Early administration of tetracycline family antibiotics, i.e ., tetracycline, chlortetracycline, doxycycline, minocycline and related antibiotics are effective. Other antibiotics are ineffective. Sites of eschar found among patients. Sites of eschar is distributed on a whole body, mostly at soft skin as shown in the left figure. Lower extremities, Surface of groins and sexual organs under drawers, and head under hair should be carefully sought for the eschar.
E E Following pictures are typical eschars at various sites of body surface.
At a primary focus of infection, a dry ulcer without pastulation appears, then developed symptoms are swelling with pressing pain at regional lymphatic nodes connected to the eschar, splenomegaly and hepatomegaly. The following pictures show daily change of a eschar following the mite bite. The time course of clinical symptoms of a case is shown in the following table. Following occurrence of eschar, swelling of regional lymphnodes, fever rises. After fever, a dark purple rash with round eruptions in sizes of miliary to soya beans dispersed on the trunk, face and limbs.