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What’s the difference between Rocky Mountain spotted fever & Lyme’s dx? The are 3 main differences: the bacteria from the tick bites, some specific signs/symptoms, & the rash with both conditions. Lyme’s disease comes from borrelia burgdorferi. RMSF comes from the bacteria rickettsia. Some of the signs/symptoms of Lyme disease & RMSF are similar. Rocky Mountain spotted fever displays abdominal pain, nausea, & vomiting. These symptoms are not typically seen with Lyme’s disease. The rash with RMSF
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