Lower respiratory tract involvement in Rocky Mountain spotted fever

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Abstract
Patients (35) with Rocky Mountain spotted fever were studied to determine the frequency of respiratory symptoms and to analyze the types of pulmonary problems encountered in hospital patients. Cough, present in only 33% of patients, led to an incorrect initial diagnosis and delay in therapy in 8 individuals. Lower respiratory tract involvement (rales, abnormal chest roentgenograms and abnormal gas exchange) was present in 42% of patients at some point during the illness. The conditions of 9 patients deteriorated during the 1st wk of hospitalization. Pulmonary edema (probably non-cardiogenic) was the usual explanation for worsening gas exchange. Bacterial pneumonia and hemorrhage were detected in only 2 patients.

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