eruption appears on the wrists, ankles or back, extending rapidly to the trunk, scalp, hands, and feet. At first it consists of minute rose-coloured spots; these soon assume a petechial character and, spreading, tend to become confluent, especially on the more dependent parts of the body and limbs. In other instances the spots remain discrete, brownish or purplish in colour, giving to the surface of the body
Fig. 65.—Dermacentor venustus, ♀. (By courtesy of Prof. Nuttall.)
a speckled appearance. A certain amount of icteric tinting of skin and scleræ is also present. During the third week desquamation sets in, the eruption fading as fever subsides. In some cases the skin of the elbows, fingers, toes, lobes of the ears, etc., becomes gangrenous.
Constipation is usual. The liver is slightly enlarged, the spleen markedly enlarged and tender. The scanty, high-coloured urine may contain albumin and casts. Early, in all severe cases, there is œdema of the face and limbs. Nausea and vomiting set in
