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It is essential to begin treatment absolutely as soon as RMSF is seriously suspected. Delaying treatment can result in death.
Antibiotics are used to treat RMSF. The first choice is a form of tetracycline; the second choice (used in young children and pregnant women) is chloramphenicol. If the patient is well enough, treatment by oral intake of medicine is perfectly effective. Sicker patients will need to be given the medication through a needle in the vein (intravenously). Penicillin and sulfa drugs are not suitable for treatment of RMSF, and their use may increase the death rate by delaying the use of truly effective medications.
Very ill patients will need to be hospitalized in an intensive care unit. Depending on the types of complications a particular patient experiences, a variety of treatments may be necessary, including intravenous fluids, blood transfusions, anti-seizure medications, kidney dialysis, and mechanical ventilation (a breathing machine).
— Rosalyn Carson-DeWitt, MD
