Eschar of scrub typhus

We report a case of a 60-year-old farmer presented with chief complaints of fever, myalgia, and headache of one week duration. Head-to-toe examination revealed an area of central necrosis surrounded by erythema (suggestive of eschar) on nape of the neck. A diagnosis of scrub typhus was made and the patient improved following 7-days course of doxicycline. Eschar is pathognomonic finding for clinical diagnosis of scrub typhus. This is to conclude, head-to-toe examination is indispensable for all the patients presenting with fever, myalgia, and headache.