title: Recurrent splinter haemorrhages weeks after a tick bite.
abstract: A 52-year-old man developed fever, headache, tinnitus, and painful joints. He reported a tick bite contracted during a summer holiday in the Netherlands, followed by erythema on his left arm three weeks earlier. Initial treatment with doxycycline had failed and he had now developed signs of meningoencephalitis. Laboratory tests showed an increased white cell count (16.1 x 10(9)/1), and elevated ESR (51/1h).
authors.affiliation: Intensive and Respiratory Care Unit, Department of Internal Medicine, Groningen University Medical Centre, PO Box 3001, 9700 RB Groningen, the Netherlands. t.s.van.der.werf@int.azg.nl
authors.forename: T S
authors.initials: TS
authors.lastname: van der Werf
authors.forename: J E
authors.initials: JE
authors.lastname: Tulleken
authors.forename: J G
authors.initials: JG
authors.lastname: Zijlstra
mesh_terms: D000890:Anti-Infective Agents / Q000627:therapeutic use; D001733:Bites and Stings / Q000150:complications* / Q000382:microbiology; D002908:Chronic Disease; D003937:Diagnosis, Differential; D006470:Hemorrhage / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009262:Nails / Q000473:pathology; D011693:Purpura / Q000175:diagnosis / Q000209:etiology; D012008:Recurrence; D017282:Tick-Borne Diseases / Q000150:complications* / Q000188:drug therapy; D014657:Vasculitis / Q000175:diagnosis* / Q000382:microbiology
chemical_list: D000890:Anti-Infective Agents