Rickettsia slovaca was recognized as the causative agent of the disease named tick - borne lymphadenopathy (TIBOLA) or Dermacentor spp.- borne necrosis - erythema lymphadenopathy (DEBONEL). Generally, this ricketsiosis is considered a mild disease but the disease is considered a mild rickettsiosis, but severe symptoms can appeare, especially in untreated patients. Described infection is the first case of TIBOLA/DEBONEL found in Poland. The patient had typical symptoms, such as enlarged painful cervical lymph nodes and maculo - papular rash. Milium on the scalp behind the ear concha, was a probably scar formation associated with typical eschar. The diagnosis was confirmed by detection of 128 titer in MIF tests with R. rickettsii and R. slovaca antigens and four-fold decrease after treatment.