Tsutsugamushi disease is an acute, febrile, typhus-like disease of rural Asia transmitted by the bite of larval trombiculid mites. The disease is caused by infection with Rickettsia tsutsugamushi. Recently the authors experienced a case of tsutsugamushi disease which was serologically confirmed. Here we report a case of tsutsugamushi disease which successfully managed with doxycycline and reviewed literatures on it briefly.