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Medical Author:

Charles Patrick Davis, MD, PhD

Charles Patrick Davis, MD, PhD

Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

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Medical Editor:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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Unfortunately, the early symptoms of RMSF are nonspecific, such as fever (usually greater than 102 F), nausea, vomiting, headache, muscle aches, and fatigue; these symptoms are frequently ignored or attributed to other causes. The rash, abdominal pain, joint pains, and diarrhea usually develop about two to 14 days after an infected tick bite. The rash usually begins on the wrists and ankles and spreads, but some individuals (about 10%-15%) do not develop it. Other symptoms that may occur are loss of appetite, hallucinations, photosensitivity, and excessive thirst.

Unless the patient realizes a tick bite has happened, the doctors may not realize the patient may have RMSF. Children that get infected tick bites may not communicate this important symptom to their parents or doctor; likewise, many adults do not remember getting a tick bite. The classic symptoms of RMSF are a tick bite followed by fever and a rash. If the patient does not exhibit all three symptoms, the diagnosis frequently either is not correct or is delayed. Severe symptoms of RMSF are thrombocytopenia (low blood platelets that can lead to internal bleeding), hyponatremia (low sodium), meningismus (a condition of neck stiffness, headache, and possible fever suggesting brain membrane irritation), confusion, blindness, or coma that can result in death.

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