African tick-bite fever : a new entity in the differential diagnosis of multiple eschars in travelers. Description of five cases imported from South Africa to Switzerland
JournalArticle (Originalarbeit in einer wissenschaftlichen Zeitschrift)
 
ID 524385
Author(s) Althaus, Fabrice; Greub, Gilbert; Raoult, Didier; Genton, Blaise
Author(s) at UniBasel Genton, Blaise
Year 2010
Title African tick-bite fever : a new entity in the differential diagnosis of multiple eschars in travelers. Description of five cases imported from South Africa to Switzerland
Journal International journal of infectious diseases : official publication of the International Society for Infectious Diseases
Volume 14 Suppl 3
Number Suppl 3
Pages / Article-Number e274-6
Keywords African tick-bite fever, Spotted fever, Rickettsia, Intracellular bacteria, Travel medicine
Abstract

African tick-bite fever (ATBF) is a newly described spotted fever rickettsiosis that frequently presents with multiple eschars in travelers returning from sub-Saharan Africa and, to a lesser extent, from the West Indies. It is caused by the bite of an infected Amblyomma tick, whose hunting habits explain the typical presence of multiple inoculation skin lesions and the occurrence of clustered cases. The etiological agent of ATBF is Rickettsia africae, an emerging tick-borne pathogenic bacterium. We describe herein a cluster of five cases of ATBF occurring in Swiss travelers returning from South Africa. The co-incidental infections in these five patients and the presence of multiple inoculation eschars, two features pathognomonic of this rickettsial disease, suggested the diagnosis of ATBF. Indeed, the presence of at least one inoculation eschar is observed in 53-100% of cases and multiple eschars in 21-54%. Two patients presented regional lymphadenitis and one a mild local lymphangitis. Though a cutaneous rash is described in 15-46% of cases, no rash was observed in our series. ATBF was confirmed by serology. Thus, ATBF has recently emerged as one of the most important causes of flu-like illness in travelers returning from Southern Africa. The presence of one or multiple eschars of inoculation is an important clinical clue to the diagnosis. It can be confirmed by serology or by PCR of a biopsy of the eschar. Culture can also be done in reference laboratories. Dermatologists and primary care physicians should know this clinical entity, since an inexpensive and efficient treatment is available

Publisher Elsevier
ISSN/ISBN 1201-9712
edoc-URL http://edoc.unibas.ch/dok/A5842801
Full Text on edoc No
Digital Object Identifier DOI 10.1016/j.ijid.2009.11.021
PubMed ID http://www.ncbi.nlm.nih.gov/pubmed/20233665
ISI-Number WOS:000282643000061
Document type (ISI) Journal Article
 
   

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