tick fevers). Tetracyclines are also used in situations in which penicillin is contraindicated, in the treatment of intestinal amebiasis, and in some skin and soft tissue infections. Oral... 

Human immunodeficiency virus Influenza Kala-azar Malaria Mycobacteria Mycoplasma Paramyxoviruses Rocky Mountain spotted fever Rubella Typhoid Varicella Variola... 

Suggested Alternatives for Differential Diagnosis Hepatitis, Legionnaires disease, myocarditis, pericarditis, cardiac tamponade, pneumonia, ehrlichiosis, relapsing fever, Rocky Mountain spotted fever, and tularemia. 

Suggested Alternatives for Differential Diagnosis Scarlet fever, cellulitis, cat scratch disease, gas gangrene, necrotizing fasciitis, tick-borne diseases such as Rocky Mountain spotted fever, pneumonia, septic shock, acute respiratory distress syndrome (ARDS), disseminated intravascular coagulation. 

Suggested Alternatives for Differential Diagnosis Dengue, measles, Rocky Mountain spotted fever, rubella, tick bite fever, epidemic typhus, Q fever, typhoid, malaria, trypanosomiasis, hepatitis, infectious mononucleosis, herpes, and influenza. 

Rickettsia A microorganism of the genus Rickettsia, made up of small rod-shaped coc-coids occurring in fleas, lice, ticks, and mites by which they are transmitted to man and other animals causing diseases such as typhus, scrub typhus, and Rocky Mountain Spotted Fever in humans. 

Rocky Mountain Spotted Fever 1. Aerosol 2. Infected vectors No High 3-10 days 2 weeks to months High Not very stable No Effective No... 

Another group of compounds, the tetracyclines, are made by fermentation procedures or by chemical modifications of the natural product. The hydrochloride salts are used most commonly for oral administration and are usually encapsulated because of their bitter taste. Controlled catalytic hydrogenolysis of chlortetracycline, a natural product, selectively removes the 7-chloro atom and produces tetracycline. Doxycycline and minocycline are other important antibacterials. Tetracycline can be prescribed for people allergic to penicillin. Doxycycline prevents traveler s diarrhea. Tetracyclines help many infections including Rocky Mountain spotted fever, Lyme disease, urinary tract infections, bronchitis, amoebic dysentery, and acne. 

Ticks have a bad reputation for good reasons. Not only are they carriers of a number of diseases, the saliva of some can cause paralysis. North American natives were aware of tick paralysis, but the condition was officially noted as a disease of both animals and humans in 1912. The bites of at least 60 species of ticks can cause paralysis, which often does not appear until several days after the bite. The first indication is redness and swelling around the site of the bite. This is followed by neuromuscular weakness and difficulty in walking. If the tick is not removed, speech and breathing are affected, with eventual respiratory paralysis and death. Fortunately, removal of the tick results in a quick recovery of function. The exact mechanism of paralysis is not known but it appears to come from a substance that affects the neuromuscular junction. While not related to the venom of the tick saliva, the tick can also transmit diseases such as Lyme disease, Rocky Mountain spotted fever, Q fever, typhus, and others. Table 13.1 lists some venomous arachnids. 

Respiratory, skin, and soft-tissue infections UTIs pelvic inflammatory disease (PID) brucellosis trachoma Rocky Mountain spotted fever typhus Q fever lickettsia severe acne (Adoxa) smallpox psittacosis ornithosis granuloma inguinale lymphogranuloma venereum intestinal amebiasis (adjunctive treatment) prevention of rheumatic fever ... 

Inflammatory acne vulgaris, Lyme disease, mycoplasmal disease, Legionella infections. Rocky Mountain spotted fever, chlamydial infections in patients with gonorrhea PO... 

Rickettsia rickettsii (Rocky Mountain spotted fever)... 

Because of potential toxicity, bacterial resistance, and the availability of many other effective alternatives, chloramphenicol is rarely used. It may be considered for treatment of serious rickettsial infections such as typhus and Rocky Mountain spotted fever. It is an alternative to a B-lactam antibiotic for treatment of meningococcal meningitis occurring in patients who have major hypersensitivity reactions to penicillin or bacterial meningitis caused by penicillin-resistant strains of pneumococci. The dosage is 50-100 mg/kg/d in four divided doses. 

Other vaccines available are those for influenza(flu), pneumonia (lifetime immunity), rabies, cholera, smallpox, typhus, typhoid, and Rocky Mountain spotted fever. Some vaccines can cause adverse effects especially to small children or the elderly. Flu vaccine has been implicated in the onset of a condition known as Guillain-Barre syndrome, a polyneuritis which can lead to anything from mild pain and weakness in the extremities to paralysis. These symptoms can last from a few weeks to a few months. 

The rickettsias (parasitic bacteria with exacting nutritional requirements and small genome sizes) and chlamydias. Chlamydia (C. trachomatis, trachoma), Rickettsia (R. rickettsii, Rocky Mountain spotted fever)... 

Rocky Mountain spotted fever 7 Rods (visual receptor cells) 390 Root hairs, dimensions of 30 Roseoflavin 788, 789s Rossmann fold. See Nucleotide-binding domain Rotamases 488 Rotary diffusion constant 463 Rotation of molecules 462,463 Rotational barrier 44 Rotifers 24, 25... 

Chloramphenicol. Chloramphenicol (Chloromycetin) is a synthetically produced agent that exerts antibacterial effects similar to those of erythromycin that is, it binds to the 50S subunit of bacterial ribosomes and inhibits peptide bond formation. Chloramphenicol is a broad-spectrum antibiotic that is active against many gram-negative and gram-positive bacteria. This drug is administered systemically to treat serious infections such as typhoid fever, Haemophilus infections such as osteomyelitis, rickettsial infections such as Rocky Mountain spotted fever, and certain forms of meningitis. Chloramphenicol may also be administered topically to treat various skin, eye, and ear infections. 

The differential diagnosis includes a number of viral and bacterial diseases, including influenza, meningo-coccemia. Rocky Mountain spotted fever, malaria, and others, as well as noninfectious causes such as idiopathic and thrombotic thrombocytopenic purpuras, hemolytic uremic syndrome, and DlC (disseminated intravascular coagulation). 

Although the clinical usefulness of tetracyclines is limited for most of the common microbial pathogens, they remain drugs of choice (or very effective alternative therapy) for a wide variety of infections caused by less common pathogens. These include brucellosis rickettsial infections such as Rocky Mountain spotted fever, typhus, and Q fever Mycoplasma pneumonia cholera plague Ureaplasma urethritis Chlamydia infections and Lyme disease. Oral doxycycline, 100 mg orally twice a day for 7 days, is a recommended treatment for chlamydial sexually transmitted disease. 

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