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Because there is no vaccine against, patients need education on prevention of tick bites. Prevention of tick bites requires careful attention to tick avoidance, including insect repellent, long clothing, and checking for ticks after outdoor activities.

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Doxycycline is the treatment of choice for RMSF. A 100mg dose twice daily is recommended for adults and 2.2mg/kg twice daily for children weighing under 100 lbs. Antibiotic treatment should be no shorter than five to seven days per CDC guidelines. The only alternative treatment is Chloramphenicol, which can be used in patients who do not tolerate doxycycline. Chloramphenicol should be administered at 12.5mg per kg of body weight.

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Currently, most cases of RMSF are diagnosed based on immunoglobulin M (IgM) and IgG serologic responses to Rickettsia rickettsii, along with a high degree of clinical suspicion. In clinical reviews of RMSF cases, about 5-10% of cases are fatal; however, the mortality rate is 20-30% without prompt antibiotic treatment. Following diagnosis treatment should start ASAP.

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Patients typically present with symptoms of RMSF four to ten days after exposure to the Rickettsia tick bite. Classic symptoms are fever, headache, and a rash, but also may include lymphadenopathy, central nervous system changes such as confusion or nuchal rigidity, myalgias and arthralgias, hepatitis, vomiting, and cardiovascular instability. The rash presents as small, pink, non-itchy spots with a diameter of 1-5 mm often begins around the wrists, forearms, and ankles, and may spread to the trunk of the body and soles of the feet.

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Rickettsia rickettsii is the causative agent of Rocky Mountain Spotted Fever (RMSF), an acute febrile tick-borne illness, that is both the most severe and the most common rickettsial infection. It affects both children and adult humans, most often children and teens younger than 15 years old.  The Rocky Mountain wood tick, the brown dog tick, and the American dog tick are the main transmitters of RMSF.

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Rickettsia rickettsii is a gram-negative, non-motile, coccobacillary, obligate intracellular organism that infects human hosts after a bite from an infected tick vector. It has ribosomes and a single circular chromosome located in an amorphous cytosol surrounded by a plasma membrane. It also has a microcapsular layer on the outer surface of the cell wall, and electron-lucent zone that represents a slime layer separates it from the host cytosol. Simply stated, it is a parasitic-like microorganism that grows and reproduces inside a host’s cells.