Linnemann C C, Janson P J
Clin Pediatr (Phila). 1978 Sep;17(9):673-9. doi: 10.1177/000992287801700901.
Rocky Mountain spotted fever continues to increase in the United States and the case-fatality ratio remains unchanged despite the availability of effective antibiotics. The apparent reason for the continuing deaths from this disease is the failure of physicians to consider the diagnosis in patients presenting with febrile exanthems in the late spring and summer months. A clinical diagnosis should be based on the history of tick exposure and the presence of fever and the typical exanthem. Serologic tests are useful mainly in retrospect. This article reviews the clinical experience with Rocky Mountain spotted fever in an endemic area in recent years and discusses problems in the diagnosis and management.
落基山斑疹热在美国的发病率持续上升，尽管有有效的抗生素，但病死率仍未改变。该病持续导致死亡的明显原因是，在春末和夏季出现发热性皮疹的患者中，医生未能考虑到这一诊断。临床诊断应基于蜱虫接触史、发热情况以及典型皮疹。血清学检测主要在回顾性诊断中有用。本文回顾了近年来在一个流行地区落基山斑疹热的临床经验，并讨论了诊断和治疗中的问题。
