African Tick-Bite Fever

Abstract

With increasing international travel, a need for the recognition of rickettsial diseases by physicians is becoming more important. Tick-bite fever, a disease caused by R africae and transmitted by Amblyomma ticks, is characterized by multiple taches noire, lymphadenopathy, lymphangitis, and edema, but no rash or a discrete rash. It is a frequent but benign disease that physicians should consider when presented with febrile patients returning from southern Africa.

Rickettsia sibiricaIsolation from a Patient and Detection in Ticks, Portugal

“…Furthermore, infections caused by different Rickettsia spp. can cause the same sign, and not only the typical signs; for example, lymphangitis has been reported in African tick bite fever, R. heilongjiangensis infections, and as a reaction to argasid tick bites ( 21 – 23 ). Among 12 patients with R. sibirica mongolotimonae strain infection, 3 (25%), from Algeria, South Africa, and Portugal, were bitten by a tick on the foot, and in the last 2 patients, the eschar was found between the toes.…”

Histopathologic features of and lymphoid populations in the skin of patients with the spotted fever group of rickettsiae: southern Africa

“…Lymphadenopathy is seen in the majority of patients with ATBF, but generally does not occur in MSF 2 . Approximately 5% of patients with MSF show a malignant form with severe internal disease, while ATBF is consistently a benign disease 1,2 …”

“…In addition to ATBFs variable incidence of cutaneous eruption, there are other clinical differences between patients with MSF and those with ATBF. Approximately 50% of patients with MSF and the majority of patients with ATBF show taches noires: frequently multiple with significant associated edema in ATBF, but are solitary and without edema when present in MSF 2 . Lymphadenopathy is seen in the majority of patients with ATBF, but generally does not occur in MSF 2 .…”

“…Approximately 50% of patients with MSF and the majority of patients with ATBF show taches noires: frequently multiple with significant associated edema in ATBF, but are solitary and without edema when present in MSF 2 . Lymphadenopathy is seen in the majority of patients with ATBF, but generally does not occur in MSF 2 . Approximately 5% of patients with MSF show a malignant form with severe internal disease, while ATBF is consistently a benign disease 1,2 …”

Fever and Vesicular Rash in a Traveler Returning from South Africa

“…However, there are several recent reports of rash in patients with African tick-bite fever [1,2,4]. After a short period of fever, myalgia, headache, and fatigue, almost half of patients develop a maculopapular or vesicular rash (51% and 45%, respectively) [5] (figure 2).…”