An eight-year-old girl, born in the province of Huesca (Spain), with no history of interest, came to the consultation in the presence of a dermal lesion in the scalp and cervical lymphadenopathy.
The examination revealed a crusted 3 × 3 cm lesion in the occipital scalp, which was easily detached, without the presence of erythematous zone or tapering.
Similarly, three 2 cm diameter retroauricular and occipital adenopathies are observed, which are very painful in nature, without other findings of interest.
The patient complained of tick bite 15 days ago, which was identified within the endangered species.
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Indications for isolation and fixation doses of 40 mg/kg/day were given for eight days. Serology was requested for toxoplasmosis, Borrelovirus cytomegalovirus, Epmon with fluorosis, Tomegaly and indirect increase of antibodies.
After the prescribed medication, there is persistence of one of the three lymph nodes for one month, which remains painful to the touch, with subsequent disappearance.
At the age of four years and having been found asymptomatic during this period, the patient consults for new appearance of small slightly painful nodules with no significant size of the symptomatic adenopathy, which were treated in a residual bilateral craniocervical inflammatory findings, appreciable
