The evaluation of boutonneuse fever begins with a medical history and physical examination.

Physical findings in someone with boutonneuse fever includes:

• A history of a tick bite
• Confusion
• High fever
• Jaundice
• Eschar at tick bite Eschar at tick bite
• Rash
• Pneumonia

Tests that may be used to evaluate boutonneuse fever include:

• Electrolytes
• Serum calcium level
• Pulse oximetry
• Liver profile
• Blood serology tests are used to confirm this diagnosis.
• MRI of the brain
• May show changes if the central nervous system is involved