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Question category: Tropical medicine

A 19 year old back packer returns from central America. She presents with a one week history of severe headache, fever, myalgia and a rash. The rash is a maculopapular rash which began on her wrists and ankles and has gradually spread to the trunk. In some areas there is evidence of petechiae. She remembers being bitten by a tick whilst on holiday. What is the most likely causative agent?

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