Spotted Fever Rickettsiosis

Infectious agent:  Rickettsia parkeri, Rickettsia philipii, Rickettsia akari

Description of illness: Symptoms include fever, chills, severe headache, malaise, myalgia, gastrointestinal symptoms (nausea, vomiting, diarrhea, anorexia, abdominal pain, diarrhea, abdominal tenderness) photophobia, focal neurologic deficits, including cranial or peripheral motor nerve paralysis or sudden transient deafness, maculopapular rash or petechial rash.  Few people will develop all symptoms and the number and combination of symptoms varies greatly from person to person.  Similar symptoms are seen with ehrlichiosis but they occur in different regions of the U.S. with anaplasmosis most frequently reported in the upper midwest and northeastern U.S. in areas that correspond with the known geographic distribution of Lyme disease.  Petechial rash is considered a sign of progression to severe disease. Every attempt should be made to begin treatment before petechiae develop.