Ehrlichia canis is a tick-borne rickettsia that causes disease in animals throughout the world. Its importance as a human pathogen, however, has only recently been documented. We report a child with serologically proven ehrlichiosis, to highlight differential diagnosis, to expand the spectrum of dermatologic manifestations, and to provide the first clinical evidence of therapeutic efficacy of chloramphenicol. CASE REPORT A 4-year-old boy from rural Missouri was admitted to the hospital on August 10, 1988, for evaluation of a fever of 2 weeks' duration. During the week before he became ill, his parents had removed numerous ticks from both the patient and the family's pet dog.