Tache noire in African tick bite fever.

摘要: A fever of 39°C, headache, and malaise developed in a traveler from Germany who had returned four week vacation to the east coast South Africa. She visited friends rural area been on safari. During tour, she discovered painless lesion her abdomen. similar, but smaller arm. On examination, two typical eschars were found ( Figure 1 ). There was no rash or regional lymphadenopathy. The patient did not recall tick bite other travelers group affected. C-reactive protein lactate dehydrogenase levels increased (5.82 mg/dL 348 U/L, respectively). leukocyte count results liver function tests normal. Treatment with doxycycline, 100 mg twice day, initiated for suspected African (ATBF) seen again days later 2 result rickettsial immunofluorescence assay using cross-reactive Rickettsia conorii antigen positive an acute-phase serum sample reconvalescent-phase eight weeks (1:40 1:160, panRickettsia real-time polymerase chain reaction (PCR) necrotic center 3 ) yielded result, confirming etiology infection. Fragments bacterial citrate synthase gene amplified by PCR. 4 Amplicons subsequently sequenced identified R . africae as causative agent. is endemic large parts sub-Saharan Africa most common rickettsiosis travelers. Aggressive cattle ticks Amblyomma sp.) act vectors reservoirs. Unlike Rocky Mountain spotted fever, ATBF life-threatening disease. However, should receive pre-travel advice how avoid infection, i.e., F igure 2. Aspect abdominal after start doxycycline treatment. inflammatory zone less marked. Epidermis shows shedding concentric rings. This figure appears color at www.ajtmh.org