infectious diseases
Other Spotted Fever Rickettsioses
Symptoms and Signs of Spotted Fever Rickettsioses
The symptoms and signs are similar for all spotted fever rickettsioses and generally milder than with RMSF. After an incubation period of 5 to 7 days, fever, malaise, headache, and conjunctival injection develop. With the onset of fever, a small buttonlike ulcer 2 to 5 mm in diameter with a black center appears (an eschar or, in boutonneuse fever, tache noire). Usually, the regional or satellite lymph nodes are enlarged. On about the fourth day of fever, a red maculopapular rash appears on the forearms and extends to most of the body, including the palms and soles. Fever lasts into the second week. Complications and death are rare except among older patients or patients who are debilitated. However, the disease should not be ignored; a fulminant form of vasculitis can occur. 