Atypical presentation of Rocky Mountain spotted fever in a young adult: A case report

Introduction: Rocky Mountain spotted fever (RMSF) is a tick-borne disease that can be potentially lethal if left untreated. Its causative agent Rickettsia rickettsii is a gram negative intracellular bacterium that is known to have a tropism for vascular endothelial cells. Classic symptoms of RMSF include fever; which is almost always present, headaches and rash. However, all of these diagnostic clues may not be present which can lead to delay in diagnosis and appropriate antibiotic therapy leading to poor outcomes in certain cases. RMSF rarely may involve the myocardium but solely presenting with cardiac signs and symptoms without any of the typical features-fever, rash or headaches at any point is even rarer and may pose a diagnostic challenge. Case Report: We report a case of an atypical presentation of Rocky Mountain spotted fever in a healthy 20-yearold male. This report describes a case of a serologically proven RMSF infection in a patient who presented with chest pain, electrocardiographic changes and elevated cardiac enzymes without any fever, rash or headaches. Conclusion: Rocky Mountain spotted fever can present solely with cardiac manifestations such as chest pain, electrocardiographic changes and elevation of cardiac markers without any of the typical features of Rocky Mountain spotted fever including fever. (This page in not part of the published article.) International Journal of Case Reports and Images, Vol. 6 No. 5, May 2015. ISSN – [0976-3198] Int J Case Rep Images 2015;6(5):286–289. www.ijcasereportsandimages.com Iroka et al. 286 CASE REPORT OPEN ACCESS Atypical presentation of Rocky Mountain spotted fever in a young adult: A case report Nneka Iroka, Mohammed Hossain, John Middleton