Rocky Mountain spotted fever (RMSF) is the most severe rickettsial disease of man in North America and is generally considered to be a seasonal disease. The overwhelming majority of cases occur between the months of April and October. This mostly warm-weather period also happens to be the time of maximum activity of the ixodid ticks that serve as both reservoir and vector for the disease. We report a case of RMSF during a prolonged cold winter period in February 1981 in North Carolina. This case is interesting not only because of its temporal occurrence but also because the etiologic agent was isolated and there was no tick bite history associated with it.
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