Infectious Disease Compendium

Boutonneuse fever


One of the tick borne spotted fevers starts, with a black ulcer (tache noir for you Francophiles) and proceeds to fevers, chills, headache, myalgias and a rash.

Epidemiologic Risks

Bit by the dog tick in the Mediterranean (so keep your Mediterranean covered): Spain, France, Israel.


R. conorii. Diagnose with serology.

Empiric Therapy

Tetracycline / doxycycline (preferred) OR chloramphenicol. Quinolones maybe effective, but stick with a tetracycline.


These are endothelial infections, so it is an infectious vasculitis, hence the systemic and nonfocal findings. Intravascular clot, and the resultant complications, are not uncommon.


Last Update: 05/14/18.