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Rocky Mountain Spotted Fever


Rocky Mountain spotted fever (RMSF)

is a bacterial infection caused by the bite of an infected tick. It occurs most often between April and September, when ticks are most active. RMSF can become life-threatening without treatment.

Common signs and symptoms:

You may or may not see a tick bite on your skin. Symptoms usually begin about 7 days after you were bitten by a tick. A rash may appear within 2 to 5 days. The rash may start small, pink, and flat. It may turn darker red or purple, and become bumpy. The rash usually starts on your wrists, forearms, or ankles and spreads to your palms or soles. Severe rashes may spread to your legs, chest, and abdomen. You may also have any of the following:

  • Fever above 102°F (38.9°C)
  • Headache
  • Nausea or vomiting
  • Abdominal pain
  • Loss of appetite
  • Muscle aches
  • Red eyes or eyes that are sensitive to light
  • Confusion, cough, sore throat, and diarrhea in children

Call 911 for any of the following:

  • You have a seizure.
  • You have chest pain, trouble breathing, or a fast or pounding heartbeat.
  • You cannot be woken.

Seek care immediately if:

  • You have a severe headache.
  • You have a swollen, hard, or tender abdomen.
  • You have swelling in your hands or legs.
  • You have trouble urinating, or you cannot urinate at all.
  • You are confused.
  • Your fever and pain do not go away in 24 hours, even after treatment.
  • You bleed from your nose or gums.
  • Your skin and the whites of your eyes turn yellow.

Contact your healthcare provider if:

  • Your rash starts to turn black.
  • You bruise without injury.
  • You have questions or concerns about your condition or care.

Treatment for RMSF

may include any of the following:

  • Antibiotics help treat a bacterial infection.
  • Acetaminophen help decrease fever and pain. It is available without a doctor's order. Ask how much to take and how often to take it. Follow directions. Acetaminophen can cause liver damage if not taken correctly.
  • Take your medicine as directed. Call your healthcare provider if you think your medicine is not helping or if you have side effects. Tell him if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.

Follow up with your healthcare provider within 2 days:

You will need close follow-up until your symptoms improve. Write down your questions so you remember to ask them during your visits.


  • Rest until you start to feel better. Return to your daily activities as directed.
  • Drink plenty of liquids as directed. Liquids will prevent dehydration. Ask how much liquid to drink each day and which liquids are best for you.

Prevent tick bites:

Ticks are most active from April to September. Be extra careful when you are outside during this time.

  • Wear light colored clothing that covers your head, neck, arms, and legs for outdoor activities. This will make it easier to see ticks.
  • Apply tick repellent on exposed skin any time you plan to be outside. Choose a tick repellant that contains DEET. Do not apply insect repellent to a child's hands, eyes, mouth, or open skin. To apply insect repellent to a child's face, first apply it to your hands. Then apply it to the child's face. Do not touch the child's eyes or mouth with your hands. Spray your clothes and gear with insect repellant that contains permethrin.
  • Stay on trails when you hike or walk in wooded or grassy areas.
  • Check your entire body for ticks after outdoor activities. Also check your gear and your pets. Check you and your child for ticks in the following places:
    • Under the arms
    • In and around the ears
    • Inside the belly button
    • Behind the knees
    • Between the legs and in the groin area
    • Around the waist
    • In the hair
  • Take a shower or bath within 2 hours of returning indoors. This will help wash off ticks and make it easier to find them.
  • Place your clothes and gear in a dryer on high heat for 10 minutes. This will help kill ticks on your clothing. If you need to wash your clothes first, wash them in hot water.
  • Use gloves and tweezers to remove ticks as directed. Grab the tick as close to the skin as possible and pull back and upward. Check to make sure you removed the whole tick, including the head. Clean the area with soap and water, alcohol, or iodine. Wash your hands after the tick is removed.
  • Treat pets with tick control products as directed. This will decrease your risk for a tick bite. Ask your pet's veterinarian about the best product to use on your pet.

© 2016 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.