RICKETTSIALPOX
RICKETTSIALPOX ICD-10: A79.1
• Epidemiology. R. akari. Vector: Mice mite (Liponyssoides sanguineus), other mites; transovarian transmission. Geography: United States, Europe, Russia, South Africa, Korea, and Europe.
CLINICAL MANIFESTATION
Tâche noire (Fig. 25-53). At tick bite site. EXANTHEM 2 to 6 days after the onset of nonspecific symptoms, red macules and papules appear. May evolve to characteristic vesicles (pox); crusted erosions occur. Lesions usually heal without scarring.
COURSE
Fever resolves in 6 to 10 days without treatment with doxycycline.
DIFFERENTIAL DIAGNOSIS
Viral exanthems, varicella, and pityriasis lichenoides et varioliformis acuta.
FIGURE 25-53 • Rickettsialpox: Tâche noire A crusted, ulcerated papule (eschar) with a red halo resembling a cigarette burn at the site of a tick bite.