Fatal Rocky Mountain spotted fever in Maryland--1901

Abstract

Rocky Mountain spotted fever (RMSF), an infection caused by Rickettsia rickettsii , is transmitted via tick bite during spring through fall. Rocky Mountain spotted fever is a misonmer because most cases occur in the southeastern and south central United States. 1 The diagnosis is based on clinical suspicion, although the classic triad of fever, headache, and rash exists in only 3% of cases at presentation. 2 A risk for significant morbidity or mortality can occur either from delayed diagnosis or from late or inappropriate therapy. Although known in some western states in the 1870s, RMSF was first described in the eastern United States in 1931. 3,4 This report demonstrates a case of RMSF in the eastern United States in 1901. A search of the autopsy files at The Johns Hopkins Hospital, Baltimore, Md, yielded a single diagnosis coded as typhus fever. Hospital records indicated that an adult male patient was admitted