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Harvard Commentaries
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Harvard Commentaries
Reviewed by the Faculty of Harvard Medical School


Rocky Mountain Spotted Fever


September 30, 2014

Lyme Disease
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Basics
Rocky Mountain Spotted Fever
Rocky Mountain Spotted Fever
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Re-emerging, right on schedule.
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InteliHealth
2011-09-07
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InteliHealth Medical Content
2014-09-07

Reviewed by the Faculty of Harvard Medical School

Rocky Mountain Spotted Fever
  

Rocky Mountain spotted fever is the deadliest of all tick-borne diseases. In the past, up to 10% of patients died. But today death occurs in less than 1% of infected people. The difference in outcome depends upon prompt diagnosis and appropriate antibiotic therapy (with doxycycline or chloramphenicol).

It is caused by a type of bacteria called rickettsia. It is carried by the American dog tick, which is found all over the continental United States. Despite its name, Rocky Mountain spotted fever is most prevalent in North Carolina, Oklahoma, Arkansas, Tennessee and Missouri. 

Symptoms include fever — which can reach 105 degrees or more — headache and a skin rash that usually first appears four to six days after the fever begins, starting as small, faint red splotches. This rash typically begins on the arms or legs, and it spreads inward toward the trunk, involving the palms and soles but usually sparing the face. Over time, the flat red splotches become elevated, then turn darker red. It is important to note that there may be no rash within the first several days of illness, and about 10 percent of persons never have a rash.
 
The diagnosis must be strongly suspected and treatment started early, because delay may be deadly and no reliable test can identify the illness in the earliest phases. Anyone who experiences these symptoms and possible tick exposure should see a doctor immediately.

 

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