Early Tick Species Identification Using Eschar‐Based <scp>PCR</scp> to Guide Presymptomatic Risk Assessment in Tick‐Borne Diseases

ABSTRACT In endemic regions where simultaneous larval tick bites frequently occur, early identification of tick species from eschar lesions may substantially influence presymptomatic clinical triage. We report a 78‐year‐old woman who was found after approximately 24 h of wandering, presenting with multiple clustered eschars on the lower extremities and several attached ticks on the trunk. PCR amplification and Sanger sequencing of the mitochondrial 16 S rRNA gene from two removed ticks and ten representative eschars consistently identified Amblyomma testudinarium . As this species is a known vector of severe fever with thrombocytopenia syndrome (SFTS) virus but not Rickettsia japonica , the risk of Japanese spotted fever (JSF) was considered low, and clinical monitoring was focused on early manifestations of SFTS. The patient remained asymptomatic and was subsequently transferred to a long‐term care facility. This case highlights that, in high‐incidence settings with numerous bite sites, selective PCR analysis of representative eschars offers a rapid and resource‐sparing approach to infer vector species and guide risk assessment before symptom onset, thereby supporting targeted surveillance and shared decision‐making in frontline practice.