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.
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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.
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
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