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Rocky Mountain Spotted Fever Encephalitis and "Starry Sky" Pattern on MRI: A Case Report
John P Mikhaiel1, Melvin Parasram1, Jaehan Park1
1Departments of Neurology.
The Neurologist
|October 9, 2024
Summary
Rocky Mountain Spotted Fever (RMSF) encephalitis is a severe tick-borne illness. This case highlights its rapid progression, distinctive MRI findings, and the importance of early suspicion for Rickettsia rickettsii infection.
Area of Science:
- Neurology
- Infectious Diseases
- Radiology
Background:
- Rocky Mountain Spotted Fever (RMSF) is a tick-borne illness caused by Rickettsia rickettsii.
- RMSF can lead to severe neurological complications, including encephalitis.
Observation:
- A 61-year-old woman presented with confusion and fever, rapidly progressing to coma.
- MRI revealed characteristic "starry sky" pattern in the brain, indicating diffuse punctate foci of diffusion restriction.
Findings:
- RMSF encephalitis was confirmed by positive Rickettsia rickettsii serology and postmortem PCR.
- The patient exhibited fever, coma, and a diffuse petechial rash.
Implications:
- This case underscores the importance of considering RMSF encephalitis in patients with encephalopathy, fever, rash, and specific MRI findings.
- Prompt diagnosis and treatment are crucial for managing this potentially fatal tick-borne disease.
