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Wien Klin Wochenschr. 2016 Aug;128(15-16):602-5. doi: 10.1007/s00508-016-1047-0. Epub 2016 Aug 3.

Molecular diagnosis of African tick bite fever using eschar swabs in a traveller returning from Tanzania.

Author information

1
Department of Medicine I, Division for Infectious Diseases and Tropical Medicine, Medical University of Vienna, Vienna, Austria.
2
Center of Infectious Diseases and Infection Control, Jena University Hospital, Jena, Germany.
3
Institute for Tropical Medicine, University of Tübingen, Tübingen, Germany.
4
Department of Medicine II, Division for Emergency Medicine, SMZ Ost - Donauspital, Vienna, Austria.
5
Institute for Hygiene and Applied Immunology, Medical University of Vienna, Kinderspitalgasse 15, 1090, Vienna, Austria.
6
Institute for Hygiene and Applied Immunology, Medical University of Vienna, Kinderspitalgasse 15, 1090, Vienna, Austria. mateusz.markowicz@meduniwien.ac.at.

Abstract

African tick bite fever is an emerging infectious disease among travellers caused by the pathogen Rickettsia africae. Most travel-associated cases have been reported from countries in southern Africa. So far it has rarely been reported among travellers to eastern Africa and our patient is one of the first described cases imported from Tanzania. A woman presented with fever, chills, headache, myalgia and a rickettsial eschar on her ankle after returning from Tanzania. The diagnosis of African tick bite fever is often based on clinical grounds due to a lack of reliable diagnostic tests at commencement of symptoms. In this patient direct molecular detection of R. africae was performed by PCR from a sample obtained non-invasively with a swab from the rickettsial eschar. A positive PCR result was achieved although the patient had already started antibiotic treatment with doxycycline. In conclusion, this non-invasive method enables early diagnosis of African tick bite fever by direct molecular detection of R. africae and might improve the management of undifferentiated fever in travellers from Africa.

KEYWORDS:

African tick bite fever; Eschar; Rickettsia africae; Rickettsiosis; Tanzania

PMID:
27488618
PMCID:
PMC5010599
DOI:
10.1007/s00508-016-1047-0
[Indexed for MEDLINE]
Free PMC Article

Conflict of interest statement

Compliance with ethical guidelinesConflict of interestN. Harrison, H. Burgmann, C. Forstner, M. Ramharter, M. Széll, A.-M. Schötta, G. Stanek and M. Markowicz declare that they have no competing interests.Ethical standardsAll studies on humans described in this article were carried out with the approval of the responsible ethics committee and in accordance with national law and the Helsinki Declaration from 1975 (in its current revised form). The patient signed a written informed consent for the publication of this case report.

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