Rickettsioses and Q fever in travelers (2004–2013)

Travel and tick-borne diseases: Lyme disease and beyond

“…Tick-borne rickettsial diseases are among the best examples of emerging infections, described in travelers [4]. African tick bite fever (ATBF) caused by Rickettsia africae and transmitted through the bite of Amblyomma ticks, occurs commonly among travelers returning from safaris or visits to game parks or reserves and represent the second most frequently identified cause of fever after malaria in travelers returning from sub-Saharan Africa [1,4,5]. Since these ticks are aggressive, attack people, and with an infection rate by R. africae up to 100% in some places, clusters of patients presenting with multiple inoculation eschars are frequent.…”

South African Tick Bite Fever: An Overview

“…observation); these latter changes, however, may also be encountered in the context of a viral exanthem or morbilliform drug rash, emphasising the need for careful clinicopathological correlation prior to rendering a definitive diagnosis. In addition to all important serological studies, the diagnosis may also be confirmed by PCR, including PCR performed on samples obtained from eschar swabs [17, 18]. …”

Fever and Multiple Eschars After an African Safari: Report of Three Cases

“…When typical clinical signs are present, treatment should be initiated before laboratory confirmation of the diagnosis. Doxycycline is the standard treatment for all spotted fever group rickettsioses, including ATBF . This treatment is also recommended as a first option in children, as good tolerance during short‐term treatments and no dental staining have been reported .…”