Medicina Interna: Acesso Aberto
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Rash after Holiday in South Africa

Matthias Grade, Christopher McAulay and Jan Bronnert

Despite of initial negative serology in a typical clinical post travelling disease, serology has to be repeated confirming the suspected diagnose. In the globalized world of today people travelling to far places even only for a short period, coming home first to their family doctors, presenting their concerns. Being aware of systemically diffuse problems in combination of a traveler’s history should not be longer a matter of infectious disease specialists only. It is important becoming familiar with pathognomonic clinical impressions. The tick -bite -fever stands substitutionally for a systemically acting bacterial infection causing a typical skin sensation the so-called Eschar or Tache noir. Due to the fact of the mortality between 3-4 %, this case shows the pitfall of a false negative serological result if serology is taken to early and shell indicate the gap between clinical sign, serological proof and clinical relevance.