Abstract
Multiple eschars including primary eschar (top right) on right leg 10 days after admission. Conclusion: Purpuric rash is previously described in rickettsia conorii infection in two immunodeficient patients. To our knowledge we are the first to present an ATBF case with multiple eschars on three limbs presenting more than 12 days after leaving the endemic area. The eschars seemed to develop metastatic rather than frommultiple tick bites. Awareness of late developing eschars in immunosuppressed patients may be important in order to alert physicians to initiate early treatment on clinical suspicion of rickettsial infection in patients with relevant exposure.
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