The Third Case of Japanese Spotted Fever on Tokunoshima Island in Kagoshima Prefecture Cured with Tetracycline Alone and Epidemiological Investigation

A 49-year-old man was admitted to a local hospital on Tokunoshima Island in Kagoshima prefecture, Ja-pan, after he experienced high fever and general fatigue for several days. A physical examination on admis-sion revealed his temperature to be over 39.5℃, an eschar on the left thigh, and generalized skin erythema. Laboratory examination revealed thrombocytopenia, liver dysfunction, and raised levels of C-reactive pro-tein. He was suspected to have Spotted Fever and recovered with the help of immediate treatment with mi-nocycline alone. He was finally diagnosed as having Japanese Spotted Fever, which was confirmed based on antibodies positive for Rickettsia japonica detected with an immunofluorescence test using paired sera and DNA determination specific to R. japonica extracted from the eschar using PCR. Since Japanese Spotted Fever can be life-threatening if diagnosis and appropriate treatment are delayed, it should always be consid-ered as a differential diagnosis for patients presenting with high fever and eruptions. 〔J.J.A. D. 92：547〜551,