Case: A 65-year-old woman was admitted with fever and rash that had developed 3 days and 1 day before admission, respectively. On physical examination, an erosion 1.5 cm by 1.5 cm with a torn bulla was observed in the right axilla, and a generalized, nonpruritic, maculopapular rash was found over the whole body (Figure 1 and 2). Over time, the center of the eschar developed a black crust covering the ulcer, which was surrounded by an erythematous rim. On the fourth day, the rash became faint.
Indirect immunofluorescence assay revealed an Orientia tsutsugamushi. What is the likely diagnosis of this case? Source: Nejm *This case is from Docplexus Editorial Team for educative purposes only
