Rocky Mountain Spotted Fever–Associated Myocarditis
A previously healthy 23-year-old enlisted man presented for 2 days of fever, gastrointestinal symptoms, cough, and disseminated rash involving the palms and soles. Initial evaluation revealed leukocytosis, elevated liver enzymes, and hyponatremia. Despite antibiotic therapy for pneumonia, his condit...
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| Format: | Article |
| Language: | English |
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American College of Physicians
2025-06-01
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| Series: | Annals of Internal Medicine: Clinical Cases |
| Online Access: | https://www.acpjournals.org/doi/10.7326/aimcc.2025.0141 |
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| author | Camily Morales Lopez Eric C. Zuberi Michael A. Acevedo Monsanto Libardo Rueda Prada Melissa P. Cortes |
| author_facet | Camily Morales Lopez Eric C. Zuberi Michael A. Acevedo Monsanto Libardo Rueda Prada Melissa P. Cortes |
| author_sort | Camily Morales Lopez |
| collection | DOAJ |
| description | A previously healthy 23-year-old enlisted man presented for 2 days of fever, gastrointestinal symptoms, cough, and disseminated rash involving the palms and soles. Initial evaluation revealed leukocytosis, elevated liver enzymes, and hyponatremia. Despite antibiotic therapy for pneumonia, his condition worsened, with development of bilateral pleural effusions and myocarditis. After treatment with doxycycline, methylprednisolone, and furosemide, his symptoms improved. He completed a 7-day antibiotic course. Rocky Mountain spotted fever serology was positive 5 weeks after symptom onset. This case highlights the importance of maintaining a broad differential diagnosis and remaining vigilant for atypical presentations of infections to prevent life-threatening complications. |
| format | Article |
| id | doaj-art-aff71fc64e434889a399cfd36ed049bd |
| institution | DOAJ |
| issn | 2767-7664 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | American College of Physicians |
| record_format | Article |
| series | Annals of Internal Medicine: Clinical Cases |
| spelling | doaj-art-aff71fc64e434889a399cfd36ed049bd2025-08-20T03:21:34ZengAmerican College of PhysiciansAnnals of Internal Medicine: Clinical Cases2767-76642025-06-014610.7326/aimcc.2025.0141Rocky Mountain Spotted Fever–Associated MyocarditisCamily Morales Lopez0Eric C. Zuberi1Michael A. Acevedo Monsanto2Libardo Rueda Prada3Melissa P. Cortes41Department of Internal Medicine, Mayo Clinic, Jacksonville, Florida1Department of Internal Medicine, Mayo Clinic, Jacksonville, Florida1Department of Internal Medicine, Mayo Clinic, Jacksonville, Florida1Department of Internal Medicine, Mayo Clinic, Jacksonville, Florida1Department of Internal Medicine, Mayo Clinic, Jacksonville, FloridaA previously healthy 23-year-old enlisted man presented for 2 days of fever, gastrointestinal symptoms, cough, and disseminated rash involving the palms and soles. Initial evaluation revealed leukocytosis, elevated liver enzymes, and hyponatremia. Despite antibiotic therapy for pneumonia, his condition worsened, with development of bilateral pleural effusions and myocarditis. After treatment with doxycycline, methylprednisolone, and furosemide, his symptoms improved. He completed a 7-day antibiotic course. Rocky Mountain spotted fever serology was positive 5 weeks after symptom onset. This case highlights the importance of maintaining a broad differential diagnosis and remaining vigilant for atypical presentations of infections to prevent life-threatening complications.https://www.acpjournals.org/doi/10.7326/aimcc.2025.0141 |
| spellingShingle | Camily Morales Lopez Eric C. Zuberi Michael A. Acevedo Monsanto Libardo Rueda Prada Melissa P. Cortes Rocky Mountain Spotted Fever–Associated Myocarditis Annals of Internal Medicine: Clinical Cases |
| title | Rocky Mountain Spotted Fever–Associated Myocarditis |
| title_full | Rocky Mountain Spotted Fever–Associated Myocarditis |
| title_fullStr | Rocky Mountain Spotted Fever–Associated Myocarditis |
| title_full_unstemmed | Rocky Mountain Spotted Fever–Associated Myocarditis |
| title_short | Rocky Mountain Spotted Fever–Associated Myocarditis |
| title_sort | rocky mountain spotted fever associated myocarditis |
| url | https://www.acpjournals.org/doi/10.7326/aimcc.2025.0141 |
| work_keys_str_mv | AT camilymoraleslopez rockymountainspottedfeverassociatedmyocarditis AT ericczuberi rockymountainspottedfeverassociatedmyocarditis AT michaelaacevedomonsanto rockymountainspottedfeverassociatedmyocarditis AT libardoruedaprada rockymountainspottedfeverassociatedmyocarditis AT melissapcortes rockymountainspottedfeverassociatedmyocarditis |