Background and objectives: Rocky Mountain spotted fever (RMSF) is a rapidly progressive and potentially fatal tickborne disease caused by Rickettsia rickettsii. Despite current recommendations and information on the severity of RMSF, studies show that delayed recognition and treatment continues to occur.
Methods: A literature search was performed on cases published in English between 1990–2017. The frequencies for demographic, clinical, and treatment variables was calculated.
Results: A total of 340 cases from 34 articles were included. Data on rash were available for 322 patients, and 261 (80%) noted rash. Mortality was 4% (2) in those who received doxycycline within the first five days of illness, and 35% (18) when treatment was delayed beyond Day five. Twenty-four (16%) reported chronic sequelae, including speech impairment (7, 5%) and ataxia (5, 3%).
Interpretation and conclusion: These data highlight the importance of early treatment, and add to our understanding of long-term sequelae. Early recognition by providers will facilitate appropriate treatment and reduction in morbidity and mortality.

中文翻译：

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美国落基山斑疹热的临床特征：文献综述

背景和目的：落基山斑疹热 (RMSF) 是一种由立克次体立克次体引起的快速进展且可能致命的蜱传疾病。尽管目前有关于 RMSF 严重程度的建议和信息，但研究表明，延迟识别和治疗继续发生。
方法：对 1990-2017 年间以英文发表的病例进行文献检索。计算人口统计学、临床和治疗变量的频率。
结果：共纳入34篇文章340例。可获得 322 名患者的皮疹数据，其中 261 名 (80%) 出现皮疹。在发病前五天内接受强力霉素治疗的患者死亡率为 4% (2)，而在治疗延迟至第五天后死亡率为 35% (18)。24 人 (16%) 报告了慢性后遗症，包括语言障碍 (7, 5%) 和共济失调 (5, 3%)。
解释和结论：这些数据突出了早期治疗的重要性，并增加了我们对长期后遗症的理解。提供者的早期识别将促进适当的治疗并降低发病率和死亡率。