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 a tick in the Mediterranean (so keep you Mediterranean covered): Spain, France, Israel.


R. conorii.

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.


ICD9 Codes (Soon to be supplanted by ICD10)

Boutonneuse fever 082.1.