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Rocky Mountain spotted fever is a bacterial disease spread by ticks.[1] It typically begins with a fever and headache, which is followed a few days later with the development of a rash.[2] Treatment of RMSF is with the antibiotic doxycycline.[3]

Signs and symptoms

The symptoms are as follows: fever, nausea, muscle pain,maculopapular rash, abdominal pain, joint pain and conjunctivitis[4][5][6]


In terms of the complications from RMSF we find the following, paraparesis, hearing loss, bladder incontinence, motor dysfunction and language disorders.[7]


Ticks are the natural hosts of the disease, serving as both reservoirs and vectors of R. rickettsii Ticks transmit the bacteria primarily by their bites, less commonly, infections may occur following exposure to crushed tick tissues, or tick feces.[8][9]


The two major vectors of R. rickettsii in the United States are the American dog tick and the Rocky Mountain wood tick. American dog ticks are widely distributed east of the Rocky Mountains and they also occur in limited areas along the Pacific Coast. Dogs and medium-sized mammals are the preferred hosts of an adult American dog tick, although it feeds readily on other large mammals, including human beings. This tick is the most commonly identified species responsible for transmitting R. rickettsii to humans.[10][9][11]


Serology testing and skin biopsy are considered to be the best methods of diagnosis; immunofluorescent antibody assays are the best serology tests available.[12][13][14]Other conditions that may appear similar to rocky Mountain spotted fever include: Dengue, Leptospirosis, Chikungunya and Zika fever.[15]


Prevention of RMSF is based on wearing long sleeve shirts and applying repellents with diethyltoluamide to skin surfaces.[16]


Doxycycline is the antibiotic of choice, being one of the only instances doxycycline is used in children.[1] Treatment typically consists of 100 milligrams every 12 hours, treatment should be continued for at least three days after the fever subsides, and until there is unequivocal evidence of clinical improvement.[17]


There are between 500 and 2500 cases of Rocky Mountain spotted fever reported in the United States per year, and in only about 20 percent of cases can the tick be found.[18][19]


In 1906, Howard T. Ricketts, a pathologist recruited from the University of Chicago, was the first to establish the identity of the infectious organism that causes this disease. He and others characterized the basic epidemiological features of the disease, including the role of tick vectors. Their studies found that Rocky Mountain spotted fever is caused by Rickettsia rickettsii, named in Howard Ricketts honor. [20][21][22]


  1. 1.0 1.1 "Rocky Mountain Spotted Fever". Centers for Disease Control and Prevention. 2018-10-26. Archived from the original on 2017-10-01. Retrieved 2017-09-11.
  2. "Signs and Symptoms Rocky Mountain Spotted Fever (RMSF)". CDC. 26 October 2018. Archived from the original on 10 January 2019. Retrieved 19 January 2019.
  3. "Treatment Rocky Mountain Spotted Fever (RMSF)". CDC. 26 October 2018. Archived from the original on 19 January 2019. Retrieved 19 January 2019.
  4. Jay, Riley; Armstrong, Paige A. (2020). "Clinical characteristics of Rocky Mountain spotted fever in the United States: A literature review". Journal of Vector Borne Diseases. 57 (2): 114–120. doi:10.4103/0972-9062.310863. ISSN 0972-9062. PMID 34290155. S2CID 234301324. Archived from the original on 20 June 2022. Retrieved 22 April 2023.
  5. "Rocky Mountain spotted fever: MedlinePlus Medical Encyclopedia". Archived from the original on 14 December 2022. Retrieved 22 April 2023.
  6. "Rocky Mountain Spotted Fever (RMSF) - Infectious Diseases". Merck Manuals Professional Edition. Archived from the original on 16 April 2023. Retrieved 29 April 2023.
  7. Archibald, L. K.; Sexton, D. J. (May 1995). "Long-term sequelae of Rocky Mountain spotted fever". Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America. 20 (5): 1122–1125. doi:10.1093/clinids/20.5.1122. ISSN 1058-4838. Retrieved 22 June 2024.
  8. Perlman, Steve J.; Hunter, Martha S.; Zchori-Fein, Einat (2006-09-07). "The emerging diversity of Rickettsia". Proceedings of the Royal Society of London B: Biological Sciences. 273 (1598): 2097–2106. doi:10.1098/rspb.2006.3541. ISSN 0962-8452. PMC 1635513. PMID 16901827.
  9. 9.0 9.1 Snowden, Jessica; Simonsen, Kari A. (2023). "Rickettsia Rickettsiae". StatPearls. StatPearls Publishing. PMID 28613631. Archived from the original on 7 March 2023. Retrieved 23 April 2023.
  10. Thompson, E. Douglas; Herzog, Keith D. (1 January 2007). "Chapter 62 - Fever and Rash". Comprehensive Pediatric Hospital Medicine. Mosby. pp. 329–339. ISBN 978-0-323-03004-5. Retrieved 30 April 2023.
  11. Taylor, M. A.; Coop, R. L.; Wall, Richard L. (21 December 2015). Veterinary Parasitology. John Wiley & Sons. p. 158. ISBN 978-0-470-67162-7. Archived from the original on 1 May 2023. Retrieved 1 May 2023.
  12. Woods CR (April 2013). "Rocky Mountain spotted fever in children". Pediatr Clin North Am. 60 (2): 455–70. doi:10.1016/j.pcl.2012.12.001. PMID 23481111.
  13. "Rickettsial Disease Diagnostic Testing and Interpretation" (PDF). Centers for Disease Control and Prevention. Archived (PDF) from the original on 23 January 2023. Retrieved 28 April 2023.
  14. Chen, Luke F.; Sexton, Daniel J. (1 September 2008). "What's New in Rocky Mountain Spotted Fever?". Infectious Disease Clinics of North America. 22 (3): 415–432. doi:10.1016/j.idc.2008.03.008. ISSN 0891-5520.
  15. Álvarez-Hernández, Gerardo; Roldán, Jesús Felipe González; Milan, Néstor Saúl Hernández; Lash, R Ryan; Behravesh, Casey Barton; Paddock, Christopher D (June 2017). "Rocky Mountain spotted fever in Mexico: past, present, and future". The Lancet Infectious Diseases. 17 (6): e189–e196. doi:10.1016/S1473-3099(17)30173-1.
  16. "Rocky Mountain Spotted Fever (RMSF) - Rocky Mountain Spotted Fever (RMSF)". Merck Manual Consumer Version.
  17. Gottlieb, Michael; Long, Brit; Koyfman, Alex (July 2018). "The Evaluation and Management of Rocky Mountain Spotted Fever in the Emergency Department: a Review of the Literature". The Journal of Emergency Medicine. 55 (1): 42–50. doi:10.1016/j.jemermed.2018.02.043. Retrieved 22 June 2024.
  18. "Rocky Mountain Spotted Fever (RMSF): Background, Etiology and Pathophysiology, Epidemiology". Medscape. 17 October 2021. Archived from the original on 14 December 2022. Retrieved 22 April 2023.
  19. "Rocky Mountain Spotted Fever – Statistics and Epidemiology". Centers for Disease Control. Archived from the original on 9 January 2019. Retrieved 26 May 2016.
  20. "History of Rocky Mountain Labs (RML) | NIH: National Institute of Allergy and Infectious Diseases". Archived from the original on 17 January 2019. Retrieved 22 April 2023.
  21. Dumler, J. Stephen (13 February 1991). "Fatal Rocky Mountain Spotted Fever in Maryland—1901". JAMA. 265 (6): 718. doi:10.1001/jama.1991.03460060048012. ISSN 0098-7484. Archived from the original on 9 July 2022. Retrieved 2 May 2023.
  22. Weiss, E.; Strauss, B. S. (1 November 1991). "The Life and Career of Howard Taylor Ricketts". Clinical Infectious Diseases. 13 (6): 1241–1242. doi:10.1093/clinids/13.6.1241. Archived from the original on 2 July 2023. Retrieved 5 May 2023.