Rocky Mountain Spotted Fever
- fever, headache, myalgias and purpura
- resides in or has traveled to an endemic area (eg, Oklahoma, North and
South Carolina, Tennessee).
- The rash begins on the second or third day of illness as
erythematous
blanching macules
that involve the wrists, ankles, palms, or soles. It then becomes
petechial or purpuric and spreads
centrally.
- Although thrombocytopenia is observed commonly in patients who have RMSF,
the white blood cell count is normal or depressed during the first 4 to 5 days
of illness.