Q. A 9-year-old girl was brought to the pediatric emergency department by her parents yesterday with a high fever and a rash on her arms and legs. According to her parents, she had been complaining of a headache and feeling unwell for the past four days. The rash had started on the third day of her illness and spread to her trunk and face. On admission, the patient was febrile with a temperature of 102.5 degrees Fahrenheit and appeared lethargic. She had a diffuse maculopapular rash on her arms, legs, and trunk (see image), as well as petechiae on her palms and soles. She had no other significant findings on examination, including no evidence of meningismus or focal neurological deficits. You order blood tests, which reveal thrombocytopenia and elevated liver enzymes. Given her clinical presentation and a history of recent outdoor activities, including hiking and camping, you suspect a diagnosis of Rocky Mountain spotted fever. Which of the following statements is FALSE concerning this diagnosis?