What is the cerebrospinal fluid (CSF) profile in Rocky Mountain Spotted Fever (RMSF)?

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Last updated: February 7, 2025View editorial policy

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From the Guidelines

The cerebrospinal fluid (CSF) profile in Rocky Mountain Spotted Fever (RMSF) is typically characterized by a pleocytosis with a lymphocytic or neutrophilic predominance, with a cell count usually less than 100 cells/μL.

Key Features of CSF Profile in RMSF

  • Cell count: usually less than 100 cells/μL, with either a lymphocytic or neutrophilic predominance 1
  • Protein levels: moderately elevated, typically in the range of 100-200 mg/dL 1
  • Glucose levels: usually within the normal range 1 It is essential to distinguish RMSF from other infections, such as meningococcal meningitis, which can present with similar symptoms 1. However, the CSF profile in RMSF is generally distinct from that of meningococcal meningitis, which often features a neutrophilic pleocytosis, very low glucose levels, and gram-negative diplococci on Gram stain 1.

From the Research

Cerebrospinal Fluid (CSF) Profile in Rocky Mountain Spotted Fever (RMSF)

  • The CSF profile in RMSF may include:
    • Neutrophilic pleocytosis 2
    • Elevated protein 2, 3
    • Lymphocytic pleocytosis 4
    • Hypoglycorrhachia in some cases 3
  • These findings are consistent with meningoencephalitis, a known complication of RMSF 3
  • The presence of these CSF abnormalities can support the diagnosis of RMSF, particularly in patients with compatible clinical and epidemiological features 5, 6
  • It is essential to consider RMSF in the differential diagnosis of patients with fever, headache, and exposure to ticks, even in the absence of a rash 5, 6

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Meningoencephalitis due to Spotted Fever Rickettsioses, Including Rocky Mountain Spotted Fever.

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2020

Research

Rocky Mountain Spotted Fever as a cause of macular star figure.

Journal of neuro-ophthalmology : the official journal of the North American Neuro-Ophthalmology Society, 2003

Research

What's new in Rocky Mountain spotted fever?

Infectious disease clinics of North America, 2008

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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