Rocky Mountain Spotted Fever Case Study
What will be your differential diagnoses for this patient?
Differential diagnoses for the child includes, Pediatric Rocky Mountain Spotted Fever, Measles and
Kawasaki Disease (Bennet, 2015).
What specific physical exam findings support these differential diagnoses?
Pediatric Rocky Mountain Spotted Fever
Clinical presentation of rocky mountain spotted fever includes, fever, headache, rash, myalgia,
toxicity and confusion. Other symptoms may include gastrointestinal symptoms such as abdominal
pain, nausea and vomiting. Conjunctival hyperemia and photophobia may also be present. Rash is
usually present in 80 90% of patients. The rash usually begins as a blanching maculopapular lesions.
And in half of the patients the rash becomes petechial or ... Show more content on Helpwriting.net ...
The most concerning diagnosis would be Kawasaki disease because of coronary artery aneurysm.
Approximately 15% 25% of children with untreated Kawasaki disease will develop coronary
aneurysm. Aneurysm may occur up to 6 months after the illness. Other complication may include,
massive myocardial infarction, CHF, myocarditis, pericarditis or pericardial effusion (Burns, Dunn,
Brady, Starr Blosser, 2013).
What additional diagnostic tests will you recommend? Why?
Diagnostic test would include, CBC with differential, ESR, platelet count, CRP, liver transaminases,
gamma glutamyltransferase (GGT), and urinalysis. CRP will be elevated but ESR is sometime normal.
Blood, urine, cerebrospinal fluid, and group A beta hemolytic streptococcus pharyngeal cultures may
be collected to identify other sources of fever. Diagnostic test would be done to confirm or rule out the
diagnosis of Kawasaki disease (Burns, Dunn, Brady, Starr Blosser, 2013).
What would be your focus for caregiver
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