Rocky Mountain Spotted Fever

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.