LONG-TERM SEQUELAE OF ROCKY-MOUNTAIN-SPOTTED-FEVER

Twenty-five patients with definite or probable Rocky Mountain spotted fever (RMSF) who were hospitalized for greater than or equal to 2 week s were identified from our database of 105 patients. Follow-up informa tion was collected for 20 patients, per telephone and/or medical recor ds, The remaining five patients were lost to follow-up or died. Nine p atients had greater than or equal to 1 long-term sequelae (defined as complications related to an original acute infection with Rickettsia r ickettsii that persisted for greater than or equal to 1 year following hospital discharge), The ages of patients with sequelae ranged from 2 to 74 years (mean and median, 38 years); duration of follow-up ranged from 1 to 18 years (mean, Il years). The mean lengths of hospitalizat ion for patients with and without long-term sequelae were 47 days and 20 days, respectively (P < .05). Long-term neurological sequelae inclu ded paraparesis; hearing loss; peripheral neuropathy; bladder and bowe l incontinence; cerebellar, vestibular, and motor dysfunction; and lan guage disorders. Nonneurological sequelae consisted of disability from limb amputation and scrotal pain following cutaneous necrosis. These data suggest that significant long-term morbidity is common in patient s with severe illness due to RMSF.