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1

Walker, David H. Rocky Mountain spotted fever. New York: Chelsea House, 2008.

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2

Rocky Mountain spotted fever: History of a twentieth-century disease. Baltimore: Johns Hopkins University Press, 1990.

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3

Society, Massachusetts Medical, ed. Extracts from a report of the Massachusetts Medical Society: Respecting a disease commonly called spotted or petechial fever, which has within a few years been epidemic in various parts of New-England. Montreal: Printed by Nahum Mower, 1985.

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4

ill, Rappe-Flowers Hedvig 1956, ed. Spotted bear: A Rocky Mountain folktale. Missoula, Mont: Mountain Press Pub. Co., 1998.

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5

National Institute of Allergy and Infectious Diseases (U.S.). Office of Research Reporting and Public Response, ed. Rocky Mountain spotted fever. Bethesda, Md: The Office, 1985.

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6

National Institutes of Health (U.S.), ed. Rocky Mountain spotted fever. Bethesda, Md: National Institutes of Health, 1987.

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7

Colby, Rucker William. Problem of Rocky Mountain Spotted Fever. Creative Media Partners, LLC, 2022.

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8

Walker, David H. Rocky Mountain Spotted Fever (Deadly Diseases and Epidemics). Chelsea House Publications, 2007.

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9

Philip, Robert N. Rocky Mountain Spotted Fever: Anatomy of a Pestilence. Stoneydale Pr Pub Co, 2000.

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10

Parker, James N., and ICON Health Publications. The Official Patient's Sourcebook on Rocky Mountain Spotted Fever. Icon Health Publications, 2002.

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11

Fletcher, Tom, and Nick Beeching. Rickettsial infection. Edited by Patrick Davey and David Sprigings. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199568741.003.0314.

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Rickettsial infections are caused by a variety of obligate intracellular, Gram-negative bacteria from the genera Rickettsia, Orientia, Ehrlichia, and Anaplasma. Rickettsia is further subdivided into the spotted fever group and the typhus group. Bartonella and Coxiella burnetii bacteria are similar to rickettsiae and cause similar diseases. The range of recognized spotted fever group infections is rapidly expanding, complementing long-recognized examples such as Rocky Mountain spotted fever (Rickettsia rickettsii) in the US, and Australian tick typhus (Rickettsia australis), as well as those in southern Europe and Africa. Animals are the predominant reservoir of infection, and transmission to people is usually through ticks, mites, fleas, or lice, during blood-feeding or from scarification of faeces deposited on the skin. This chapter focuses on the two of the most relevant infections encountered in UK practice: African tick typhus, and Q fever.
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12

Colton, Max. §lx þills: The Super Active Medication for the Treatment Infections and Diseases Such As Rocky Mountain Spotted Fever, Typhus Fever and the Typhus Group, Q Fever, Rickettsialpox, and Tick Fevers, Respiratory Tract Infections, Urinary Tract Infections. Independently Published, 2019.

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13

Burdmann, Emmanuel A., and Vivekanad Jha. Rickettsiosis. Edited by Vivekanand Jha. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199592548.003.0193.

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Rickettsiae are obligate intracellular bacteria transmitted by arthropods to a vertebrate host. Clinically relevant rickettsioses have a similar clinical pattern, manifesting as an acute febrile disease accompanied by headache, articular and muscle pain, and malaise.Epidemic typhus is a worldwide distributed disease caused by the Rickettsia prowazekii, with a human louse as a vector. Data on epidemic typhus-related renal injury is extremely scarce.Murine typhus is caused by the Rickettsia typhi and has a rodent flea as the vector. It is one of the most frequent rickettsioses, and is usually a self-limited febrile illness. Proteinuria, haematuria, elevations in serum creatinine (SCr) and/or blood urea nitrogen (BUN) and AKI have been reported. The real frequency of renal involvement in murine typhus is unknown. Renal abnormalities recover after the infectious disease resolution.Scrub typhus, caused by the Orientia tsutsugamushi, has the Leptotrombidium mite larva as vector. It is endemic in the Tsutsugamushi triangle delimited by Japan, Australia, India, and Siberia. It can manifest either as a self-limiting disease or as a severe, life-threatening multiorgan illness. Early administration of adequate antibiotics is essential to prevent adverse outcomes. Proteinuria, haematuria, and acute kidney injury (AKI) are frequent.Tick-borne rickettsioses are caused by bacteria from the spotted fever group and have ticks as vectors. Rocky Mountain spotted fever (RMSF) is caused by Rickettsia rickettsii. It is the most severe of the spotted fever rickettsial diseases, causing significant morbidity and lethality. RMSF occurs in North, Central, and South America. Renal impairment is frequent in severe forms of RMSF. Mediterranean spotted fever is caused by Rickettsia conorii, and is endemic in the Mediterranean area. It is usually a benign disease, but may have a severe course, clinically similar to RMSF. Haematuria, proteinuria, increased serum creatinine, and AKI may occur. Japanese spotted fever is caused by Rickettsia japonica. Lethal cases are reported yearly and AKI has occurred in the context of multiple organ failure.
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14

News, PM Medical Health. 21st Century Complete Medical Guide to Rocky Mountain Spotted Fever (RMSF) and Related Tick Bite Diseases, Authoritative Government Documents, Clinical ... for Patients and Physicians (CD-ROM). Progressive Management, 2004.

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15

Tuddenham, Susan. Ehrlichia, Anaplasma, and Rickettsia. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199976805.003.0051.

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Rickettsia, Ehrlichia, and Anaplasma are infections primarily transmitted by ticks (but, in the case of certain Rickettsial species, are transmitted by other vectors as well), which can cause an abrupt, febrile, and flu-like illness often associated with headache, nausea, vomiting, abdominal pain, rash, elevated liver function tests, and thrombocytopenia. Disease can be severe, particularly when patients are infected with Rickettsia rickettsii (Rocky Mountain Spotted Fever); patients may develop central nervous system involvement, shock, and multiorgan failure. Diagnostic tests are imperfect, and prompt empiric treatment should be initiated if disease is suspected. Doxycycline is the treatment of choice, and coinfection with other vector-borne pathogens may need to be considered.
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16

Sun, Lisa, and Michael V. Johnston. Rickettsial Diseases. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199937837.003.0157.

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Tick-borne rickettsioses are emerging as more important health problems throughout the world. The spotted fever group including Rickettsia rickettsia can cause encephalopathy, meningitis and brain damage by selectively targeting capillary endothelial cells in the brain, and stimulating inflammation, capillary leakage, hemorrhage, and intravascular coagulation. Rickettsia are are arthropod-borne gram-negative coccobacilli bacteria and are obligate intracellular organisms that do not survive in artificial medium. In North and South America, the most common rickettsial disorder is rocky mountain spotted fever (RMSF) transmitted by the dog tick Dermacentor variabilis or the wood tick Dermacentor andersoni. A characteristic “starry sky” pattern can be seen on MRI imaging of the brain in some patients with RMSF encephalopathy and is thought to reflect the organisms targeting of brain endothelial cells in capillaries the white matter. Early treatment with doxycycline is curative and reverses signs of encephalopathy if given within a few day of onset, but delayed treatment can be associated with permanent neurological disability. The typhus group of rickettsia bacteria include R. prowazekii, which causes epidemic typhus and R. typhi, which causes murine typhus (endemic) typhus in tropical and subtropical parts of the world. Flying squirrels and humans carry R prowazekii and rats are carry R. typhi. Q fever caused by the rickettsia organism Coxiella burnetti is transmitted from farm animals including sheep and is seen throughout the world including the United States.
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17

Cuttle, Lisa. Dermatologic Manifestations of Infectious Disease. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199976805.003.0044.

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Toxic infectious exfoliative conditions include staphylococcal toxic shock syndrome (TSS), streptococcal toxic shock syndrome (STSS), and staphylococcal scalded skin syndrome (SSSS). All three are mediated by bacterial toxin production and are considerations in the differential diagnosis of a febrile, hypotensive patient with a rash. Meningococcemia is potentially fatal and extremely contagious with a short incubation period. Disseminated gonococcal infection (DGI) presents with tenosynovitis, dermatitis, and polyarthralgias without purulent arthritis or with purulent arthritis but without skin lesions. Ecthyma gangrenosum (EG) is a cutaneous manifestation of Pseudomonas aeruginosa infection. Rocky Mountain Spotted Fever (RMSF) is caused by Rickettsia rickettsii, most commonly transmitted by the American dog tick. Patients present with nonspecific symptoms, such as fever, headache, myalgias, arthralgias, nausea, vomiting, and abdominal pain. Finally, vibrio vulnificus is a gram-negative bacterium that causes serious wound infections, sepsis, and diarrhea in patients exposed to shellfish or marine water.
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