Diagnose RMSF for every patient with fever & headache if you’re in both:
- Tick Season — April through September; AND
- Endemic Area: The belt from North Carolina through Tennessee, Arkansas, Missouri, and Oklahoma, plus northern counties of Georgia & Alabama. NOT the Rockies!
The “spots” are petichiae, beginning on hands/feet and spreading centrally. Check palms & soles. Petichiae don’t blanche, but actually do during their first 6-12 hours. They begin just before shock ensues [and sometimes, sadly, just after].
Give empiric doxycycline in the endemic area during tick season (even to kids & pregnant women).
See posting Acute Headache – 3.
DiagnosisDude 