Transmitted by tick bites, which predominantly occur in spring and summer.
Fever, rash, headache, vomiting, and history of tick bite are commonly reported; however, the absence of any of these does not exclude the diagnosis.
Signs and symptoms may be difficult to distinguish from those of common viral illnesses, leading to delayed diagnosis.
Doxycycline is the drug of choice for treatment in patients of all ages.
Because the risk of death rises if appropriate therapy is not started before the fifth day of illness, doxycycline should be prescribed for suspected Rocky Mountain spotted fever without awaiting confirmatory diagnostic test results.
Child's right arm with characteristic spotted rash of Rocky Mountain spotted fever
CDC Image Library; used with permission
- triad of fever, rash, and history of tick exposure
- triad of fever, rash, and headache
- any rash
- petechial rash
- altered mental status
- known recent tick exposure
- residence in or recent exposure to rural area
- abdominal pain
- peripheral edema
1st Tests To Order
- serum electrolytes
- indirect immunofluorescent antibody (IFA)
- blood cultures
Other Tests to Consider
- complement fixation
- latex agglutination
- indirect hemagglutination
- enzyme immunoassay
- lumbar puncture
- convalescent serology
suspected Rocky Mountain spotted fever
- meningococcal or other pyogenic infectious disease cannot be excluded
- third-generation cephalosporin
- staphylococcal sepsis or toxic shock syndrome cannot be excluded
- critically ill
- aggressive supportive therapy