Silpapojakul and others reported that eschars were observed in 7% of dark-skinned children in Thailand.11 In contrast, eschars are observed frequently in yellow-skinned children in Japan.12 In children in Thailand, eschars are relatively difficult to detect because of darker skin, and when the eschars are atypical at the early stage they are easily overlooked. In countries in Southeast Asia such as Thailand, where scrub typhus and hepatitis A are endemic, differentiation between scrub typhus and hepatitis A is difficult in cases where eschars or rashes do not occur. Therefore, we attempted to identify markers from laboratory findings that would distinguish scrub typhus from hepatitis A.