Neurologic complications of Rocky Mountain spotted fever

Rocky Mountain spotted fever, a serious systemic infectious illness, is common in the southeastern United States. Approximately one fourth of the cases in the United States occur in North Carolina. Widespread organ involvement occurs, with central nervous system involvement being common and occasionally severe. Since the onset of treatment with drugs such as tetracycline or chloramphenicol, the mortality has been 4%. Residual deficits are rare, but the disease retains potentially serious neurologic manifestations that must be considered and aggressively treated. A high index of suspicion should be maintained during the tick season in endemic areas. The simultaneous occurrence of illnesses such as influenza, mycoplasmal infection, and aseptic meningitis makes diagnosis a challenge.