Unusually High Number of Eschars on the Face of a Patient with Scrub Typhus

Hwang, In Tae; Lee, Jae Hoon

doi:10.3904/kjim.2011.26.3.365

Cited by 1 publication

(1 citation statement)

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“…which carry R. africae, thus people are often bitten by multiple infected ticks simultaneously [8,85,91,92]. Multiple eschars seem to be a characteristic of ATBF; this clinical finding has described in other rickettsioses such as infections caused by R. conorii or Orientia tsutsugamushi [93,94]. Comparing our results with other studies on confirmed and probable cases of ATBF and SFG rickettsioses in U.S. travelers returning from Africa, our data was more similar to the reported of Raoult et al regarding fever (88%), inoculation eschar (95%) (single [46%] or multiple [54%]) and rash (46%) [10,11,64].…”

Section: Demographic and Epidemiological Datamentioning

confidence: 99%

Clinical, epidemiological, and laboratory features of Rickettsia africae infection, African tick-bite fever: A systematic review

Silva-Ramos

Faccini-Martínez

2021

Infez Med

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African tick-bite fever (ATBF), caused by Rickettsia africae, is the main tick-borne rickettsiosis and the second most frequent cause of fever after malaria in travelers returning from sub-Saharan Africa. General descriptions on ATBF were made in the first two decades after recognized as a new infectious entity, and since then, many authors have contributed to the knowledge of the disease by reporting clinical cases in scientific literature. We developed a systematic review that evaluated all available evidence in the literature regarding clinical, epidemiological, and laboratory features of confirmed R. africae rickettsiosis cases. We followed the recommendations made by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guide. A total of 48 scientific publications (108 confirmed cases) were analyzed in order to extract data for developing this review. Overall, our results show that R. africae rickettsiosis is more frequent in males in the age group of 18-64 years, more than 80% of the SUMMARY cases occurred in European travelers, South Africa was the country where most infections were acquired, and almost 40% of cases occurred in clusters. Clinically, more than 80% of the cases had fever and eschar (55% developed multiple eschars), rash was present in less than the half of cases, and lymphangitis was not a common sign (11%). Headache, myalgia and regional lymphadenopathy were predominant nonspecific clinical manifestation (mean of 60%, 49% and 51%, respectively). Our results show that at least 70% of R. africae cases had altered laboratory parameters, most often showing an increase in transaminases and C-reactive protein. Tetracycline-class antibiotics, as monotherapy, were used in most (>90%) of the patients. Overall, only 4% of cases had complications, 12% required hospitalization, and there was a 100% rate of clinical recovery.

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