Rocky Mountain Spotted Fever - Symptoms and Signs

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What are Rocky Mountain spotted fever symptoms and signs?

The signs and symptoms of RMSF can appear within the first few days after the tick bite, or they can be delayed by up to two weeks.

RMSF typically begins with headaches, a high fever, and muscle aches. Some individuals may also develop abdominal pain, nausea, and vomiting. It is frequently followed by a rash (usually two to five days after the onset of fever) that appears around the ankles, forearms, and wrists. The rash consists of small, non-itchy, flat pink spots that then spread to the individual's chest and back and then down the remainder of the extremity. The rash can sometimes involve the palms and soles. In some cases (about 10% of the time), no rash develops, which makes diagnosing RMSF much more difficult. In about 35%-60% of patients with RMSF, a spotty rash that is red or purple (petechiae) may develop around the sixth day or later after the onset of symptoms. The appearance of this type of rash indicates that the disease has become more severe.

The damage to the lining of small blood vessels causes them to become leaky, with bleeding or clot formation leading to the following potential complications:

  • Kidneys: Kidney failure may occur due to damage of the small blood vessels in the kidney.
  • Extremities: Due to damage to the smallest blood vessels in the fingers or toes, blood flow can be disrupted, leading to gangrene, with amputation sometimes being necessary.
  • Brain: Headaches, lethargy, confusion, and even seizures can occur due to damage to the blood vessels in the brain.
  • Heart and lungs: Inflammation of heart tissue (myocarditis) or respiratory failure can lead to death.
  • Eyes: Damage to the eyes may occur, often due to inflammation of the vascular structures of the eye (uveitis or retinal vasculitis).
Return to Rocky Mountain Spotted Fever (RMSF)

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Comment from: Vernon, 45-54 Male (Caregiver) Published: October 08

I had severe flu like symptoms on March 2008. I was wiped out. My fever peaked at 104 three days after the first symptoms. By 5 days, my neck hurt so bad I could not sleep. I could not move it. Excruciating pain. The doctor's diagnosis was post viral syndrome. A shot, Valium, and painkillers made it better. The next morning, the pain was back. I had to hold my head to sit up. This went on for five months. I had severe knee pain one day, and severe hip pain the next day, and bouts of severe diarrhea. I felt buzzing all over my body, and in my brain. I saw doctor after doctor. I told them I had a tick bite. I slowly recovered. Five months later, I could not move my legs right and I was not able to move fast. I was falling. Vertigo. I've fallen hundreds of times. I started having severe back pain. Three MRIs showed bulging discs, but no nerve impingement. I almost could not walk and had severe pain. Nerve conduction studies showed neuropathy in both legs. I had muscle pain in both legs, very tight. I couldn't use stairs without a railing, had muscle weakness, pain went to my knees and hips. I thought it was Lyme's disease. Test came back RMSF. I had positive IgG for rickettsia. The gold standard is 1:64 titer by IFA. That was negative. I had one round of doxycycline, which is not enough to clear a chronic infection. I was referred to a rheumatologist. I still have not been treated. I started taking 2000 mg of vitamin C, and my back, knees, and hips are better. I need the full course of antibiotics.

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Comment from: Jody, 55-64 Female (Patient) Published: June 05

I spent the winter in Costa Rica, on the Caribbean-Panama Border and must have been bitten by a tick there, though never saw it. I got suddenly very tired, had fevers and chills and had no appetite. I asked the local doctor for antibiotics and took them two weeks in a row (Cipro). I then returned to the U.S., not knowing what was wrong with me, wondered if I had malaria. I developed a rash at 2 1/2 weeks that looked like lots of mosquito bites and was not itchy. I walked into an emergency room and was first diagnosed with swimmers' itch. I returned a week later and the doctor said he did not know what it was. I had trouble walking, slept most of the time, did not eat and lost 18 lb. and had terrible brain fog. The next morning, he called me and said to check myself into the hospital right away and was diagnosed with Rocky Mountain spotted fever (RMSF). Because it is never seen here, many doctors stopped in to see what it looked like and ask questions. I was put on doxycycline for 12 days and was feeling better, the rash was going away. After 6 days of stopping the medications, the rash was returning to my hands and I am now on the doxycycline again. I am very tired and cannot work.

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