| CASE REPORT |
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| Year : 2022 | Volume
: 26
| Issue : 2 | Page : 86-88 |
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Spotted fever rickettsioses should be considered in the differential diagnosis of “Fever with Purpuric Rash” in Saudi Arabia: A Case report
Ahmed H Nassar1, Abdullah S Abu-Aliat2, Salim Jamil3, Mohammed S Alshahrani2, Soha A Hawwam4, Esmat R Eid2
1 Department of Dermatology and Venereology, Tanta University, Tanta, Egypt; Department of Dermatology, The Armed Forces Hospitals-Southern Region, Khamis Mushait, Saudi Arabia
2 Department of Dermatology, The Armed Forces Hospitals-Southern Region, Khamis Mushait, Saudi Arabia
3 Department of Pathology, The Armed Forces Hospitals-Southern Region, Khamis Mushait, Saudi Arabia
4 Department of Dermatology and Venereology, Tanta University, Tanta, Egypt
Correspondence Address:
Dr. Soha A Hawwam
Department of Dermatology and Venereology, Faculty of Medicine, Tanta University Hospitals, El Geish Street, Tanta 31111
Egypt
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/jdds.jdds_99_20
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There is a paucity of literature about human spotted fever rickettsioses (SFR) from the Arab Gulf Region, including Saudi Arabia. Here, we present an elderly Saudi man who had fever, headache, purpuric maculopapular skin rash, and an eschar. Together, the clinical findings, the serologic positivity, the presence of a vector tick in addition to the histopathologic changes, and the dramatic clinical response to oral doxycycline confirmed the diagnosis of SFR. This may be the first case of SFR reported to the health-care authorities in Saudi Arabia. We recommend considering SFR in the differential diagnosis of “fever with purpuric rash” in Saudi Arabia. Ideally, treatment with a tetracycline antibiotic should be considered for patients with fever and headache even before a purpuric rash develops.
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