A 60-year-old man presented with fever that developed 1 day before admission. The patient had recently returned from collecting acorns in the mountains 8 days before admission. Physical examination revealed a 0.5 × 0.5-cm eschar on the right chest wall. Indirect immunofluorescent antibody testing revealed an Orientia tsutsugamushi antibody titer of 1:2,560. The appearance of eschar was evaluate...

We report here on the case of a child who was infected with scrub typhus, and we made the diagnosis according to the serology and by performing PCRs on the child's eschar. The patient was treated with azithromycin, and he did not experience any complications. Performing nested PCR on the eschar might be both a rapid diagnostic test for scrub typhus in the early acute stage and a differential te...

We report on a 20-year-old female high-school student with fulminant meningococcal sepsis presenting as severe skin necrosis in lower extremities. The wound surface affected 2% of her total body surface area and was covered with black eschar. The adipose tissue beneath the eschar was degenerated and turned to necrosis as to deep fascia and periosteum of lower tibia. Excision of necrotic eschar,...

Recent reports have suggested that very early excision (less than 24 hours post-burn) and primary closure of burn wounds might circumvent the immunosuppression which follows severe thermal trauma. The total body surface are (TBSA) involved in burn injuries of human subjects at risk for significant post-burn immunosuppression is large enough to require grafting. In the present study cell-mediate...

bottle under his left foot. He woke up one morning and noticed burns on the lateral aspect of the foot. He did not seek any medical help and chose to dress the burn himself. After 2 weeks he noticed a foul smelling discharge from the wound and went to the Accident and Emergency (A&E) department. He was subsequently referred to our hospital department of plastic surgery. On examination he had a ...

BACKGROUND Scrub typhus is a rickettsiosis which is caused by Orientia tsutsugamushi and occurs throughout the Asia-Pacific region. Molecular diagnosis of rickettsioses using eschar swabs has recently emerged, and may be very useful for the diagnosis of these diseases in tropical settings. METHODOLOGY/PRINCIPAL FINDINGS Quantitative polymerase chain reaction (qPCR) was used to detect O. tsuts...

INTRODUCTION In 25 to 35% of cases, the aetiological agent of scalp eschar and neck lymphadenopathy after a tick bite remains undetermined. To date, Rickettsia slovaca, Rickettsia raoultii and more recently Bartonella henselae have been associated with this syndrome. CASE PRESENTATION A four-year-old Caucasian boy was admitted to hospital with fever, vomiting and abdominal pain. On physical e...

Scrub typhus, also called tsutsugamushi disease in Japan, is one of the most common rickettsial diseases in this country. Fever, skin rash, eschar and elevated hepatic enzymes are main clinical features of scrub typhus. We present the case of a 55 year-old woman contracted with this infection without skin eruption and abnormal liver function. The finding of an unusual eschar helped us to make a...