VCOM Research Day Program Book 2023

Medical Resident Research Case Reports

30 Rocky Mountain Spotted Fever Associated with Cardiac Arrhythmias

Shahzeib Syed, DO, PGY II; Christian Scott, DO, PGY II; Bao Nguyen, MD, IM- PGY3; Dr. Ei Phyu IM Faculty Corresponding author:

Lewis Gale Medical Center, Salem

Rickettsia rickettsii, the cause of Rocky Mountain Spotted Fever (RMSF), is a common and curable tick-borne illness found primarily in the United States. Dermacentor variabilis , the American dog tick is responsible for spread of this infection in the eastern United States and Dermacentor andersoni, the Rocky Mountain wood tick plays a role in the spread in the western United States. Rickettsia organisms are typically released into the dermis with salivary

excretions after 6 or more hours of feeding whereupon they spread lymphohematogenously. Clinical Manifestations are typically nonspecific and similar to nonspecific viral illness; fever, myalgias, nausea, vomiting, headaches. Later clinical manifestations include the characteristic petechial rash that begins peripherally at the wrist and ankles and spreads towards the chest. Rickettsia rickettsii is known to affect endothelial cells specifically and therefore can

affect multiple organ systems including, neurologic, respiratory, cardiac, digestive, and renal. Although much is known about this particular disease process, this case report will present a healthy 83 year old female diagnosed with RMSF infection ultimately resulting in cardiac arrhythmia and eventual pacemaker placement. 1


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