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Mediterranean Botonous Fever (MBF) is an infectious disease which provokes multisystemic vasculitis due to endothelial proliferation of rickettsia conorii. Its incidence, in our environment, has greatly increased during the last years being endemic in many large cities and their surrounding suburbs. In some cases its evolution is specially malignant resulting in septic shock, adult respiratory distress syndrome, and multiorgan failure. The purpose of this communication is to present a new case of malignant MBF with a bad evolution factor which has not been previously referred to, which is the persistence of vector ticks in the inoculation spot.
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