Detection of Rickettsia amblyommii in association with a tick bite rash

In the summer of 2006, an Amblyomma americanum tick was removed from a woman in central North Carolina, who subsequently developed a rash at the site of tick attachment. When examined by polymerase chain reaction (PCR) for Borrelia, Anaplasma, Ehrlichia, Babesia, Rickettsia, and Bartonella DNA, only the Rickettsia primers generated an amplicon, which was identified as R. amblyommii by sequencing. To our knowledge, this is the first case in which R. amblyommii was temporally associated with a rash.