Potomac Horse Fever (PHF) is a potentially-fatal febrile illness affecting horses caused by the intracellular bacterium Neorickettsia risticii. PHF is also known as Shasta River Crud and Equine Monocytic Ehrlichiosis. It was first described in areas surrounding the Potomac River northwest of Washington, D.C., in the 1980s, but cases have been described in many other parts of the United States, such as Minnesota, California, and Pennsylvania. Currently, it is found in more than 40 U.S. states and Canada.[1]