W. B. Wadlington, MD

The rash of tick tularemia is seen here on the arm of a 5-year-old boy. He also had a tick bite on his back that became necrotic and ulcerated. Within 2 weeks of his having been bitten, axillary lymph nodes developed.

The rash of tick tularemia is seen here on the arm of a5-year-old boy. He also had a tick bite on his back that becamenecrotic and ulcerated. His axillary lymph nodesbecame palpable within 2 weeks after the tick bite.

Rickettsia rickettsii is transmitted tohumans by a tick bite. This boy hadbeen camping a short time beforea fever and the classic rash of RockyMountain spotted fever developed.The erythematous macular rashfirst appears on wrists and anklesand spreads to the trunk. Note thepuffy appearance of the skin resultingfrom vasculitis.