Infect Chemother.  2020 Sep;52(3):403-406. 10.3947/ic.2020.52.3.403.

Erythematous Patch in Tsutsugamushi Disease – An Atypical Form of Eschar

Affiliations
  • 1Department of Internal Medicine, Seogwipo Medical Center, Seogwipo, Korea
  • 2Department of Microbiology, Inha University, Incheon, Korea

Abstract

Tsutsugamushi disease is caused by the bacterium, Orientia tsutsugamushi and transmitted by chigger mites. In addition to the typical dark eschar, various forms of the eschar, including papules and vesicles, develop at chigger bite sites. Macular lesions were reported only in a human inoculation study; the inoculation lesions relapsed as erythematous macules or erythema-based papules concomitant with fever relapse. Herein, we report an erythematous patch as an inoculation lesion in two patients with tsutsugamushi disease, which, additionally, displayed a central small circle of 1 mm in diameter, possibly a chigger bite site, and desquamation around the circle during doxycycline therapy.

Keyword

Erythema; Eschar; Orientia tsutsugamushi; Scrub typhus; Tsutsugamushi disease
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