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A 43-year old veterinarian presents to his doctor with this rash. The patient first noticed the slightly pruritic red raised plaques on his body four days ago, after he had returned from inspecting a herd of cattle at a village farm, where he had inspected cows. The patient states that the cows were healthy.

Since he first noticed the initial rash, more patches appeared, as well as erythematous streaks between them. The right side of the body appears to be more affected than the left. A colleague of the patient who visited the same farm has a similar presentation.

No other symptoms are present.

The infectious disease physician who posted the case believes this is not an infection. Rather, he includes insect bites with aggravated skin reaction in his differential diagnosis.

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