PURPURA is a common manifestation of several infections including Rocky Mountain Spotted Fever (RMSF), meningococcemia, bacterial endocarditis, and sepsis, and may occur in rubella, varicella, measles, tuberculosis, infectious mononucleosis, and scarlet fever.1-3Although thrombocytopenia may occur in most of these, its occurrence in RMSF is not frequent4-6and we are aware of only one previous case report specifically calling attention to this association.7Recently a patient with documented RMSF was admitted to this hospital with severe thrombocytopenia, pursued a rapid downhill course, and died. It is the purpose of this paper to call attention to this rather unusual association. Case Report A 40-yr-old female developed fever and chills with malaise 9 days prior to admission to this hospital. Four days prior to admission she received a single intramuscular injection of penicillin, and because of a progressive downhill course, was admitted to another hospital. At that time a