A 15-year-old male from west-central New Jersey has been ill for five days with

Question

A 15-year-old male from west-central New Jersey has been ill for five days with fever, chills, and headache, and today woke to find a rash covering his body and limbs, including his palms and soles. The rash is composed of fine macular lesions (macule = flat spot, red but not raised). Rocky Mountain Spotted Fever should be high on your list of possible causes. To help confirm or rule out this possibility, you need to ask him about possible exposure to the source of this disease.

1.What should you ask him about?

2.Explain the tests used to diagnose this pathogen.

3.Indicate appropriate treatment of this of disease.

Explanation / Answer

The disease is one of the most difficult diseases to be diagnosed. One should ask the patient if he was bitten by a tick in the recent past. A tick bite helps enter the bacterium into humans. Also if genetically he is deficient in glucose-6-phosphate dehydrogenase enzyme, he is at a higher risk. Tests include serology testing. Low platelet levels, low sodium in blood and high levels of liver enzymes hint towards a positive diagnosis. Skin biopsy can also be carried out. Doxycycline is the drug of choice. It is an antibiotic against broad range of bacteria.

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