A black, 7.0 x 8.0-cm eschar
, consisting of the epidermis, dermis, periosteum, and compact cranial bone, was observed on the dorsal head and underlying tissue (Fig 1).
Our study showed a high proportion of eschars
among scrub typhus patients (53.4%), and presence of eschar
, a well-known clinical sign for scrub typhus (13), was 1 consideration used for defining suspect cases.
A prospective study was done at Khaja Banda Nawaz Institute of Medical Sciences, Gulbarga from June 2016 to May-2017, Suspected clinical feature samples like signs and symptoms of fever, chills, rash, eschar
, edema, PUO, lymphadenopathy, hepatospenomegaly and history of tick or flea exposure were included.
Table 1: Distribution of Eschars
(Present Study) Site of Eschar
Number of Percentage Patients (%) (n=72) (<12 years) Head & Neck 8 11.11 Axilla 24 33.33 Arms 3 4.17 Chest 6 8.33 Back 2 2.78 Abdomen 5 6.95 Groin 16 22.22 Thighs 6 8.33 Legs 2 2.78 Table 2: Comparison of Distribution of Eschars
Bahubali D Gane Study Present Study (2011-2015).
(2,4) A blood PCR detects R africae, (13) and if a rash or eschar
is present, a biopsy can confirm the diagnosis.
A history of tick bites, bite site eschars
, fever, maculopapular rashes, and painful regional lymphadenopathy will help to establish the correct diagnosis, especially in the absence of adequate molecular diagnostic laboratory services.
(29) In patients with more severe bites, eschar
may take months to develop and the skin may take several months more to heal.
Patients with JSF more frequently had rashes on the palms/soles, purpura, and small eschars
. Moreover, the following severe conditions occurred more frequently among patients with JSF than among those with ST: hypotension, low platelet counts, and increased creatinine levels.
Study was done with aim of describing the distribution of eschar
. Cases between June 2011 to May 2015 were included.
Of the 12 samples, 9 were positive ([greater than or equal to] 1:512 for IgM or [greater than or equal to] 1:256 for IgG) (Table), including samples from all 6 students who had eschars
. All samples from the 12 students were negative for Orientia DNA by using quantitative PCR.
African tick-bite fever: a new entity in the differential diagnosis of multiple eschars
During 2011-2014, we identified patients in hospitals throughout France, who had eschars
after tick bite.