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Rocky Mountain Spotted Fever


What is Rocky Mountain spotted fever?

Rocky Mountain spotted fever (RMSF) is an acute infection caused by bacteria from a tick bite. Acute means symptoms start suddenly, get worse quickly, and last a short time. RMSF is more common April through September.

What increases my risk for RMSF?

  • A tick bite within the last 2 weeks
  • Outdoor activity in a wooded area
  • Contact with outdoor pets or wild animals
  • Similar illness in a close family member or coworker

What are the signs and symptoms of RMSF?

Symptoms usually begin about 7 days after you were bitten by a tick. A rash will appear within 3 to 5 days. The rash may start small, red, and flat, and turn darker red or purple, and become bumpy. The rash usually starts on your wrists or ankles and spreads to your palms or soles. Severe rashes may spread to your arms, legs, and midsection. You may also have any of the following:

  • Fever above 102°F (38.9°C)
  • Headache
  • Nausea or vomiting
  • Abdominal pain
  • Tiredness
  • Muscle aches
  • Joint pain
  • Cough

How is RMSF diagnosed?

Your caregiver will examine you and ask about your signs and symptoms. Tell him about any recent outdoor activity, or if you or your pets have been in wooded areas. You may need any of the following:

  • Blood tests will be used to find out if you have the bacteria in your system that causes RMSF.
  • A skin biopsy of your rash may be taken and sent to a lab for tests. These tests will show if the rash is caused by RMSF. Ask your caregiver for more information about a skin biopsy.

How is RMSF treated?

  • Antibiotics will help fight infection caused by bacteria.
  • Acetaminophen will help decrease your fever. Acetaminophen is available without a doctor's order. Ask your caregiver how much to take and when to take it. Follow directions. Acetaminophen can cause liver damage if not taken correctly.

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 lead to lung problems, such as fluid buildup or swelling in and 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, heart, or meninges (the membrane that surrounds your brain and spinal cord). You may develop congestive heart failure. You may slip into a coma if your RMSF infection is severe.
  • Without treatment, your RMSF infection may cause tissue death or gangrene. This is a skin infection that causes your skin to rot, and could lead to limb loss. Severe RMSF may damage your blood vessels and cause blood to leak into your body. This may prevent blood from reaching your organs, and cause life-threatening organ damage.

How can I prevent RMSF?

  • Wear light colored clothing that covers your head, neck, arms, and legs for outdoor activities.
  • Spray your exposed skin with a tick repellant that contains DEET for outdoor activities. Spray your clothes and gear with insect repellant that contains permethrin.
  • Check your entire body for ticks after outdoor activities. Also check your pets and gear for ticks. Take a shower as soon as possible when you go indoors. Use gloves and tweezers to remove ticks. Check to make sure you removed the whole tick, including the head. Clean the area with soap and water. Wash your hands after the tick is removed. Dry your clothes on high for at least 1 hour to kill any ticks.

How can I manage my symptoms of RMSF?

  • Rest until you start to feel better. Return to your daily activities as directed.
  • Eat small, healthy meals every 2 to 3 hours during the day. Healthy foods include fruits, vegetables, whole-grain breads, low-fat dairy products, beans, lean meats, and fish.

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:

When should I contact my caregiver?

Contact your caregiver if:

  • Your rash starts to turn black.
  • Your fever and pain do not go away, even after treatment.
  • Your skin and the whites of your eyes turn yellow.
  • You bleed from your nose or gums.
  • You bruise without injury.
  • You have questions or concerns about your condition or care.

When should I seek immediate care?

Seek care immediately or call 911 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 have chest pain, trouble breathing, or a fast or pounding heartbeat.
  • You are confused.
  • You have a seizure.

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.

© 2015 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.