Case #219 – January, 2008

Five hunters spent a weekend in a cabin in the Northeastern United States. One of the hunters, who slept in a sleeping bag on the floor of the cabin, awoke in the morning with a rash on various parts of his body (Figure A). Because the area was endemic for Lyme disease, public health officials wanted to search for the tick vector. Arthropods (Figures B and C) found under a rug in the cabin were collected and sent to the state public health laboratory for identification. What is your diagnosis? Based on what criteria?

These images were kindly contributed by Dr. Harold Harlan and the Armed Forces Pest Management Board.

Images presented in the DPDx case studies are from specimens submitted for diagnosis or archiving. On rare occasions, clinical histories given may be partly fictitious.

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