Abstract
Erythema chronicum migrans (ECM) developed in a man after a tick bite; the tick was probably lxodes pacificus. Despite extensive laboratory evaluation, including bacterial culture of involved skin, viral and rickettsial titers, biopsy and special stains, animal inoculation and EM the causal agent could not be identified. Although probably unrelated, an elevated measles titer with a 2-fold drop on serial determinations was of interest. This report documents the 1st reported case of ECM acquired in the USA in which the tick that caused the disease was recovered.

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