The patient presents with fever and a rash that started on hands and ankles, likely indicating which condition?

The symptoms presented—fever and a rash that specifically begins on the hands and ankles—are characteristic of Rocky Mountain spotted fever (RMSF). This condition is caused by the Rickettsia rickettsii bacteria and is transmitted through tick bites. The rash typically starts at extremities (like the wrists and ankles) and progresses centrally, which aligns with the presentation described in the question. The early signs of RMSF often include a sudden onset of fever, along with the distinctive rash that can become petechial and maculopapular.

In contrast, Kawasaki's disease primarily affects children and involves prolonged fever, conjunctival injection, and a rash that does not specifically start on the extremities. Meningococcemia would typically present with fever and a petechial or purpuric rash, but the rash does not specifically localize to the hands and ankles initially. Measles features spreading rashes that start on the face and trunk and can be accompanied by Koplik spots in the oral cavity, which are not mentioned in this scenario. Thus, the specific symptomatology of RMSF directly correlates with the details given.