A 20 year old college female recently returned from spring break after hiking in the Virginia woods approximately two weeks prior to her presentation to the E.D. One day prior to presentation, she developed fever, chills, and anorexia. In the emergency department, she complains of headache, photophobia, and myalgias. On exam, one notices a disseminated, non-blanching, papular rash. Which of the following statements regarding this condition is FALSE?
A. A skin biopsy shows a necrotizing vasculitis.
B. Characteristically the rash begins on the trunk and spreads to the extremities.
C. If untreated, fatality rates range between 25-50%; however, treatment reduces the rate to 10%.
D. It is caused by the tick borne parasite Rickettsia rickettsii.
E. 95% of patients develop symptoms between the period of April 1 and September 30.