Your Health

Rocky Mountain Spotted Fever

(RMSF)

Definition

Rocky Mountain spotted fever (RMSF) is a severe infectious disease that affects your blood vessels. It is potentially fatal.
Ticks in North, Central, and South America spread the disease.

Causes

Specific bacteria cause RMSF. The American dog tick and the Rocky Mountain wood tick carry these bacteria. It passes to humans when an infected tick bites the skin. The bacteria can then pass into the bloodstream.
The bacteria sit in the lining of small blood vessels and multiply. The growth of the bacteria causes irritation and swelling in the blood vessels. Blood and other fluids can then leak out of the blood vessels into the surrounding tissue.

Risk Factors

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 preventative steps (listed below)

Symptoms

The first symptoms of RMSF often occur within 2-14 days after a tick bite and may include:
  • Fever
  • Headache
  • Rash
  • Nausea and vomiting
  • Abdominal pain
  • Muscle or joint pain
  • Lack of appetite
  • Red eyes
  • Light hurting the eyes
  • Lethargy or altered mental status
  • Severe bleeding
  • Difficulty breathing
Most but not all people with RMSF develop a rash. The rash begins as small, flat pink spots but can later progress to red-purple spots. The rash most often starts on the wrists, forearms and ankles.
If left untreated, RMSF can cause severe problems to organs or skin near the leaky blood vessels. Symptoms will depend on what organs are involved.
Immune System Including Spleen and Lymph Nodes
Immune system
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Diagnosis

The doctor will ask about your symptoms and medical history. A physical exam will be done. RMSF can be difficult to diagnose because the symptoms are similar to many other diseases and the rash may not be there at first. Many people do not realize they have been bitten by a tick, which can also make the diagnosis more difficult.
A blood test may be done to confirm the diagnosis if your doctor suspects RMSF. Other tests, like a complete blood count and electrolytes, may be done to evaluate the severity of the disease. A spinal tap may be done to look for infection in the spinal fluid.

Treatment

Treatment may be started before a clear diagnosis is made based on your risk and fever.
RMSF is treated with antibiotics. Doxycycline is the drug of choice, but others may be chosen if necessary. It is important to start this treatment early. Make sure to take all of your medication as recommended. Do not stop taking the medication once you feel better, unless your doctor says it is safe to do so.

Prevention

The best way to prevent RMSF is to limit your exposure to ticks. If you live in an area that is prone to ticks, take the following precautions:
  • Wear light-colored clothing. This makes ticks are more visible.
  • Tuck pant legs inside socks. This stops ticks from crawling up under your pants.
  • Apply insect repellents containing DEET (applied to exposed skin). Apply permethrin to clothing.
    • For young children, DEET should be avoided or used sparingly. Carefully follow the directions on the label.
  • Carefully check your entire body for ticks after returning from outdoor areas.
  • Check pets for ticks.

RESOURCES

Centers for Disease Control and Prevention http://www.cdc.gov

National Library of Medicine http://www.nlm.nih.gov

CANADIAN RESOURCES

Canadian Family Physician http://www.cfpc.ca

Public Health Agency of Canada http://www.phac-aspc.gc.ca

References

Rocky Mountain spotted fever. Centers for Disease Control and Prevention (CDC) website. Available at: http://www.cdc.gov/rmsf/symptoms/index.html#considerations. Updated April 30, 2012. Accessed May 21, 2013.

Rocky mountain spotted fever. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated April 10, 2013. Accessed May 21, 2013.

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