We report on a patient in Austria with scalp eschar and neck lymphadenopathy. Rickettsial etiology was excluded by culture, PCR, and serologic tests. Borrelia afzelii was identified from the eschar swab by PCR. Lyme borreliosis can mimic rickettsiosis; appropriate tests should be included in the diagnostic workup of patients with eschars.
Keywords: Borrelia burgdorferi; Lyme borreliosis; Lyme disease; SENLAT; bacteria; eschar; rickettsiosis; scalp eschar and neck lymphadenopathy.