@article{oai:jichi-ir.repo.nii.ac.jp:00000019,
 author = {Yamamoto, Yu and Kuroki, Shigehiro and Kajii, Eiji},
 journal = {自治医科大学紀要, Jichi Medical University Journal},
 month = {Mar},
 note = {We report the case of an 80-year-old man with tsutsugamushi disease who did not develop a typical eschar, but had a past history of cat bite and signs and symptoms mimicking disseminated Bartonella infection. He was hospitalized for fever, malaise, and skin rash after being bitten by a stray cat 2 weeks prior to admission. Initially, the patient was clinically diagnosed with severe Bartonella infection and treated with azithromycin, but he only defervesced the following day. Because of the presence of a maculopapular rash, elevated liver enzymes, and a partial response to azithromycin, a diagnosis of tsutsugamushi disease was considered, although no eschar was found after repeated meticulous physical examinations.
Tsutsugamushi disease was confirmed by serological testing, and the patient was successfully treated with minocycline. This disease should be considered in endemic areas when a patient presents with fever and diffuse skin rash, even in the absence of a typical eschar on physical examination.},
 pages = {103--108},
 title = {A case report of tsutsugamushi disease mimicking disseminated Bartonella infection},
 volume = {34},
 year = {2012}
}