BACKGROUND Rickettsia conorii, the causative agent of the Mediterranean spotted fever, is transmitted to humans by the bite of infected ticks Rhipicephalus sanguineus. The skin thus constitutes an important barrier for the entry and propagation of R. conorii. Given this, analysis of the survival strategies used by the bacterium within infected skin is critical for our understanding of rickettsi...

this study was conducted to determine the causes and outcomes of burn in patients referred to shahid mohammadi hospital in bandar abbass, southern iran, in which 212 burned patients were assessed from march 2007 to march 2008 .mean age of patients was 22.14 yr. heat contact was the main cause of burn with 92.5%. 49.1% of total burns occurred among less than 20 yr old people. mortality rate was ...

Figure 1. Black and gangrenous eschar tissue in the right third digit previously amputated to the middle phalanx with distal gangrene and erythema around the right middle metacarpophalangeal joint.

Barwell JR, Davies CE, Deacon J, et al. Comparison of surgery and compression with compression alone in chronic venous ulceration (ESCHAR study): randomised controlled trial. Lancet 2004;363:1854–9. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...

An eschar is highly suggestive of scrub typhus in a case of fever. Multiple eschars are rare in scrub typhus. We present a picture of multiple eschars in scrub typhus.

60-year-oldmanpresentedwith a seven-day history of fever, eadache, fatigue, and decreased urine output. On examinaion, he was febrile (38 ◦C), and had tachycardia. A blackish kin lesion was noted on the right side of his neck (Fig. 1). scharwas not preceded by any pain or itching. His hemogram evealed a hemoglobin count of 11.8 gm/dL, total leukocyte ount of 6300/mm3, and a platelet count of 80...

To cite: Sundriyal D, Kumar N, Chandrasekharan A, et al. BMJ Case Rep Published online: [please include Day Month Year] doi:10.1136/ bcr-2013-010105 DESCRIPTION A 35-year-old woman, a farmer by occupation, resident of Uttranchal (a sub-Himalayan area) in India, presented in the emergency department with complaints of fever for 1 week and breathlessness for 2 days. Fever was high grade, intermit...

The typical clinical presentation of several spotted fever group Rickettsia infections includes eschars. Clinical diagnosis of the condition is usually made by analysis of blood samples. We describe a more sensitive, noninvasive means of obtaining a sample for diagnosis by using an eschar swab specimen from patients infected with Rickettsia parkeri.