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Case 169. Japanese spotted fever (38 y-o F)
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| Hemorrhagic skin spots on the trunk and extremities in a Tokushima resident presenting high fever and thrombocytopenia (biopsy from the leg) |
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Key words : Rickettsia japonica, Japanese spotted fever
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| The eschar (the site of mite bite) in Japanese spotted fever is smaller than in Tsutsugamushi disease (gross findings). Rickettsia japonica is transmitted by a larva of the tick Hamoaphysalis flava. | The skin rash is often hemorrhagic and predominantly seen on the extremities. The transmission occurs during the summer season. These make points of difference from Tsutsugamushi disease. | |
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| Histologic features of skin rash are nonspecific. Perivascular infiltration of small lymphocytes and some plasma cells is seen in the entire thickness of the dermis (HE, low power). | High powered view shows nonspecific lymphocytic infiltration around small vessels (HE). This emerging rickettsial disorder was discovered by Dr. Fumihiko Mahara in Tokushima in 1984. | |
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