<unk>  fever can be very difficult to diagnose in its early stages, due to the similarity of symptoms with many different diseases. People infected with R. rickettsii usually notice symptoms following an incubation period of one to two weeks after a tick bite. The early clinical presentation of<unk>  is nonspecific and may resemble a variety of other infectious and noninfectious diseases. Initial symptoms: * Fever * Nausea * Emesis (vomiting) * Severe headache * Muscle pain * Malaise Later signs and symptoms: * Maculopapular rash * Petechial rash * Abdominal pain * Joint pain * Conjunctivitis * Forgetfulness The classic triad of findings for this disease are fever, rash, and history of tick bite. However, this combination is often not identified when patients initially present for care. The rash has a centripetal, or "inward" pattern of spread, meaning it begins at the extremities and courses towards the trunk. Rash The rash first appears two to five days after the onset of fever, and it is often quite subtle. Younger patients usually develop the rash earlier than older patients. Most often the rash begins as small, flat, pink, nonitchy spots (macules) on the wrists, forearms, and ankles. These spots turn pale when pressure is applied and eventually become raised on the skin. The characteristic red,<unk>  (petechial) rash of<unk>  is usually not seen until the sixth day or later after onset of symptoms, but this type of rash occurs in only 35 to 60% of patients with<unk> . The rash involves the palms or soles in as many as 80% of people. However, this distribution may not occur until later on in the course of the disease. As many as 15% of patients may never develop a rash. Complications People can develop permanent disabilities including "cognitive deficits, ataxia, hemiparesis, blindness, deafness, or amputation following gangrene".
Rocky Mountain spotted fever
Zika fever
Flinders Island spotted fever
American tick bite fever
Trench fever
Chikungunya
Japanese spotted fever
Dengue fever