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Rocky Mountain Spotted Fever


What is 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.

What increases my risk for RMSF?

  • A tick bite within the last 2 weeks
  • Outdoor activity in a wooded or high grass area
  • Contact with outdoor pets or wild animals

What are the signs and symptoms of RMSF?

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 as small, pink, flat dots. 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

How is RMSF diagnosed?

Your healthcare provider will examine you and ask about your signs and symptoms. Tell him about any recent outdoor activity, travel, or if you or your pets have been in wooded areas. Also tell him if you have seen a tick or tick bite on you, a family member, or a pet. You may need any of the following:

  • Blood tests will check your blood cell levels, liver function, and for signs of infection.
  • A skin biopsy may be taken and sent to a lab for tests. These tests will show if the rash is caused by RMSF. Ask your healthcare provider for more information about a skin biopsy.

How is RMSF treated?

You may need to be monitored in an intensive care unit if your infection is severe. You will need antibiotics to treat the infection. You may also need medicine to decrease your fever and pain.

What are the risks of RMSF?

You may develop kidney failure or breathing problems. Your blood may clot more than it should. This can keep the blood from flowing where it should in your body. RMSF may cause fluid to build up around your lungs. The bacteria can spread and infect organs or other parts of your body. RMSF may also cause swelling or damage in your liver, brain, or heart. RMSF may cause a coma if the infection is severe.

What long-term problems can RMSF cause?

Long term problems may be caused by a severe RMSF infection. You may have permanent damage to organs or body parts such as your fingers, toes, or limbs. These body parts may need to be amputated if damage is severe. You may have problems with memory, movement, speech, or controlling your urine or bowel movements. You may also have hearing or vision loss.

How can I prevent RMSF?

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.

How can I manage my symptoms of RMSF?

  • 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.

Where can I find more information?

  • Centers for Disease Control and Prevention (CDC)
    1600 Clifton Road
    Atlanta , GA 30333
    Phone: 1- 800 - 232-4636
    Web Address:

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.

When should I seek immediate care?

  • 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.

When should I contact my healthcare provider?

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

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. 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.

© 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.