Although many people become ill within the first week after infection, signs and symptoms may not appear for up to 14 days. Initial signs and symptoms of Rocky Mountain spotted fever often are nonspecific and can mimic those of other illnesses:
- High fever
- Severe headache
- Muscle aches
- Nausea and vomiting
- Restlessness and insomnia
Rash is distinctive
The red, nonitchy rash associated with Rocky Mountain spotted fever typically appears a few days after the initial signs and symptoms begin. The rash usually makes its first appearance on your wrists and ankles, and can spread in both directions — down into the palms of your hands and the soles of your feet, and up your arms and legs to your torso.
A few people who are infected with Rocky Mountain spotted fever don't ever develop a rash, which makes diagnosis much more difficult.
When to see a doctor
See your doctor if you develop a rash or become sick after a tick bite. Rocky Mountain spotted fever and other infectious diseases carried by ticks can progress rapidly and may be life-threatening. If possible, take the tick along with you to your doctor's office for laboratory testing.