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Image 12:
This man presented,on his return from Australia, with a fever and headache of 5 days duration, and a widespread papulovescicular rash for 3 days. He also had had a painless lesion on his temple of 10 days duration, appearing several days after he removed a tick from the site.
Diagnosis:
This is Queensland tick typhus, the forehead lesion an eschar. He had visited a vacation spot just north of Sydney, Australia in April 2000, and found a tick on his forehead the next day. He responded over 2 days to doxycycline. His typhus, spotted fever group, serology titer rose from 1:128 to 1:4096.
