title: Sequential changes in hematologic and biochemical parameters in African tick bite fever.
abstract: OBJECTIVE
  To evaluate the sequential changes and to estimate the frequencies of abnormalities in some commonly measured biological variables in patients with African tick bite fever (ATBF), an emerging spotted fever group (SFG) rickettsiosis in international travelers to rural sub-Saharan Africa.
  
  
  METHODS
  A study was done of hemoglobin, total leukocyte count, absolute lymphocyte count, blood platelet count and serum levels of C-reactive protein (S-CRP), alanine aminotransferase (S-ALAT), aspartate aminotransferase, lactic dehydrogenase, gamma-glutamyl transferase, alkaline phosphatase, bilirubin, sodium and creatinine during the first two weeks of illness and prior to the institution of antirickettsial therapy in 108 patients with travel-associated ATBF.
  
  
  RESULTS
  There were significant falls in mean total leukocyte count, mean absolute lymphocyte count, and mean platelet count, and significant increases in mean S-CRP and S-ALAT. During the first ten days of illness, elevated S-CRP, lymphopenia and elevated S-ALAT were detected in 91.7%, 73.3% and 40.7% of patients, respectively. Most abnormalities were mild. For 55 patients who underwent both S-CRP and absolute lymphocyte count determination, at least one parameter was abnormal in 52 (94.5%) patients.
  
  
  CONCLUSIONS
  The sequential changes in many biological parameters during the acute phase of ATBF mimic those reported in other SFG rickettsioses. Mild abnormalities are frequent, with increased S-CRP and lymphopenia being the two most consistent findings.
authors.affiliation: Department of Internal Medicine, Department of Clinical Chemistry, Aker University Hospital, Oslo, Norway. mogens.jensenius@ioks.uio.no
authors.forename: M
authors.initials: M
authors.lastname: Jensenius
authors.forename: P-E
authors.initials: PE
authors.lastname: Fournier
authors.forename: K B
authors.initials: KB
authors.lastname: Hellum
authors.forename: L
authors.initials: L
authors.lastname: Wesslén
authors.forename: G
authors.initials: G
authors.lastname: Caruso
authors.forename: T
authors.initials: T
authors.lastname: Priø
authors.forename: K
authors.initials: K
authors.lastname: Løhne
authors.forename: S
authors.initials: S
authors.lastname: Vene
authors.forename: D
authors.initials: D
authors.lastname: Raoult
authors.forename: B
authors.initials: B
authors.lastname: Myrvang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D001772:Blood Cell Count; D002097:C-Reactive Protein / Q000378:metabolism; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012281:Rickettsia / Q000276:immunology; D012282:Rickettsia Infections / Q000097:blood / Q000276:immunology / Q000503:physiopathology*; D017282:Tick-Borne Diseases / Q000097:blood / Q000276:immunology / Q000503:physiopathology*
chemical_list: D002097:C-Reactive Protein; D000410:Alanine Transaminase