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Rocky Mountain Spotted Fever

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Condition Detail

(RMSF)

Definition

Rocky Mountain spotted fever (RMSF) is a severe disease. It is potentially fatal. The disease is spread by ticks. It was first recognized in the Rocky Mountain states. RMSF is now found in practically all states in the US.

Causes

RMSF is caused by the bacterium Rickettsia rickettsii . It is carried by the American dog tick and the Rocky Mountain wood tick. When an infected tick bites a human, the disease is passed through the skin into the bloodstream.

The bacteria multiply inside cells of the inner lining of small arteries. This causes inflammation. The inflammation is known as vasculitis.

Risk Factors

Factors that increase your chance of RMSF include:

Sex: male
Age: children and young adults
Exposure to tick-infested areas
Contact with pets that roam in tick-infested areas
Being outdoors often during the months of April to September
Residence in or visits to states where RMSF occurs most commonly; these include, but are not limited, to:
- Arkansas
- Georgia
- Kentucky
- North and South Carolina
- Oklahoma
- Tennessee
- Virginia

Symptoms

The first symptom of RMSF is a sudden high fever. It often occurs within 1-14 days after a tick bite. Other symptoms may include:

Nausea
Vomiting
Muscle pain
Lack of appetite
Severe headache

Later signs may include:

Rash
Abdominal pain
Joint pain
Diarrhea
Cough
Irritability
Insomnia
Lethargy
Confusion
Delirium or, in severe cases, coma
Enlarged liver, spleen, and lymph nodes
In severe cases, low blood pressure or shock

Immune System Including Spleen and Lymph Nodes

Diagnosis

The doctor will ask about your symptoms and medical history. A physical exam will be done. RMSF can be difficult to diagnose. It can resemble other diseases. Three indicators that your doctor will look for are:

Fever
Rash (may not be present early)
History of a tick bite (sometimes you may not have noticed)

Blood tests may be done to confirm the diagnosis. Treatment is often started based on a best guess basis. Sometimes doctors forget to think of RMSF when adults or children have only high fever.

Especially if you have been outdoors around ticks, ask your doctor:

“Could I (or my child) have Rocky Mountain spotted fever?"

That simple question may save a life.

Treatment

RMSF is treated with antibiotics. It is important to start this treatment early. The most commonly used antibiotics are:

Doxycycline
Tetracycline

Prevention

The best way to prevent RMSF is to limit your exposure to ticks. If you live in an area that is prone to ticks, take the following precautions:

Wear light-colored clothing. This makes ticks are more visible.
Tuck pant legs inside socks. This stops ticks from crawling up under your pants.
Apply insect repellents containing DEET (applied to exposed skin). Apply permethrin to clothing.
- For young children, DEET should be avoided or used sparingly. Carefully follow the directions on the label.
Carefully check your entire body for ticks after returning from outdoor areas.
Check pets for ticks.

RESOURCES

Centers for Disease Control and Prevention (CDC) http://www.cdc.gov/

National Library of Medicine http://www.nlm.nih.gov/

CANADIAN RESOURCES

Canadian Family Physician http://www.cfpc.ca/

Public Health Agency of Canada http://www.phac-aspc.gc.ca/

References

Bratton RL, Corey GR. Tick-borne disease. Am Fam Physician . 2005;71:2323.

Rocky mountain spotted fever. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated June 2009. Accessed July 21, 2009.

Rocky mountain spotted fever. Mayo Clinic website. Available at: http://www.mayoclinic.com/health/rocky-mountain-spotted-fever/DS00600 . Updated June 2009. Accessed July 21, 2009.

Revision Information

Reviewer: Rosalyn Carson-DeWitt, MD
Review Date: 12/2011 -
Update Date: 12/30/2011 -

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

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