Rocky Mountain Spotted Fever and Ehrlichiosis Rashes

Rash of Rocky Mountain Spotted Fever

• The rash typically appears 2 - 4 days following the onset of fever

• The rash often starts on the wrists, forearms, and ankles and appears as small, flat, pink macules

• The rash spreads to the trunk, and on occasion to the palms and soles, and will become petechial

• The petechial appearance is typically not seen until day 6 or more following symptom onset and indicates the disease has progressed to a severe state

Rash of Ehrlichiosis

• Approximately one in three people with ehrlichiosis will have a rash

• The rash is more commonly seen in children than adults

• The rash usually develops five days after fever begins

• The rash can appear as non-specific erythematous macules or petechiae

References

Centers for Disease Control and Prevention. (2006). Rocky mountain spotted fever, early-stage rash and late-stage rash [Digital images]. https://phil.cdc.gov/



Centers for Disease Control and Prevention. (1962). Rocky mountain spotted fever - dorsal view of child's hand and wrist [Digital image]. https://phil.cdc.gov/



Pace, E. J., & O'Reilly, M. (2020). Tickborne diseases: Diagnosis and management. American Family Physician, 101(9), 530-540. https://www.aafp.org/afp/2020/0501/p530.html

These pathways do not establish a standard of care to be followed in every case. It is recognized that each case is different, and those individuals involved in providing health care are expected to use their judgment in determining what is in the best interests of the patient based on the circumstances existing at the time. It is impossible to anticipate all possible situations that may exist and to prepare a pathway for each. Accordingly, these pathways should guide care with the understanding that departures from them may be required at times.