Transovarial transmission of rickettsiae occurs in various ticks. After an incubation period of 5 to 7 days, fever, malaise, headache, and conjunctival injection develop. Usually the regional or satellite lymph nodes are enlarged. On about the 4th day of fever, a red maculopapular rash appears on the forearms and extends to most of the body, including the palms and soles. Fever lasts into the 2nd wk.
Complications are rare, and death is rare except among aged or debilitated patients.
For diagnosis and treatment, see Differential Diagnosis and Treatment of Rickettsial Diseases, above. All rights reserved.