Rocky Mountain Spotted Fever (RMSF): The Daily PANCE Blueprint
A 54-year-old woman presents to the emergency department with a 5-day history of high fever, severe headache, muscle aches, and a maculopapular rash that began on her wrists and ankles and has now spread to her trunk. She recently returned from a hiking trip in the Appalachian Mountains. Her husband reports that she has become increasingly confused over the past two days. On examination, her temperature is 39.5°C (103.1°F), blood pressure is 100/60 mm Hg, pulse is 110/min, and respiratory rate is 22/min. Physical examination reveals a diffuse maculopapular rash on her extremities and trunk, including the palms and soles. What is the most important step in the management of this patient?
A. Start intravenous ceftriaxone
B. Begin oral doxycycline immediately
C. Perform a lumbar puncture
D. Order blood cultures and wait for results before starting treatment
E. Administer intravenous acyclovir
Smarty PANCE Content Blueprint Review:
Covered under ⇒ PANCE Blueprint Infectious Disease ⇒ Bacterial Disease ⇒ Rocky Mountain spotted fever