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A pilgrim's progress: severe Rickettsia conorii infection complicated by gangrene

Puvesh Punj, Renjy Nelson, Sarah Gardiner, Michelle Lodge, Stephen R Graves and Morgyn S Warner
Med J Aust 2013; 198 (11): 629-631.
doi:
10.5694/mja13.10025

This challenging case of acute febrile illness and rapidly evolving petechial rash and digital gangrene in a traveller who returned from North India and highlights the need for a high index of suspicion for rickettsial infection in returned travellers.

Puvesh Punj, MB BS, Surgical Resident1
Renjy Nelson, MB BS, FRACP, Infectious Diseases Physician1
Sarah Gardiner, BM BS, Surgical Registrar1
Michelle Lodge, MB BS, FRACS, Plastic and Reconstructive Surgeon1
Stephen R Graves, FASM, FRCPA, PhD, Medical Director2
Morgyn S Warner, MD, FRACP, FRCPA, Clinical Microbiologist and Infectious Diseases Physician1,3
1 Queen Elizabeth Hospital, Adelaide, SA.
2 Australian Rickettsial Reference Laboratory, Geelong
3 SA Pathology, Adelaide, SA.
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