[Rickettsia africae infection. Three cases confirmed by PCR].
OBJECTIVE
African tick bite fever or Rickettsia africae infection has been recognized as an emerging health problem in the last few years. The aim of this study was to describe 3 cases of Spanish tourists who suffered from R. africae infection after visiting South Africa.


METHODS
Three patients with a suspected rickettsial disease according to epidemiological and clinical manifestations (fever, eschar and exanthema) were studied. Antibodies against Rickettsia conorii were determined by IFI assays. Semi-nested PCR reactions (rOmpA) and subsequent sequence analysis of the amplified products were also carried out.


RESULTS
Epidemiological and clinical aspects of this rickettsiosis are described. For diagnosis of this rickettsial disease, conventional serological assays (IFI) were less useful than semi-nested rOmpA PCR reactions, which showed a sensitivity of 100% in our samples.


CONCLUSIONS
Three cases of R. africae infection are reported. PCR and subsequent sequencing of the amplicons are useful for the microbiological confirmation of this type of infection. We must think about African tick-bite fever as a possible diagnosis in patients with a febrile rash after returning from endemic areas.
Oteo
José A
JA
Servicio de Medicina Interna y Enfermedades Infecciosas, Hospital de La Rioja, Logroño, España. medoteo@saludalia.com
Portillo
Aránzazu
A
Blanco
José R
JR
Ibarra
Valvanera
V
Santibáñez
Sonia
S
D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D012281:Rickettsia / Q000145:classification / Q000302:isolation & purification*; D012282:Rickettsia Infections / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology*; D013019:South Africa / Q000453:epidemiology; D013030:Spain / Q000453:epidemiology; D017282:Tick-Borne Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology*; D014195:Travel