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Rocky Mountain spotted fever — ABEM Board MCQ

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HardInfectious disease emergenciesRocky Mountain spotted feverABEM Board

A 37-year-old man presents as triage level 3 with fever, severe headache, myalgias, and a petechial rash after hiking in North Carolina. Sodium is 128 mEq/L and platelets are 72,000/microL. Which of the following is the most likely diagnosis?

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Correct answer: B — Rocky Mountain spotted fever

Fever, severe headache, thrombocytopenia, hyponatremia, and petechial rash after tick exposure in the southeastern US suggest RMSF.

Reference: CDC rickettsial disease guidance; ABEM EM Model