Key Points
Rocky Mountain spotted fever (RMSF) is a potentially fatal tick-borne disease that requires awareness and vigilance to recognize and treat in a timely fashion.
Although concentrated in south-central US states, RMSF cases occur in most US states.
Classic findings such as rash, hyponatremia, and thrombocytopenia may not occur in all patients.
Doxycycline should be administered to all children with suspected RMSF without waiting for diagnostic testing.
RMSF is prevented by avoidance of tick bites and prompt identification and removal of ticks when found.
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