Family Nurse Practitioner Exam

What symptom is primarily associated with typical presentations of Rocky Mountain spotted fever?

1. Desquamating rash

2. Slapped cheek rash

3. Rash on the wrists and ankles

4. Crusty lesions

The correct answer is: Rash on the wrists and ankles

The symptom primarily associated with typical presentations of Rocky Mountain spotted fever is a rash on the wrists and ankles. This disease, caused by the Rickettsia rickettsii bacterium and transmitted by tick bites, often presents with a characteristic rash that typically begins on the wrists and ankles and can spread to other parts of the body. The initial phase of the illness usually includes symptoms such as fever, headache, and myalgia, which can lead to the development of the distinctive rash. The rash often becomes petechial, meaning it presents as small, red or purple spots due to bleeding underneath the skin. This rash is critical for diagnosis and usually emerges within a few days after the onset of fever. In contrast, desquamating rashes are more commonly associated with other conditions, such as Kawasaki disease or toxic shock syndrome. A slapped cheek rash is primarily seen in conditions like parvovirus B19 infection, typically in children. Crusty lesions might suggest a variety of skin infections or conditions, such as impetigo, but do not pertain specifically to Rocky Mountain spotted fever. Understanding these differentiations is essential for accurate diagnosis and management in clinical practice.