Symptoms:

Symptoms usually develop about 2 to 14 days after the tick bite. They may include:

• Chills
• Fever
• Severe headache
• Muscle pain
• Mental confusion
• Rash -- usually starts a few days after the fever; first appears on wrists and ankles, then spreads to most of the body; some people do not get a rash

Additional symptoms that may be associated with this disease:

• Abnormal sensitivity to light
• Diarrhea
• Excessive thirst
• Hallucinations
• Loss of appetite
• Nausea
• Vomiting

Signs and tests:

Tests that may be done include:

• Antibody titer by complement fixation or immunofluorescence
• Kidney function tests
• Platelet count
• Partial thromboplastin time (PTT)
• Prothrombin time (PT)
• Red blood cell count
• Skin biopsy taken from the rash to check for R. rickettsii
• Urinalysis to check for blood in the urine and protein in the urine