R K Alwadhi
BLK Super Speciality Hospital
- Suspect Rickettesial disease in any sick child with fever.
- Check history of travel , look for eschar (a crusty necrotic lesion with or without surrounding erythematous halo) However presence of eschar is not necessary for diagnosis.
- Rash can involve palms and soles in Rocky mountain spotted fever whereas in the typhus group it usually spares palms and soles
- Doxycycline 2.2 mg/kg twice daily for 10 days (over 40 kg-100 mg BD X 10 days )
- If fever does not settle in 48 hours of Doxycycline, review the diagnosis.
- Serology is usually positive after 7 days. PCR (expensive) can be done during the 1stweek.
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