Rocky Mountain Spotted Fever - Symptoms

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What are symptoms and signs of Rocky Mountain spotted fever in children and adults?

Symptoms appear within about a week of exposure to the bacteria (range two to 14 days). Initially, people feel like they have influenza (flu) with headache, high temperature, body aches, and fatigue. Other possible symptoms include abdominal pain, vomiting, and lack of appetite. Symptoms in children may be slightly different than in adults. Children may complain less of headache and more of abdominal pain, which may be severe. The eyes may be red (conjunctivitis).

A rash appears within three to five days, often starting around the wrists or ankles and then spreading to the trunk, palms, and soles. The rash starts as discrete, small red areas and resembles the rashes (exanthems) of many other viral illnesses. Over a few days, these areas may become bright red or purple and are known as petechiae, a sign of more severe disease. The petechiae may merge as the rash advances to create a diffuse redness.

In some cases, the rash may be so mild that it is missed on examination. People with dark skin often have delayed diagnosis because the rash is harder to detect. In severe cases, the skin may turn black and necrotic (meaning there is death of tissue), resembling gangrene.

Headache is often very severe and may be the presenting complaint, especially in adults. Other neurological signs that might appear include a stiff neck, difficulty hearing, confusion, and weakness or paralysis of some muscles. Severe cases may reduce the ability of the blood to clot, which causes the patient to be at risk for internal bleeding.

None of the above symptoms is specific for RMSF. Other tick-borne illnesses may cause similar symptoms, including other members of the spotted fever rickettsiosis group. Ticks may also spread other diseases such as Lyme disease.

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See what others are saying

Comment from: outdoors, 45-54 Male (Patient) Published: November 14

I discovered red rash that grew over 5 to 7 days. Approximately 5 to 7 long red, oval, bumpy, itchy, raised rashes. I woke up on day 5 with severe headache, confusion, joint pain, severe vertigo and high blood pressure. I had no fever, but a spotty rash. I was misdiagnosed for over 4 weeks and all tests were negative for Lyme. After 2 emergency room visits it was finally discovered by infectious disease doctor. Too Late, I did 2 rounds of antibiotics. I have permanent brain lesions and dead areas. One year later, I still have headaches, dizziness, memory problems and fatigue.

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Comment from: traveler, 45-54 Female (Patient) Published: November 18

I had severe headaches, loss of appetite, and extreme fatigue. After feeling something in my head, my initial test for Lyme disease and RMSF were negative. (I was prescribed doxycycline, thank goodness). I continued to feel like I was in poor health and persuaded my doctor to run another panel for the diseases, the 2nd RMSF test came back positive.

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