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Rocky Mountain Spotted Fever




Rocky Mountain spotted fever (RMSF) is a severe infection. It can be deadly. It is spread through the bite of a tick.

The ticks are most common in North, Central, and South America.


Causes    TOP

RMSF is caused by a specific bacteria. An infected tick can spread it through a bite.


Risk Factors    TOP

Factors that increase your chance of RMSF include:

  • Being outdoors in areas known to have RMSF especially from April to September
  • Exposure to tick-infested areas such as long grass, weeds, or low brush
  • Exposure to dogs
  • Not using preventive steps like bug spray or appropriate clothes

Symptoms    TOP

The first symptoms of RMSF often occur within 2 to 14 days after a tick bite. Symptoms may include:

  • Fever
  • Headache
  • Rash—begins as small, flat pink spots on wrists and ankles
  • Nausea and vomiting
  • Abdominal pain
  • Muscle or joint pain
  • Lack of appetite
  • Red eyes
  • Light hurting the eyes
  • Fatigue
  • Altered mental status
  • Severe bleeding
  • Difficulty breathing

If left untreated, RMSF can cause severe problems. Other symptoms will depend on which organs are involved.

See your doctor if you have a fever after:

  • Tick bite
  • Being in an area likely to have ticks

Immune System Including Spleen and Lymph Nodes

Immune system

Copyright © Nucleus Medical Media, Inc.


Diagnosis    TOP

You will be asked about your symptoms and health history. A physical exam will be done. RMSF can be hard to diagnose. There are many conditions that cause similar symptoms. You may also be unaware of a tick bite. The rash may not be present yet.

The doctor may suspect RMSF based on your symptoms. A blood test may be done. They will help to find more signs of this infection.

A spinal tap may be done to look for infection around the brain.


Treatment    TOP

Early treatment is important. Treatment may be started before all your tests come back.

RMSF is treated with antibiotics. Doxycycline is first choice. Make sure to take all of the medicine as advised.


Prevention    TOP

Tick bites can cause a number of infections. If you are in an area that may have ticks:

  • Wear light-colored clothing. You will be better able to see ticks.
  • Tuck pant legs inside socks. This will stop ticks from crawling up under your pants.
  • Use insect repellents with DEET. Apply to exposed skin. Permethrin can be put on clothing.
    • DEET should be avoided or used sparingly for small children. Follow the directions on the label.
  • Carefully check your entire body for ticks after returning from outdoor areas.
  • Treat your pets for ticks. Check pets for ticks after being outdoors.

Centers for Disease Control and Prevention

Family Doctor—American Academy of Family Physicians


Public Health Agency of Canada

The College of Family Physicians of Canada


Rocky Mountain spotted fever. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T116078/Rocky-Mountain-spotted-fever . Updated June 4, 2015. Accessed February 15, 2018.

Rocky Mountain spotted fever (RMSF). Centers for Disease Control and Prevention website. Available at:
...(Click grey area to select URL)
Updated December 9, 2016. Accessed February 15, 2018.

Last reviewed March 2018 by EBSCO Medical Review Board David L. Horn, MD, FACP
Last Updated: 8/23/2018

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