Spotted fever case surprises doctors
Wyo. girl's illness progressed in unusual fashion
Brantley Hargrove, The Gillette News-Record
Published June 20, 2007 at midnight
GILLETTE, Wyo. - The only mementos 4-year-old Cydni Herman has from an excruciating illness that dragged on for nearly three weeks are faint pockmarks the size of BBs that resemble chickenpox, mostly on her legs and feet.
But the severe tick-borne bacterial infection she contracted in late April was a far cry from that childhood disease. And Cydni's case illustrated a lack of awareness in the medical community of a rare disease with increasing incidence in Campbell County.
On May 17, Cydni was diagnosed with Rocky Mountain spotted fever after going from doctor to doctor, only to be told it was a viral infection that could be treated with Motrin.
"They started out like flat bumps," her mother, Melissa Herman, said. "I gave her a bath and then they started getting pimply things like the chickenpox."
Her case, so far, was atypical. Rocky Mountain spotted fever usually begins in the extremities. Hers began on the trunk. But the disease was on the tip of no one's tongue.
Her mother thought she had rubella and sought treatment. She was told she had a viral infection.
When she got worse, they again sought treatment at a different place and were told the same thing - give her Motrin.
By this time, she was sleeping all day and not eating. The rash had spread everywhere, from the insides of her ears to the bottoms of her feet.
Her temperature never fell below 102 degrees and peaked at over 105. She had to be carried to the bathroom because her joints were inflamed and painful.
When she didn't improve, they made an appointment with Dr. David Fall of Big Horn Pediatrics. One of his first thoughts was leukemia.
He talked with several pediatricians, cracking medical books and even consulting a specialist in Casper.
Fall sent her back to the hospital to have her blood drawn and checked for rheumatoid arthritis, leukemia and Rocky Mountain spotted fever - a long shot in their minds because of the atypical presentation of her symptoms.
Inexplicably, she began to improve.
Three days later the tests came back and, sure enough, it was Rocky Mountain spotted fever. The doctors, who had racked their brains over her mystery malady, were stunned.
"I haven't seen a case and I've been in Gillette for 27 years," Fall said.
"Tick-borne disease is not necessarily something on the forefront of everyone's minds," said Janae Stovall, state Health Department surveillance epidemiologist.
The illness is characterized by fever, muscle pain, abdominal pain, vomiting, headache, diarrhea and a rash. It can be fatal if left untreated.
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