The purpose of the present paper is to report two more cases of Rocky Mountain spotted fever, which brings to four the total number of cases reported on the Isthmus of Panama. Both patients were treated with antibiotics and recovered. The diagnosis in both cases was confirmed by the complement fixation test.
Report of the Cases. Case No. 1—J. W., yellow race, female, 65 years old, was admitted to the Panama Hospital the 26th of January, 1951, because of a remittent fever of six days duration, with rhinitis, headache, nausea and vomiting.
The physical examination revealed a discrete maculo-papular rash on the lateral wall of the thorax, the abdomen, and the extremities. No petechial spots were observed. The tongue was coated and the breath was unpleasant. The liver was two fingerbreadths below the right costal margin upon inspiration and was not tender.