Rocky Mountain Spotted Fever (RMSF)

Clinical Information for Patients

Signs and Symptoms

RMSF symptoms often start with headache and fever, but no case is the same. A tick bite is usually painless and some people who have RMSF do not remember being bitten.

The following is a list of symptoms seen with RMSF; however, it is important to note that most people do not have all of these symptoms:

  • Fever
  • Rash (occurs 2-5 days after fever, may be absent in some cases)
  • Headache
  • Nausea
  • Vomiting
  • Abdominal pain
  • Muscle pain
  • Lack of appetite
  • Upper respiratory symptoms


  • 6 out of 10 people will have a rash
  • Rash is uncommon in Arizona cases
  • Rash develops late in disease process

Long-term Health Problems

RMSF can cause long term health problems in some people depending upon how serious the disease and how soon after symptoms the antibiotics are taken.

Physician Diagnosis and Testing

It is difficult to tell if a patient has RMSF. A doctor must determine whether you have RMSF based off of your sign and symptoms. It is important to remember that a doctor should give treatment even if the first test does not show RMSF.

If the doctor suspects RMSF, two blood samples must be taken:

  • During the patients first visit where RMSF is suspected
  • 2-4 weeks later to confirm illness and the patient has RMSF.

It is important to remember to follow-up with your doctor for your 2nd blood sample, even if you are feeling better.


Doxycycline, an antibiotic, is the recommended treatment for RMSF. It should be given immediately if RMSF is suspected.

  • Take all of the prescribed antibiotics, even if you feel better
  • Use of other antibiotics doesn’t work to cure RMSF and the patient has a higher risk of a death
  • Treatment is more likely to work if the medicine is given in the first 5 days of symptoms
  • Treatment should be given based on signs and symptoms alone

If the patient is treated within the first 5 days of the disease, fever generally subsides within 24-72 hours. It is important to remember that patients should take all of their medicine even if they start to feel better.

  • Treating Children
    Doxycycline is the recommended treatment for children with suspected RMSF cases as recommended by both CDC and the AAP Committee on Infectious Diseases.
  • Other Treatments
    Use of antibiotics other than doxycycline is not recommended.


Antibiotic treatment following a tick bite is not recommended to prevent RMSF. There is no evidence this practice is effective, and may simply delay onset of disease.

If you have experienced a tick bite, the preventative action is to be alert for symptoms that may suggest RMSF. If fever for two or more days, or other symptoms occur, consult a physician as soon as possible.