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African Tick-Bite Fever; African tick typhus

Etiology: - tick bite, Rickettsia africae Epidemiology: - South Africa - emerging cause of influenza-like illness in travelers - second only to malaria in travelers returning from Africa Clinical manifestations: - evidence of tick bite (inoculation eschar) - regional lymphadenitis - persistent fever, headache, & myalgia - malaise, conjunctivitis, pharyngitis [3] - maculopapular, petechial or vesicular rash on the wrists, legs, & trunk [2] Laboratory: - peripheral blood smear - no erythrocyte parasitemia [3] - Rickettsia africae DNA (PCR done at CDC) Management: - doxycycline

General

rickettsial spotted fever; tick typhus

References

  1. Bohaty BR, Hebert AA African Tick-Bite Fever after a Game-Hunting Expedition. N Engl J Med 2015; 372:e14. March 5, 2015 PMID: 25738687 http://www.nejm.org/doi/full/10.1056/NEJMicm1312910
  2. Mack I, Ritz N. African Tick-Bite Fever. N Engl J Med 2019; 380:960. March 7, 2019 PMID: 30855745 https://www.nejm.org/doi/full/10.1056/NEJMicm1810093
  3. Medical Knowledge Self Assessment Program (MKSAP) 19 Board Basics. An Enhancement to MKSAP19. American College of Physicians, Philadelphia 2022