We report herein on the case of a 54-year-old Japanese male diagnosed as having Rickettsia disease based on the detection of Rickettsia japonica in the blood crust from the biopsy scar of an eschar. In late September 2016, the patient suffered from a 39℃ fever and visited a hospital. He had an eschar on the right abdomen and a rash present over the whole body. Blood tests showed thrombocytopenia, severe inflammation,and mild liver dysfunction. A real-time PCR procedure detected Rickettsia japonica DNA in the blood crust from the biopsy scar of the eschar, suggesting Japanese spotted fever. He recovered well from the disease with the administration of minocycline and ciprofloxacin. The PCR detection of R. japonica DNA in the blood crust from a biopsy scar of an eschar can be a sensitive method for the early diagnosis of Rickettsia disease.
