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What is the cause of the spots associated with Rocky Mountain Spotted Fever?

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What is the cause of the spots associated with Rocky Mountain Spotted Fever?

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Rocky Mountain Spotted Fever begins as small, flat, pink, non-itchy spots (macules) on the wrists, forearms, and ankles. These spots turn pale when pressure is applied and eventually become raised on the skin. It eventually becomes a rash of red spotsbon the palms or soles and is present in at least half of those who get it.

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