Rocky Mountain spotted fever can be difficult to diagnose because the early signs and symptoms are similar to those caused by many other diseases.

Laboratory tests can check a blood sample, rash specimen or the tick itself for evidence of the organism that causes the infection. Because early treatment with antibiotics is so important, doctors don't wait for these test results before starting treatment if Rocky Mountain fever is strongly suspected.


People who develop Rocky Mountain spotted fever are much more likely to avoid complications if treated within five days of developing symptoms. That's why your doctor will probably have you begin antibiotic therapy before receiving conclusive test results.

Doxycycline (Monodox, Vibramycin, others) is the most effective treatment for Rocky Mountain spotted fever, but it's not a good choice if you're pregnant. In that case, your doctor may prescribe chloramphenicol as an alternative.

Preparing for your appointment

You'll likely start by seeing your family doctor. In some cases, you might be referred to a doctor who specializes in infectious diseases.

What you can do

  • Be aware of any pre-appointment restrictions. At the time you make the appointment, be sure to ask if you need to do anything in advance.
  • Write down any symptoms you're experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.
  • Write down key personal information, including any recent life changes or travel.
  • Make a list of all medications, vitamins or supplements that you're taking.
  • Write down questions to ask your doctor.

Preparing a list of questions can help you make the most of your time with your doctor. For Rocky Mountain spotted fever, some basic questions to ask your doctor include:

  • What's the most likely cause of my symptoms?
  • Do I need any tests?
  • What treatments are available? Which do you recommend?
  • Do I need follow-up testing?
  • I have other health problems. How can I best manage these conditions together?

What to expect from your doctor

Your doctor may ask some of the following questions:

  • What are your symptoms, and when did they start?
  • Have you recently been bitten by a tick?
  • Do you spend a lot of time outdoors in grassy or wooded areas?
  • Have you recently removed any ticks from family pets?
  • Is anyone else in your family ill?
  • Have you traveled anywhere recently?
Oct. 06, 2020
  1. Bennett JE, et al., eds. Rickettsia rickettsii and other spotted fever group Rickettsiae (Rocky Mountain spotted fever and other spotted fevers). In: Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 8th ed. Philadelphia, Pa.: Saunders Elsevier; 2015. https://www.clinicalkey.com. Accessed June 8, 2017.
  2. Ferri FF. Rocky Mountain spotted fever. In: Ferri's Clinical Advisor 2017. Philadelphia, Pa.: Elsevier; 2017. https://www.clinicalkey.com. Accessed June 8, 2017.
  3. Sexton DJ. Clinical manifestations and diagnosis of Rocky Mountain spotted fever. https://www.uptodate.com/home. Accessed June 8, 2017.
  4. Kliegman RM, et al. Spotted Fever Group Rickettsioses. In: Nelson Textbook of Pediatrics. 20th ed. Philadelphia, Pa.: Elsevier; 2016. https://www.clinicalkey.com. Accessed June 8, 2017.
  5. CDC. Preventing ticks in the yard. https://www.cdc.gov/ticks/avoid/in_the_yard.html. Accessed June 8, 2017.
  6. Preventing tick bites. Centers for Disease Control and Prevention. https://www.cdc.gov/ticks/avoid/on_people.html. Accessed June 8, 2017.
  7. How to remove a tick. Centers for Disease Control and Prevention. https://www.cdc.gov/ticks/removing_a_tick.html. Accessed June 8, 2017.
  8. Steckelberg, JM (expert opinion). Mayo Clinic, Rochester, Minn. June 12, 2017.

Rocky Mountain spotted fever