rocky mountain spotted fever

Summary

Summary: An acute febrile illness caused by RICKETTSIA RICKETTSII. It is transmitted to humans by bites of infected ticks and occurs only in North and South America. Characteristics include a sudden onset with headache and chills and fever lasting about two to three weeks. A cutaneous rash commonly appears on the extremities and trunk about the fourth day of illness.

Top Publications

  1. Dumler J, Walker D. Rocky Mountain spotted fever--changing ecology and persisting virulence. N Engl J Med. 2005;353:551-3 pubmed
  2. Spolidorio M, Labruna M, Mantovani E, Brandao P, Richtzenhain L, Yoshinari N. Novel spotted fever group rickettsiosis, Brazil. Emerg Infect Dis. 2010;16:521-3 pubmed publisher
    ..Molecular analysis of skin samples indicated the agent was a novel spotted fever group strain closely related to Rickettsia africae, R. parkeri, and R. sibirica...
  3. Kidd L, Maggi R, Diniz P, Hegarty B, Tucker M, Breitschwerdt E. Evaluation of conventional and real-time PCR assays for detection and differentiation of Spotted Fever Group Rickettsia in dog blood. Vet Microbiol. 2008;129:294-303 pubmed publisher
    ..They may also facilitate the discovery of novel SFG Rickettsia infecting dogs, and in the investigation of dogs as sentinels for emerging rickettsioses...
  4. Ogrzewalska M, Saraiva D, Moraes Filho J, Martins T, Costa F, Pinter A, et al. Epidemiology of Brazilian spotted fever in the Atlantic Forest, state of São Paulo, Brazil. Parasitology. 2012;139:1283-300 pubmed publisher
    ..However, not all forest patches in the southern part of the SPMA were shown to be associated with BSF endemism...
  5. Raoult D, Parola P. Rocky Mountain spotted fever in the USA: a benign disease or a common diagnostic error?. Lancet Infect Dis. 2008;8:587-9 pubmed publisher
  6. Zavala Castro J, Zavala Velazquez J, Walker D, Ruiz Arcila E, Laviada Molina H, Olano J, et al. Fatal human infection with Rickettsia rickettsii, Yucatán, Mexico. Emerg Infect Dis. 2006;12:672-4 pubmed
    ..The diagnosis of R. rickettsii infection was established by immunohistochemistry and specific polymerase chain reaction. ..
  7. Moraes Filho J, Pinter A, Pacheco R, Gutmann T, Barbosa S, Gonzáles M, et al. New epidemiological data on Brazilian spotted fever in an endemic area of the state of São Paulo, Brazil. Vector Borne Zoonotic Dis. 2009;9:73-8 pubmed publisher
    ..sanguineus in the epidemiology of R. rickettsii, corroborating previous findings in Mexico and the United States, where R. sanguineus has been implicated in the transmission of R. rickettsii to humans...
  8. Blair P, Jiang J, Schoeler G, Moron C, Anaya E, Cespedes M, et al. Characterization of spotted fever group rickettsiae in flea and tick specimens from northern Peru. J Clin Microbiol. 2004;42:4961-7 pubmed
    ..Furthermore, molecular analysis of sequences derived from the two separate species of hard ticks identified a possibly novel member of the SFG rickettsiae. ..
  9. Galvâo M, Dumler J, Mafra C, Calic S, Chamone C, Cesarino Filho G, et al. Fatal spotted fever rickettsiosis, Minas Gerais, Brazil. Emerg Infect Dis. 2003;9:1402-5 pubmed
    ..The diagnosis in the two fatal cases from Coronel Fabriciano and the surviving patient from Novo Cruzeiro was further supported by immunofluorescence serologic tests. ..

More Information

Publications70

  1. Cragun W, Bartlett B, Ellis M, Hoover A, Tyring S, Mendoza N, et al. The expanding spectrum of eschar-associated rickettsioses in the United States. Arch Dermatol. 2010;146:641-8 pubmed publisher
    ..Rickettsia parkeri, originally thought to be nonpathogenic in humans, was recently proved to be another cause of tick-borne SFG rickettsiosis...
  2. Labruna M, Kamakura O, Moraes Filho J, Horta M, Pacheco R. Rocky Mountain spotted fever in dogs, Brazil. Emerg Infect Dis. 2009;15:458-60 pubmed publisher
    ..We report 2 natural clinical cases of Rocky Mountain spotted fever in dogs in Brazil...
  3. Eremeeva M, Dasch G, Silverman D. Evaluation of a PCR assay for quantitation of Rickettsia rickettsii and closely related spotted fever group rickettsiae. J Clin Microbiol. 2003;41:5466-72 pubmed
  4. Argüello A, Hun L, Rivera P, Taylor L. A fatal urban case of rocky mountain spotted fever presenting an eschar in San Jose, Costa Rica. Am J Trop Med Hyg. 2012;87:345-8 pubmed publisher
    This study reports the first urban human case of Rocky Mountain spotted fever caused by Rickettsia rickettsii, in Costa Rica...
  5. Piranda E, Faccini J, Pinter A, Pacheco R, Cançado P, Labruna M. Experimental infection of Rhipicephalus sanguineus ticks with the bacterium Rickettsia rickettsii, using experimentally infected dogs. Vector Borne Zoonotic Dis. 2011;11:29-36 pubmed publisher
    ..It appears that Rh. sanguineus, in the absence of horizontal transmission, would not maintain Ri. rickettsii through successive generations, possibly because of low filial infection rates...
  6. Apperson C, Engber B, Nicholson W, Mead D, Engel J, Yabsley M, et al. Tick-borne diseases in North Carolina: is "Rickettsia amblyommii" a possible cause of rickettsiosis reported as Rocky Mountain spotted fever?. Vector Borne Zoonotic Dis. 2008;8:597-606 pubmed publisher
    Cases of Rocky Mountain spotted fever (RMSF) in North Carolina have escalated markedly since 2000. In 2005, we identified a county in the Piedmont region with high case numbers of RMSF...
  7. Chen L, Sexton D. What's new in Rocky Mountain spotted fever?. Infect Dis Clin North Am. 2008;22:415-32, vii-viii pubmed publisher
    b>Rocky Mountain spotted fever (RMSF) remains an important illness despite an effective therapy because it is difficult to diagnose and is capable of producing a fatal outcome. The pathogenesis of RMSF remains, in large part, an enigma...
  8. Stromdahl E, Jiang J, Vince M, Richards A. Infrequency of Rickettsia rickettsii in Dermacentor variabilis removed from humans, with comments on the role of other human-biting ticks associated with spotted fever group Rickettsiae in the United States. Vector Borne Zoonotic Dis. 2011;11:969-77 pubmed publisher
    ..in a small number of samples, but no ticks were found positive for Rickettsia rickettsii, the agent of Rocky Mountain spotted fever (RMSF) until May 2009, when it was detected in one D. variabilis male removed from a child in Maryland...
  9. Nicholson W, Paddock C, Demma L, Traeger M, Johnson B, Dickson J, et al. Rocky Mountain spotted fever in Arizona: documentation of heavy environmental infestations of Rhipicephalus sanguineus at an endemic site. Ann N Y Acad Sci. 2006;1078:338-41 pubmed
    A recent epidemiologic investigation identified 16 cases and 2 deaths from Rocky Mountain spotted fever (RMSF) in two eastern Arizona communities...
  10. Paddock C, Brenner O, Vaid C, Boyd D, Berg J, Joseph R, et al. Short report: concurrent Rocky Mountain spotted fever in a dog and its owner. Am J Trop Med Hyg. 2002;66:197-9 pubmed
    A sequential occurrence of Rocky Mountain spotted fever (RMSF) in a dog and its owner is described. Diagnosis of RMSF in the animal guided subsequent testing for and diagnosis of the same disease in the human patient...
  11. de Lemos E, Alvarenga F, Cintra M, Ramos M, Paddock C, Ferebee T, et al. Spotted fever in Brazil: a seroepidemiological study and description of clinical cases in an endemic area in the state of São Paulo. Am J Trop Med Hyg. 2001;65:329-34 pubmed
    ..Twenty-two (4.2%) of these samples demonstrated titers > or = 1:64. The results indicate that Brazilian spotted fever is endemic within this region of Brazil...
  12. Souza C, Moraes Filho J, Ogrzewalska M, Uchoa F, Horta M, Souza S, et al. Experimental infection of capybaras Hydrochoerus hydrochaeris by Rickettsia rickettsii and evaluation of the transmission of the infection to ticks Amblyomma cajennense. Vet Parasitol. 2009;161:116-21 pubmed publisher
    ..Our results indicate that capybaras act as amplifier host of R. rickettsii for A. cajennense ticks in Brazil...
  13. Labruna M, Ogrzewalska M, Soares J, Martins T, Soares H, Moraes Filho J, et al. Experimental infection of Amblyomma aureolatum ticks with Rickettsia rickettsii. Emerg Infect Dis. 2011;17:829-34 pubmed publisher
    ..infected Amblyomma aureolatum ticks with the bacterium Rickettsia rickettsii, the etiologic agent of Rocky Mountain spotted fever (RMSF). These ticks are a vector for RMSF in Brazil. R...
  14. Breitschwerdt E, Papich M, Hegarty B, Gilger B, Hancock S, Davidson M. Efficacy of doxycycline, azithromycin, or trovafloxacin for treatment of experimental Rocky Mountain spotted fever in dogs. Antimicrob Agents Chemother. 1999;43:813-21 pubmed
    ..and trovafloxacin to that of the current antibiotic standard, doxycycline, for the treatment of Rocky Mountain spotted fever. Clinicopathologic parameters, isolation of rickettsiae in tissue culture, and PCR amplification of ..
  15. Chapman A, Bakken J, Folk S, Paddock C, Bloch K, Krusell A, et al. Diagnosis and management of tickborne rickettsial diseases: Rocky Mountain spotted fever, ehrlichioses, and anaplasmosis--United States: a practical guide for physicians and other health-care and public health professionals. MMWR Recomm Rep. 2006;55:1-27 pubmed
    ..Viral and Rickettsial Zoonoses Branch, in consultation with 11 clinical and academic specialists of Rocky Mountain spotted fever, human granulocytotropic anaplasmosis, and human monocytotropic ehrlichiosis, developed guidelines to ..
  16. Dantas Torres F. Rocky Mountain spotted fever. Lancet Infect Dis. 2007;7:724-32 pubmed
    b>Rocky Mountain spotted fever (RMSF) is a life-threatening disease caused by Rickettsia rickettsii, an obligately intracellular bacterium that is spread to human beings by ticks...
  17. Oster C, Burke D, Kenyon R, Ascher M, Harber P, Pedersen C. Laboratory-acquired Rocky Mountain spotted fever. The hazard of aerosol transmission. N Engl J Med. 1977;297:859-63 pubmed
    Nine patients with laboratory-acquired Rocky Mountain spotted fever were seen during the period 1971 to 1976...
  18. Horta M, Moraes Filho J, Casagrande R, Saito T, Rosa S, Ogrzewalska M, et al. Experimental infection of opossums Didelphis aurita by Rickettsia rickettsii and evaluation of the transmission of the infection to ticks Amblyomma cajennense. Vector Borne Zoonotic Dis. 2009;9:109-18 pubmed publisher
    ..The study demonstrated that R. rickettsii was capable of infecting opossums without causing illness and developing rickettsemia capable of causing infection in guinea pigs and ticks, although the infection rate in ticks was low...
  19. Demma L, Eremeeva M, Nicholson W, Traeger M, Blau D, Paddock C, et al. An outbreak of Rocky Mountain Spotted Fever associated with a novel tick vector, Rhipicephalus sanguineus, in Arizona, 2004: preliminary report. Ann N Y Acad Sci. 2006;1078:342-3 pubmed
    ..This study describes preliminary results of an investigation of RMSF in Arizona associated with the brown dog tick, Rhipicephalus sanguineus. High numbers of dogs and heavy infestations of ticks created a situation leading to human disease...
  20. Adjemian J, Krebs J, Mandel E, McQuiston J. Spatial clustering by disease severity among reported Rocky Mountain spotted fever cases in the United States, 2001-2005. Am J Trop Med Hyg. 2009;80:72-7 pubmed
    b>Rocky Mountain spotted fever (RMSF) occurs throughout much of the United States, ranging in clinical severity from moderate to fatal infection...
  21. Venzal J, Portillo A, Estrada Pena A, Castro O, Cabrera P, Oteo J. Rickettsia parkeri in Amblyomma triste from Uruguay. Emerg Infect Dis. 2004;10:1493-5 pubmed
    ..Rickettsia parkeri was detected in A. triste, which suggests that this species could be considered a pathogenic agent responsible for human rickettsioses in Uruguay...
  22. Labruna M, Whitworth T, Horta M, Bouyer D, McBride J, Pinter A, et al. Rickettsia species infecting Amblyomma cooperi ticks from an area in the state of São Paulo, Brazil, where Brazilian spotted fever is endemic. J Clin Microbiol. 2004;42:90-8 pubmed
    ..These results do not support the role of A. cooperi in the ecology of R. rickettsii in the area studied, but they add two more species of rickettsiae to the poorly developed list of species occurring in ticks in South America...
  23. Paddock C, Finley R, Wright C, Robinson H, Schrodt B, Lane C, et al. Rickettsia parkeri rickettsiosis and its clinical distinction from Rocky Mountain spotted fever. Clin Infect Dis. 2008;47:1188-96 pubmed publisher
    ..parkeri and comment on distinctions between R. parkeri rickettsiosis and other United States rickettsioses...
  24. Angerami R, Câmara M, Pacola M, Rezende R, Duarte R, Nascimento E, et al. Features of Brazilian spotted fever in two different endemic areas in Brazil. Ticks Tick Borne Dis. 2012;3:346-8 pubmed publisher
  25. Estripeaut D, Aramburú M, Saez Llorens X, Thompson H, Dasch G, Paddock C, et al. Rocky Mountain spotted fever, Panama. Emerg Infect Dis. 2007;13:1763-5 pubmed publisher
    We describe a fatal pediatric case of Rocky Mountain spotted fever in Panama, the first, to our knowledge, since the 1950s...
  26. Pinter A, Horta M, Pacheco R, Moraes Filho J, Labruna M. Serosurvey of Rickettsia spp. in dogs and humans from an endemic area for Brazilian spotted fever in the State of São Paulo, Brazil. Cad Saude Publica. 2008;24:247-52 pubmed
    ..parkeri, R. felis, or R. bellii. Our serological results showed that dogs are important sentinels for the presence of R. rickettsii in areas where the tick A. aureolatum is the main vector of Brazilian spotted fever...
  27. Seijo A, Picollo M, Nicholson W, Paddock C. [Rickettsial spotted fever in the Paraná Delta. An emerging disease]. Medicina (B Aires). 2007;67:723-6 pubmed
    ..Several considerations relating to the identity of the rickettsial species and tick vector are discussed, including the possibility that this patient's illness may have been caused by Rickettsia parkeri...
  28. Gasser A, Birkenheuer A, Breitschwerdt E. Canine Rocky Mountain Spotted fever: a retrospective study of 30 cases. J Am Anim Hosp Assoc. 2001;37:41-8 pubmed
    b>Rocky Mountain spotted fever (RMSF) was diagnosed in 30 dogs examined at North Carolina State University, Veterinary Teaching Hospital between 1984 and 1997. Historical, physical examination, and laboratory abnormalities were reviewed...
  29. Chapman A, Murphy S, Demma L, Holman R, Curns A, McQuiston J, et al. Rocky mountain spotted fever in the United States, 1997-2002. Ann N Y Acad Sci. 2006;1078:154-5 pubmed
    The increased incidence of Rocky Mountain spotted fever (RMSF) in 1997-2002 compared with previous years may be related to enhanced awareness and reporting of RMSF as well as changes in human-vector interaction...
  30. Oliveira K, Pinter A, Medina Sanchez A, Boppana V, Wikel S, Saito T, et al. Amblyomma imitator ticks as vectors of Rickettsia rickettsii, Mexico. Emerg Infect Dis. 2010;16:1282-4 pubmed publisher
    ..Sequence analyses of 17-kD common antigen and outer membrane protein A and B gene fragments showed to it to be R. rickettsii, which suggested a potential new vector for this bacterium...
  31. del Sá DelFiol F, Junqueira F, da Rocha M, de Toledo M, Filho S. [Rocky Mountain spotted fever in Brazil]. Rev Panam Salud Publica. 2010;27:461-6 pubmed
    ..Since early diagnosis and the adequate drug treatment are key to a good prognosis, health care professionals must be better prepared to recognize and treat spotted fever...
  32. Stallings S. Rocky Mountain spotted fever and pregnancy: a case report and review of the literature. Obstet Gynecol Surv. 2001;56:37-42 pubmed
    ..rash occurring 1 to 2 weeks after a tick bite in an endemic area should raise suspicions for Rocky Mountain spotted fever (RMSF)...
  33. Demma L, Traeger M, Blau D, Gordon R, Johnson B, Dickson J, et al. Serologic evidence for exposure to Rickettsia rickettsii in eastern Arizona and recent emergence of Rocky Mountain spotted fever in this region. Vector Borne Zoonotic Dis. 2006;6:423-9 pubmed
    During 2002 through 2004, 15 patients with Rocky Mountain spotted fever (RMSF) were identified in a rural community in Arizona where the disease had not been previously reported...
  34. Piranda E, Faccini J, Pinter A, Saito T, Pacheco R, Hagiwara M, et al. Experimental infection of dogs with a Brazilian strain of Rickettsia rickettsii: clinical and laboratory findings. Mem Inst Oswaldo Cruz. 2008;103:696-701 pubmed
    The bacterium Rickettsia rickettsii is the etiological agent of an acute, severe disease called Rocky Mountain spotted fever in the United States or Brazilian spotted fever (BSF) in Brazil...
  35. Demma L, Traeger M, Nicholson W, Paddock C, Blau D, Eremeeva M, et al. Rocky Mountain spotted fever from an unexpected tick vector in Arizona. N Engl J Med. 2005;353:587-94 pubmed
    b>Rocky Mountain spotted fever is a life-threatening, tick-borne disease caused by Rickettsia rickettsii. This disease is rarely reported in Arizona, and the principal vectors, Dermacentor species ticks, are uncommon in the state...
  36. Paddock C, Fernandez S, Echenique G, Sumner J, Reeves W, Zaki S, et al. Rocky Mountain spotted fever in Argentina. Am J Trop Med Hyg. 2008;78:687-92 pubmed
    We describe the first molecular confirmation of Rickettsia rickettsii, the cause of Rocky Mountain spotted fever (RMSF), from a tick vector, Amblyomma cajennense, and from a cluster of fatal spotted fever cases in Argentina. Questing A...
  37. Trout R, Steelman C, Szalanski A, Williamson P. Rickettsiae in Gulf Coast ticks, Arkansas, USA. Emerg Infect Dis. 2010;16:830-2 pubmed publisher
    ..Of the screened ticks, 30% had PCR amplicons consistent with Rickettsia parkeri or Candidatus Rickettsia amblyommii...
  38. Yoder J, Benoit J, Rellinger E, Tank J. Developmental profiles in tick water balance with a focus on the new Rocky Mountain spotted fever vector, Rhipicephalus sanguineus. Med Vet Entomol. 2006;20:365-72 pubmed
    ..tick, or kennel tick, Rhipicephalus sanguineus (Latreille) (Acari: Ixodidae) is a competent vector of Rocky Mountain spotted fever in the U.S.A...
  39. Silva N, Eremeeva M, Rozental T, Ribeiro G, Paddock C, Ramos E, et al. Eschar-associated spotted fever rickettsiosis, Bahia, Brazil. Emerg Infect Dis. 2011;17:275-8 pubmed publisher
    ..The etiologic agent is most related to Rickettsia parkeri, R. africae, and R. sibirica and probably widely distributed from Sao Paulo to Bahia in the Atlantic Forest...
  40. Hidalgo M, Orejuela L, Fuya P, Carrillo P, Hernandez J, Parra E, et al. Rocky Mountain spotted fever, Colombia. Emerg Infect Dis. 2007;13:1058-60 pubmed publisher
    We investigated 2 fatal cases of Rocky Mountain spotted fever that occurred in 2003 and 2004 near the same locality in Colombia where the disease was first reported in the 1930s...
  41. Vishwanath S, McDonald G, Watkins N. A recombinant Rickettsia conorii vaccine protects guinea pigs from experimental boutonneuse fever and Rocky Mountain spotted fever. Infect Immun. 1990;58:646-53 pubmed
    There are no vaccines against boutonneuse fever and Rocky Mountain spotted fever. Previous studies have identified a Rickettsia rickettsii surface protein as a vaccine candidate and shown that an antigenically related protein is present ..
  42. Mikszewski J, Vite C. Central nervous system dysfunction associated with Rocky Mountain spotted fever infection in five dogs. J Am Anim Hosp Assoc. 2005;41:259-66 pubmed
    ..northeastern United States were presented with clinical signs of neurological disease associated with Rocky Mountain spotted fever (RMSF) infection. Four of the five dogs had vestibular system dysfunction...
  43. Ammerman N, Swanson K, Anderson J, Schwartz T, Seaberg E, Glass G, et al. Spotted-fever group Rickettsia in Dermacentor variabilis, Maryland. Emerg Infect Dis. 2004;10:1478-81 pubmed
    ..8%, as determined by polymerase chain reaction. Single strand conformational polymorphism (SSCP) analysis followed by sequencing indicated that all infections represented a single rickettsial taxon, Rickettsia montanensis...
  44. Azad A, Beard C. Rickettsial pathogens and their arthropod vectors. Emerg Infect Dis. 1998;4:179-86 pubmed
    ..This article examines the common features of the host-pathogen relationship and of the arthropod vectors of the typhus and spotted fever group rickettsiae...
  45. Medeiros A, Souza A, Moura A, Lavina M, Bellato V, Sartor A, et al. Spotted fever group Rickettsia infecting ticks (Acari: Ixodidae) in the state of Santa Catarina, Brazil. Mem Inst Oswaldo Cruz. 2011;106:926-30 pubmed
    ..parkeri strain Atlantic rainforest was recently shown to have caused two cases of human spotted fever in other states of Brazil, the role of this rickettsial agent as a possible etiological agent of spotted fever in SC is discussed...
  46. Elchos B, Goddard J. Implications of presumptive fatal Rocky Mountain spotted fever in two dogs and their owner. J Am Vet Med Assoc. 2003;223:1450-2, 1433 pubmed
    ..The dog was not examined by a veterinarian, but Rocky Mountain spotted fever (RMSF) was suspected on the basis of clinical signs...
  47. Folkema A, Holman R, McQuiston J, Cheek J. Trends in clinical diagnoses of Rocky Mountain spotted fever among American Indians, 2001-2008. Am J Trop Med Hyg. 2012;86:152-8 pubmed publisher
    American Indians are at greater risk for Rocky Mountain spotted fever (RMSF) than the general U.S. population...
  48. Pacheco R, Moraes Filho J, Guedes E, Silveira I, Richtzenhain L, Leite R, et al. Rickettsial infections of dogs, horses and ticks in Juiz de Fora, southeastern Brazil, and isolation of Rickettsia rickettsii from Rhipicephalus sanguineus ticks. Med Vet Entomol. 2011;25:148-55 pubmed publisher
    ..Overall, the results of the present study indicate a potential risk for transmission of R. rickettsii to humans by Rh. sanguineus, an occurrence yet to be documented in Brazil...
  49. Chapman A, Murphy S, Demma L, Holman R, Curns A, McQuiston J, et al. Rocky Mountain spotted fever in the United States, 1997-2002. Vector Borne Zoonotic Dis. 2006;6:170-8 pubmed
    b>Rocky Mountain spotted fever (RMSF) is the most commonly reported fatal tick-borne disease in the United States...
  50. Beati L, Kelly P, Matthewman L, Mason P, Raoult D. Prevalence of rickettsia-like organisms and spotted fever group rickettsiae in ticks (Acari: Ixodidae) from Zimbabwe. J Med Entomol. 1995;32:787-92 pubmed
  51. Soares J, Soares H, Barbieri A, Labruna M. Experimental infection of the tick Amblyomma cajennense, Cayenne tick, with Rickettsia rickettsii, the agent of Rocky Mountain spotted fever. Med Vet Entomol. 2012;26:139-51 pubmed publisher
    ..Our results indicate that A. cajennense have a low efficiency to maintain R. rickettsii for successive generations, as R. rickettsii-infection rates should decline drastically throughout the successive tick generations...
  52. Childs J, Paddock C. Passive surveillance as an instrument to identify risk factors for fatal Rocky Mountain spotted fever: is there more to learn?. Am J Trop Med Hyg. 2002;66:450-7 pubmed
    National surveillance for Rocky Mountain spotted fever (RMSF) dates from 1920; however, the collection of detailed epidemiologic, clinical, and laboratory data on RMSF by using case report forms began in 1970...
  53. Masters E, Olson G, Weiner S, Paddock C. Rocky Mountain spotted fever: a clinician's dilemma. Arch Intern Med. 2003;163:769-74 pubmed
    b>Rocky Mountain spotted fever is still the most lethal tick-vectored illness in the United States...
  54. Openshaw J, Swerdlow D, Krebs J, Holman R, Mandel E, Harvey A, et al. Rocky mountain spotted fever in the United States, 2000-2007: interpreting contemporary increases in incidence. Am J Trop Med Hyg. 2010;83:174-82 pubmed publisher
    b>Rocky Mountain spotted fever (RMSF), a potentially fatal tick-borne infection caused by Rickettsia rickettsii, is considered a notifiable condition in the United States...
  55. Vaphiades M. Rocky Mountain Spotted Fever as a cause of macular star figure. J Neuroophthalmol. 2003;23:276-8 pubmed
    ..The serum Rickettsia rickettsii antibody test was markedly positive, establishing a diagnosis of Rocky Mountain Spotted Fever (RMSF) as the cause of the ophthalmic findings...
  56. Paddock C, Sumner J, Comer J, Zaki S, Goldsmith C, Goddard J, et al. Rickettsia parkeri: a newly recognized cause of spotted fever rickettsiosis in the United States. Clin Infect Dis. 2004;38:805-11 pubmed
    ..Only Rickettsia rickettsii, the agent of Rocky Mountain spotted fever, has been definitively associated with disease in humans in the United States...
  57. Lacz N, Schwartz R, Kapila R. Rocky Mountain spotted fever. J Eur Acad Dermatol Venereol. 2006;20:411-7 pubmed
    b>Rocky Mountain spotted fever (RMSF) is an unusual but important dermatological condition to identify without hesitation...
  58. Paddock C, Holman R, Krebs J, Childs J. Assessing the magnitude of fatal Rocky Mountain spotted fever in the United States: comparison of two national data sources. Am J Trop Med Hyg. 2002;67:349-54 pubmed
    To assess the magnitude of fatal Rocky Mountain spotted fever (RMSF) and to evaluate the completeness of national surveillance for this occurrence from 1983 through 1998, two independent sources of RMSF mortality data were analyzed using ..
  59. Jones T, Craig A, Paddock C, McKechnie D, Childs J, Zaki S, et al. Family cluster of Rocky Mountain spotted fever. Clin Infect Dis. 1999;28:853-9 pubmed
    Soon after a patient from Tennessee died of Rocky Mountain spotted fever (RMSF), several family members developed symptoms suggestive of the disease and were treated presumptively for RMSF...
  60. Valbuena G, Bradford W, Walker D. Expression analysis of the T-cell-targeting chemokines CXCL9 and CXCL10 in mice and humans with endothelial infections caused by rickettsiae of the spotted fever group. Am J Pathol. 2003;163:1357-69 pubmed
    b>Rocky Mountain spotted fever and other related diseases are systemic infections caused by rickettsiae...
  61. Fournier P, Dumler J, Greub G, Zhang J, Wu Y, Raoult D. Gene sequence-based criteria for identification of new rickettsia isolates and description of Rickettsia heilongjiangensis sp. nov. J Clin Microbiol. 2003;41:5456-65 pubmed
    ..3% for the ompA and ompB genes and gene D, respectively. By use of our classification scheme, "Rickettsia heilongjiangii" belongs to a new species for which we officially propose the name Rickettsia heilongjiangensis sp. nov...