October 13, 2014 - Eminent Dangers

I frequently see patients in my office with vague symptoms of fever, rash, fatigue, headache, and a general sense of ill being.


Often this is a simple viral illness that will pass in a day or two, but sometimes – it’s not.

In Alabama, a number of possibilities must be considered when such symptoms develop, but two of the most dangerous are Rocky Mountain spotted fever and Lyme disease.

RMSF, although thought to be common only in the Rocky Mountains, as its name would imply, is quite prevalent in Alabama and anywhere ticks are found.

Most of us believe that if we had a tick bite we’d remember it. Unfortunately, deer ticks are the culprits for both RMSF and Lyme disease, and they are tiny compared to what we commonly refer to as dog ticks. You may be bitten by a deer tick and not realize it since they can be showered off or inadvertently brushed loose without your knowledge.

The hallmarks of RMSF are:

  • Fever
  • Rash (occurs 2-5 days after fever, but may be absent in some cases)
  • Headache
  • Nausea
  • Vomiting
  • Abdominal pain (may mimic appendicitis or other causes of abdominal pain)
  • Muscle pain
  • Lack of appetite
  • Conjunctival inflammation (red eyes)

Lyme disease is different from RMSF in the manner in which it presents. In Lyme disease a small, red bump may appear at the site of the tick bite, which over the next few days develops reddish inflammation, expands, and forms a bull’seye pattern. This appearance is one of the hallmarks of Lyme disease. Some people develop the bulls eye pattern at more than one location on their bodies.

Symptoms of Lyme disease include:

  • Fever
  • Chills
  • Fatigue
  • Body aches
  • Headache
  • Rash in a bulls eye pattern

In addition to RMSF and Lyme disease, a new threat to the southeast is a condition called Acute Neurologic Illness (ANI).

Anyone 21 years of age or younger with sudden onset of focal limb weakness occurring after August 1st, 2014 is suspect. Diagnosis of this condition requires a physical examination and MRI.

Possible causes are West Nile Virus, an uncharacteristic form of Guillain-Barré Syndrome, enteroviruses (such as EV-D68), Herpes Virus (similar to the one responsible for Shingles), and adenoviruses.

ANI, Lyme disease and RMSF are completely different illnesses that happen to be prevalent in the community at the same time. ANI is virus borne, where RMSF and Lyme disease are due to a bacterial infection transmitted by tick bites. ANI requires early hospitalization – RMSF and Lyme disease are treated with oral antibiotics, usually without the need for hospitalization.

If you sustain a fever and unexplained rash, seek medical attention.

A sore that develops an inflammatory halo and cleared space should be checked out early on.

If you have a single extremity weakness that started after August 1st, 2014, do not delay in having your doctor evaluate your condition.

All of these infections are serious and should be thoroughly evaluated by your physician. They are curable if caught in time, but are often fatal if ignored.