Overview
Introduction
A patient with fever, severe headache, and recent tick exposure may have Rocky Mountain spotted fever (RMSF) even when the skin is clear.
A patient with fever, severe headache, and recent tick exposure may have Rocky Mountain spotted fever (RMSF) even when the skin is clear. The infection can progress from a nonspecific febrile illness to shock or multiorgan failure because Rickettsia rickettsii damages the vascular endothelium throughout the body. For a patient in Canada, ask where and when the tick exposure occurred, including travel, camping, brush exposure, and contact with dogs. Do not let the disease name narrow the history to the Rocky Mountain region. The practical diagnostic question is whether the illness, exposure, examination, and laboratory pattern are compatible enough to justify immediate empiric doxycycline.