Case Report: A Fatal Urban Case of Rocky Mountain Spotted Fever Presenting an Eschar in San Jose, Costa Rica

This study reports the first urban human case of Rocky Mountain spotted fever caused by Rickettsia rickettsii, in Costa Rica. An 8-year-old female who died at the National Children's Hospital 4 days after her admission, and an important and significant observation was the presence of an eschar (tache noire), which is typical in some rickettsial infections but not frequent in Rocky Mountain spotted fever cases.