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CASE OF THE MONTH - October 2019

Dr Max Peter Winkler
South African Society of Travel Medicine



Case Report 1


A 48-year-old male patient presented in July 2019 with a one-week history of an erythematous rash on the right thigh, arthralgia, myalgia and persistent headaches. The symptoms had started soon after he had returned with his family from a holiday to the Scottish Highlands (Kyle District). He had spent a large amount of time during the holiday hiking with his family in the Scottish countryside and noted that he had been bitten by a tick while out hiking. He is originally from the United Kingdom but now lives in Cape Town with his family. He travels extensively for work and has no other medical co-morbidities and is not currently on any chronic medication.

On examination a large flat (+- 5cm) erythematous skin lesion was noted on the lateral aspect of the right upper thigh. There was no evidence of an eschar or lymphadenopathy in the vicinity of the bite. He was apyrexial at the time of examination and he had no other physical findings of clinical significance.


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