History and clinical findings: A 61-year-old female patient presented with multiple tick bites. Some of them turned into skin ulcera. The patient acquired the tick bites during a stay in South Africa for several weeks. EXAMINATIONS AND DIAGNOSIS: According to the history and typical skin manifestations, a tick borne infection (rickettsiosis) was diagnosed and serologically confirmed.
Treatment and clinical course: The empiric treatment with doxycycline resulted in a fast regression of the skin ulcera.
Conclusion: Rickettsial infections can be diagnosed in the presence of typical skin manifestations (eschar andor centripedal exanthema) and after an appropriate history of travel. In such cases, empiric treatment with tetracyclines can be performed.
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